“That is a training issue.”

Anyone who works with technology development knows that there will be a time when someone will say, “That is a training issue”. This statement often comes after someone asks, “how will the user know how to do <insert workflow step>?”

Sometimes the technical steps are not necessarily intuitive to the user’s anticipation of what to do next. This is a mismatch in the user experience. When this occurs, the user has (at best) confusion in trying to identify the next step. The confusion can lead to extreme frustration that halts progress toward completing the next step in the process (and lost time). 

Example: Pop Up Window Advertisements

Consider when you see a pop-up window to save you 10% on your first order for any given advertisement. You may or may not be interested in the welcome discount. If not, it can be quite difficult to find the “X” on the screen to exit the offer. You look around all four corners and sometimes need to locate the very faint area where you can exit out. If not found, you could exit the screen or put in your email to just get to what you wanted to see. (Of note, this is likely by design to obtain your email address  ). 

The lack of visibility of the “X” is a user experience or more specifically, a usability design issue. Sure, one could say it is a training issue and tell each person they need to look VERY CAREFULLY each time they accidentally find themselves with a discount offer. However, this becomes the user’s issue rather than the system design issue that removes this extra step. This usability design issue turns into a training issue. The usability shifts from the responsibility of the system designers to that of the individual to “learn” how to “workaround” the intended design.

Healthcare Training Issues

Now, let us look at healthcare. Healthcare is dependent upon clinical and administrative information systems to manage the individual and population level care. However, most clinicians are not formally educated on the foundations of informatics and/or information system design. Therefore, there is an inherent concern and perhaps intimidation faced where there is concern about whether they are charting the right way. 

Some clinicians will over chart while others will struggle to know what exactly needs to be charted and may unintentionally miss something. The extremes here are a result of a culture, especially in nursing, of “if it is not documented, it is not done”. However, when it becomes hard to know where to go next or how to enter some data correctly, you see the (largely unintentional) risk of error.  Add to this baseline, a handful of “training issues” and we have just added more stress to an already  stressed and fatigued workforce. 

Of course there are some aspects that do require training. However, for a moment think about how many times you have turned to watch a video or training session to use your new smart phone. Much of what you need to be able to do with your smart phone or device can be figured out without a training session.

We should be striving for this type of user experience with healthcare technology.  The need for formal training sessions should be minimal or very brief. Instead, the design of the systems should be such that the user is able to follow what the next step is through an intuitive human computer interaction experience. 

There is an abundance of qualitative and quantitative data to show that nurses, doctors, and healthcare professionals in general are working against the clock each day. There are never enough minutes to go around for everything that needs to get done in that shift. To add more things to what is expected of them will only increase the burden felt rather than create relief.

Healthcare cannot be delivered without the use of technology. However, we must consider that we have a workforce already spread thin. Instead of putting more responsibility through “training issues”, why not create a sense of ease and/or intuitive flow for them to experience each day? 

~ Dr. Kelley

Transitioning from the Bedside: One Skill for Success

I often receive questions from other nurses, informaticists, entrepreneurs and students about things on their mind and what they should do or how should they do something. If one person is having the question, there are likely others as well. So last month I decided to use Facebook live as a method of addressing these questions on a weekly basis on my page: Tiffany Kelley PhD RN

In many of my videos I  mention that there were some core business skills that I had to learn when I left bedside nursing and transitioned into a more business oriented nursing role (e.g., specifically informatics and IT).These business skills included appropriate use of email, excel, powerpoint, and many others to start.

Another skill is how to have an effective phone meeting with someone.

I wanted to offer some tips on how to structure a phone call so that you can effectively utilize the time you have with that person. This can be applied to any situation!

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Many people will offer you 15 or 30 minutes to start which is NOT a lot of time so you want to make sure you can use the time effectively and also make sure that person felt his/her time was well spent too!

So…if you are going to reach out and request to speak with someone, the best way to get the conversation going once on the call is to:

1. Set the stage for the call by telling the person why you are calling.

2. Briefly introduce yourself and/or company.

3. Ask the person to tell you a little about themselves to fill in any gaps that you might have from your prep research before the call (ps…you should be prepared for the call) .

4. After this, you can move on to the true purpose of the call – why you wanted to have the phone meeting.

5. It is also best to end the call with what to expect next and who is responsible for those next steps.

PS…If you need to for the first few calls, put this outline together and fill in the blanks to keep track of where you are so that time does not run out on you.

?It is a simple outline to follow that really does work well! ?

I hope this helps some of you who might be starting to get going with a new venture, adventure, etc. – whatever it might be!

Have a great day and let me know what you think!

 

Best,
Tiffany12279141_10206802826123482_3052069955447221008_n

PhD versus DNP: Which one should you choose?

Are you deciding upon a doctoral degree in nursing? There are two primary choices: a Doctor of Philosophy (PhD) and a Doctor of Nursing Practice (DNP). Both degrees are supported by the American Association of Colleges of Nursing (AACN) and represent terminal degrees in the field of Nursing. However, there are differences between the two degree programs that prospective students should be aware of before selecting one or the other.

In this linked video, I compare the PhD and DNP in the field of Nursing. I look forward to hearing your thoughts.

DNP versus PhD: Which one should you choose?

Best,

Tiffany

‘If it wasn’t documented, it wasn’t done.’

  • If you are a nurse or health care professional, the phrase, “if it wasn’t documented, it wasn’t done”, is something you have likely heard, said, and/or thought during one of your shifts. For those that aren’t familiar with this phrase, it means that if there isn’t a record of the care you delivered in the patient’s chart, (by way of your documentation), the activity was not done. While this makes sense at face value, when placed in the context of patient care delivery, this statement has more extensive implications on documentation since health care organizations have transitioned from paper based records to electronic health records.

 

When on paper based records, nurses documented on the patient’s flowsheet, progress note, and care plans. The paper based records offered more freedom to potentially ‘go outside of the lines’.  The boundaries were flexible but the paper record also left opportunities for unintended omissions. As the nation moved to electronic health records (EHRs) over the last several decades, we have fewer flexible boundaries.  Additionally, nurses have more documentation options. Often, there are too many documentation options for the newer nurse who is concerned about a complete patient record, or the nurse who is terrified to be the one who didn’t chart his or her work.  Thus, instead of unintended omissions, we now run the risk of having too many documented data elements that make it difficult to differentiate the essential from non-essential information.

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A School Nurse & Off Duty Nurse Make a Difference

This morning I’ll share two stories that have been in the news and continue to be in the theme of this weeks stories. I’ve provided the video stories as well as the associated media links.

The first is of a school nurse who noticed a young boy’s coloring seemed out of the ordinary.

https://youtu.be/5gBk2cbcjUM

 

The second is of a pediatric nurse who was at a gymnastics event and saw a man was in trouble and gave him CPR.

 

There are countless stories similar to the ones I’ve depicted below. As a nurse you never know when your knowledge and skills will be called upon for someone else. Later today, I’ll be sharing the last post for the week for Nurses Week! I hope you’ve enjoyed the stories thus far.

 

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When nursing care, intuition, and technology work together.

Today I’ll share some thoughts on one of my own experiences as a nurse on the lives of others. I’ll admit, I’ve not been in the position of having a patient in critical condition that needs life saving measures during my shift. However, there have been several instances over the course of my career where I’ve been able to proactively identify events that could have led patients or people down a less optimal pathway for their health.

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