Meeting Informatics Needs for TogetherCare (MINT): A Collaborative Approach to Refresher Training

In January 2020, Trinity Health Michigan took a “big bang” approach, and transitioned 9 hospitals, 13 outpatient medical centers, and 11 emergency departments to a single, shared electronic health record (EHR). In March 2020, the COVID-19 pandemic set hospitals into disaster mode charting and deployed many users to areas they did not normally work, as office visits and procedures were canceled. During a time that users should have been cementing in new learning, they were, instead, learning how to provide care in a pandemic setting. Our EHR vendor recommended refresher training within 3 months of go-live; however, given pandemic restrictions this was not achievable.

With the post-pandemic transition back to our new normal, we quickly learned that the pathway to grant access to the electronic health record (EHR) system is relatively straightforward: complete online learning modules, then attend a live class or satisfy a test-out method. This training focused on educating end users on the basic functionality of the system: chart review, admission, discharge, blood administration, and so on. Then, the user received some personalization assistance and/or coaching by a preceptor. Time spent in personalization or with a preceptor is critical, because classroom training fails to speak to the workflows utilized by the end users within their unique departments. Generic training generates workaround and negative feelings towards the HER. Carson et al. (2021) identified this training gap when onboarding nurse leaders and charge registered nurses (RN) and designed training focused on their roles in the department. This intervention generated improved knowledge for those nurse leaders; however, Trinity Health Grand Rapids lacked a specific plan on looping back with end users regarding: quality/regulatory measures, efficiency training, upgrade information, and more, after the initial personalization and preceptor time was completed. Finding the time to pull a user back into a classroom setting proved difficult, too, in lieu of the pandemic, and staffing shortages.

We identified the need to provide ongoing training, and staff provided the feedback that they wanted to experience this training at-the-elbow, so we developed a refresher training program focused on embedding knowledge experts into the units themselves. While nursing informatics (NI) provided the structure and content, bedside staff involvement was the key to success. Department leads meet directly with NI to receive information monthly and then disseminate it to their units. Since team members actively provide bedside care, they sometimes contribute ideas on efficiency, and often, identify which topics need to be reviewed. Freeman and Wilson (2023) identify that we should work to incorporate our bedside staff as “the subject matters experts” (p. 6). With nurse leader and clinical ladder support, it was relatively easily to embed our program into the department, and garner participation. Since April 2021, program successes include covering over 30 topics between inpatient, emergency, and surgical areas; pathway for updating and educating end users; blueprint for additional ministries going live to follow, for their own refresher programs; and increased staff awareness of informatics resources.