Advancing Innovation, Engagement & Learning through the Development & Implementation of a New E-Learning Platform between Eastern Health & Saint Elizabeth

Mollie Butler, RN PhD Regional Director Professional Practice Heather Hunt Smith, MN RN Professional Practice Consultant – Nursing Katherine Chubbs, RN, BN, MHS, CHE Vice President & Chief Nursing Officer

Outline

• The Partners

• The E-Learning Platform & Module

• LEADS in a Caring Environment Framework

• Applying LEADS

Partners Involved

• Eastern Health - Professional Practice

• Saint Elizabeth

Four Regional

Health Authorities

Population 526,329 - 2015

Eastern Health

• Serves a population of over 306,000+ residents

• Provides several provincial programs (cancer care)

• In March 2015, there were 12, 810 employees

• Large interprofessional team (6000+) delivers almost 5 million hours of health care services each year

• Offices throughout Canada

• Web-based e learning solution that is:

– Competency based

– Evidence-based curriculum

– Supports adult learners & ongoing professional development

Types of Education Offered By

• Informational-course resources such as tools and templates, web links, forms, etc. to provide further information and build on the curriculum and learners’ existing knowledge.

• Instructional-eLearning modules are designed to be engaging and interactive, brief tutorials with engagement activities, self tests for learners, one screen=one key concept

• Experiential-Context-based case studies, scenarios, and simulations that mimic ‘real-life.’ Corrective feedback and analysis of decisions are key tactics used to help learners build their knowledge within each of these experiential components.

The Partnership

Fall 2012: Pilot project proposed

Fall 2012-Winter 2013: Review of educational modules

March 2013: Pilot confirmed

October 1-December 31, 2013-staff access to module

Lots of Choices…

• Nursing-Infusion Therapy and Med Admin; Skills & Competencies; Health Assessment; Cardiac Care; Palliative Care; Community Health Nursing; Mental Health & Addictions; Wound care; Diabetes Management

• Personal Support Worker (PSW)-Bowel and Bladder Training; Seizures; Skills Education (Oral Suctioning, Enteral Feeds); Falls Prevention; Dementia; Palliative Care; Diabetes management

• General Health Care Provider-Sharps Safety; WHIMIS; Elder Abuse; Violence in the Workplace

Focus on Diabetes

• In 2011, Eastern Health chose diabetes as its chronic disease management focus

• Newfoundland and Labrador currently has the highest rate of diabetes prevalence in Canada. – 38, 084 people in 2013

– By 2020, 32 % of the population will be living either with diabetes or pre-diabetes

– Impacts to the population

• Health-cardiovascular disease, renal disease, increased comorbidities

• Health system & economic impact-increased and longer hospital stays, increased costs

Diabetes Care-Clinical Module

• For regulated and unregulated healthcare providers

• Adult and older adult population

• Current and evidence-based – Canadian Diabetes Association Clinical Practice Guidelines for the Prevention &

Management of Diabetes in Canada (2013)

LEADS in a Caring Environment

5 LEADS Domains

• Lead Self

• Self-aware

• Manages self

• Develops self

• Demonstrates character

Engage Others

• Foster the development of others

• Contribute to the creation of a healthy organization

• Communicate effectively

• Build teams

Achieve Results

• Set direction

• Strategically align decisions with vision, values and evidence

• Take action to implement decisions

• Assess and evaluate

Develop Coalitions

• Purposefully build partnerships and networks to create results

• Demonstrate a commitment to customers and service

• Mobilize knowledge

• Navigate socio-political environments

System Transformation

• Demonstrates systems/critical thinking

• Encourage and support innovation

• Orient themselves strategically to the future

• Champion and orchestrate change

Lead Self

• Self-aware

• Manages self

• Develops self

• Demonstrates character

Engage Others

• Foster the development of others

• Contribute to the creation of a healthy organization

• Communicate effectively

• Build teams

How to Engage

• Promotional materials shared with nursing & allied health staff

• Working group of key stakeholders

• Newsletters, bulletins, information sheets, web page

Achieve Results

• Set direction

• Strategically align directions with vision, values and evidence

• Take action to implement decisions

• Assess and evaluate

Level of

Participation

n Percent

Number of individuals who requested a login. 512 -

Number of individuals who initiated the course. 322 63% (322/512)

Number of individuals who completed the course. 224 70% (224/322)

Participant Age

Work Location of

Participants

Practice Setting of

Participants

Professional Designation of

Participants

Plan for Evaluation

• An electronic pre-survey completed by participants prior to accessing the diabetes learning module

• Pre and post knowledge tests

• An electronic three month post-survey

• A cost analysis

Pre/Post Knowledge Tests

• The average pre-test score was 81.9% (n=306)

• The average post-test score was 95.4% (n=224)

• There was an average of 13.5% difference between pre and post knowledge test scores

Pre/Post Survey Results

• Assess learner’s knowledge, skill and comfort with caring for a client with diabetes, both prior to as well as after completing the module.

• Completion of surveys:

– 415 participants (81% of 512) - pre-survey

– 168 (33% of 512) - three month post-survey

• Of the post survey respondents, 88% noted they had completed the module

Comfort With Technology

• Easy to use/navigate-

– 53.6% of participants rating ease of use a 5, meaning very easy to use.

– Additional 31.4% rated ease of use a 4

• The majority of participants rated the overall experience of completing the e-learning course

– 5(53.6%) with another 36% rating it a 4

Knowledge Uptake & Transfer

Pre

(n=415)

Post

(n=168)

Level of knowledge about diabetes

3 (54.1%) 4 (51.4%)

Level of skill caring for a client with diabetes

3 (46.6%) 4 (53.3%)

Comfort level in applying skills and knowledge to a client

with diabetes

3 (49.8%) 4 (53%)

Usefulness of Module

• 58.9% of participants rated usefulness of the module as 5 (very useful)

• Participants were asked to narratively describe how they incorporated this learning into their practice. Responses included: o “Able to provide more information to patients regarding diabetes”

o “More knowledge of dietary choices for low blood sugar management”

o “While interacting with diabetic patients everyday my comfort level in greatly increased”

o “Strong knowledge base in helping to identify problems and issues”

o “It is easier to discuss how diet and lifestyle can impact the effects of diabetes”

o “My assessment skills have greatly improved for the diabetic patient”

Barriers to Participation

• 78%-cited lack of time at work

• 45.9%-cited lack of time beyond family obligations; no time outside of work

Develops Coalitions

• Purposefully build partnerships and networks to create results

• Demonstrate a commitment to customers and service

Systems Transformation

• Demonstrate Systems/critical thinking

• Encourage and support innovation

• Orient themselves strategically to the future

• Champion and orchestrate change

Conclusions

• Provided opportunity to Partner, Use LEADS Framework & Share – Across large geographic span

– Built trust during process

– Had very positive impact

• Required leadership and solid collaboration at all levels – Brokered by senior executive leaders (from EH & SE)

– Required extensive planning & conversation before & after launching

– Involved clinical directors, designers and clinical stakeholders to increase number & types of professional staff and student participants

• Gathered evidence EH professionals’ improved their knowledge about Diabetes

• Feedback from leaners - what worked & barriers

• Organizational learning important for future web-based education

• Next steps – we are preparing a journal article

Acknowledgements

Katherine Chubbs, Vice-President and Chief Nursing Officer, Eastern Health Heather Hunt Smith, Professional Practice Consultant, Eastern Health Nancy LeFebre, RN, MSN, CHE, Senior Vice President and Chief Clinical Executive, Saint Elizabeth Tracy Scott, RN, MN, Program Lead (Education Services), Saint Elizabeth Kimberly Miller, RN, BSN, MScN, Advanced Practice Consultant (Education Services), Saint Elizabeth Tina Barry, Administrative Support – Professional Practice, EH Canadian College of Health Leaders - NL for sponsorship to the Conference

For Further Information

Eastern Health - http://www.easternhealth.ca

Contacts:

Dr. Mollie Butler at mollie.butler@easternhealth.nl.ca

Heather Hunt Smith, Professional Practice Consultant – Nursing at heather.huntsmith@easternhealth.ca

Thank you!