asq/asa fall technical conference october 18, 2002 ron king corporate statistician patricia bush...

ASQ/ASA Fall Technical ASQ/ASA Fall Technical ConferenceConference

October 18, 2002October 18, 2002

Ron KingCorporate Statistician

Patricia BushCorporate Director of

Outcomes Management

Pilot E Learning Seminar

Pilot Project to test and evaluate the feasibility of implementing web based learning system in an international system of hospitals

E Learning Seminar ObjectivesParticipants Will Be Able To:

Understand the health care system challenges that can be resolved using E Learning

Outline functionality and limitations Review a blood utilization case study that

reflects the process and content of an E Learning statistical session

Discuss “lessons learned” and pitfalls to avoid when using E Learning

SYSTEM SYSTEM CHALLENGES CHALLENGES

RESOLVED WITH RESOLVED WITH THE USE OF THE USE OF

E LEARNING E LEARNING

SHC System Overview

SHC is the largest philanthropic organization in North America with no third party payments or government funding

Survival is based on realized gains from the SHC Endowment fund

“State of the Industry” health care is rendered free of charge to patients and their families

SHC System Overview 22 hospital system (40-80 beds):

– 16 States (Honolulu)– 3 Countries (USA, Mexico, Canada)– Patients originate from the entire North American

Continent so over 15 languages/dialects spoken by staff – 6 time zones

Mission is three pronged: Patient Care, Education/Teaching and Research

SHC System Overview

Specialty Organization:– Burn Care (4)– Spinal Cord Injury (3)– Orthopaedic Surgery (19)

Organizational structure provides:– System Wide Outcomes Team– One Performance Improvement Director per Hospital

to support statistical analysis and data management

SHC System Challenges to Meetings

“It takes so long to get stuff done, so many people have input and I am emailed to death with changes…”

“Our conference calls are so hard to follow when everyone is talking at once…”

“Our system has 22 sites, we just can’t get all those people together at one time…”

SHC System Challenges

“I don’t have time…”

“Travel costs are sky high, our budget is stretched to the max... conferences, training and education just have to go…”

E LEARNING E LEARNING FUNCTIONALITY FUNCTIONALITY

AND LIMITATIONS AND LIMITATIONS

Logistical Issues Getting Started

Originally Planned for July 2002 Protracted contract negotiations Agreement made to use product in last week of

August Invitations to attend sent with little notice Firewall issues Last minute vendor change Session Actually took place Friday, October

11th

A Partner With Functionality

Cyber CE (Established in 2000):– Internet-based Training & Education Company– Based on successful Physicians Executive MBA

Program at the University of Tennessee– Blended learning model that includes:

• Self-paced content review

• Testing & evaluations

• Learner tracking and certification (as needed)

• Live, interactive web conferencing across the world

Functionality

CyberCE Learning Lab • Customized & secured educational web sites • Asynchronous, self-paced content delivery:

– Word documents

– PDFs

– Narrated PowerPoint slides

– Streaming video

Functionality

CyberCE Online Conference Room • Live, interactive, synchronous sessions• Uses voice-over IP technology• Content sharing tools include:

– PowerPoint slides – Chat box– Application sharing – Whiteboard– Web Safari – Surveys

• Archiving recorded sessions for playback

Technology Support

Staff services include: – Establishment of E Learning goals – Course development and deployment– Evaluation design and implementation – Student tracking and certification– Presenter training– “Help Desk” support

Program Limitations

Presenter “observes the class” for activity, can’t see participants in person

Lag time between changes made to a shared document and/or pointer movement and visibility on participant screens

Powerpoint presentations/shared applications are not able to be used simultaneously

Presenters and Participants must have designated equipment and applications in advance of the program

A CASE STUDY: A CASE STUDY: E LEARNING E LEARNING STATISTICAL STATISTICAL

TRAINING SESSIONTRAINING SESSION

Get Ready

Get Set

GO!

Readiness Assessment

Perform a readiness assessment of your system that includes:– Learning culture assessment/computer literacy– Computer access and configurations (Sound Card,

Windows 95+ and Internet Explorer+)– Availability of microphone head sets; computer with

external speakers/microphone,laptop, etc.– Availability of the presenter to participate in a one

hour training session– Technical support to download Java script and

presentations (Java Applet with GIF files)

Program Set Up Collaborate with constituencies to identify

learning needs/session date and time Generate an invitation with: session purpose,

time involved, equipment needed, participants, presenter, content, objectives/anticipated outcomes and instructions for download of Applet and files (done the day before the program)

Contact vendor to set up technical requirements, email access passwords

Content Preparation

Develop power point slides and an agenda (if using one) for the presentation and submit to the vendor so the information can be “published”

Develop shared documents that will be used for the session and store them on the presenters desktop (Excel, Word, etc.)

A CASE STUDY: A CASE STUDY: E LEARNING E LEARNING STATISTICAL STATISTICAL

TRAINING SESSIONTRAINING SESSION

Blood Utilization Control ChartSelection and

Interpretation

Agenda for Blood Utilization

How should you look at this data? What Control Chart is appropriate for this

data? Why Use individual X Chart and mR

Charts?– CT Ratio is a measurement– Each month consists of one CT ratio

measurement


Building the Control Chart and mR Chart– Creating with Formulas in Excel– Creating using QI Macros

Interpreting the Control Chart– Data Meets Assumptions?– Control Chart Shifts and Trends– Points out of Control

Hospitals with Neither Laboratory nor Blood Bank on Site

1.6UCL =

0.5 CL =

0.0

1.0

2.0

3.0

Jan-

00

Feb-

00

Mar

-00

Apr

-00

May

-00

Jun-

00

Jul-0

0

Aug

-00

Sep

-00

Oct

-00

Nov

-00

Dec

-00

Jan-

01

Feb-

01

Mar

-01

Apr

-01

May

-01

Jun-

01

Jul-0

1

Aug

-01

Sep

-01

Oct

-01

Nov

-01

Dec

-01

Jan-

02

Feb-

02

Mar

-02

Apr

-02

May

-02

Jun-

02

Month

CT

Rat

ios

Blood Utilization CT RatiosmR Chart

(January 2000 - July 2002)

UCL - Upper Control Limit UWL - Upper Warning LimitLCL - Lower Control Limit LWL - Lower Warning LimitCL - Center Line


4.4UCL =

1.9LCL =

3.2 CL =

4.0UWL =

2.3LWL =

1.0

2.0

3.0

4.0

5.0

6.0

Jan-

00

Feb-

00

Mar

-00

Apr

-00

May

-00

Jun-

00

Jul-0

0

Aug

-00

Sep

-00

Oct

-00

Nov

-00

Dec

-00

Jan-

01

Feb-

01

Mar

-01

Apr

-01

May

-01

Jun-

01

Jul-0

1

Aug

-01

Sep

-01

Oct

-01

Nov

-01

Dec

-01

Jan-

02

Feb-

02

Mar

-02

Apr

-02

May

-02

Jun-

02

Jul-0

2

Month

CT

Rat

ios

Blood Utilization CT RatiosiX Chart



Hospitals with Both Laboratory and Blood Bank on Site

UCL=3.04

CL=2.26

LCL=1.48

1.4

1.6

1.8

2.0

2.2

2.4

2.6

2.8

3.0

3.2

1/1/

00

2/1/

00

3/1/

00

4/1/

00

5/1/

00

6/1/

00

7/1/

00

8/1/

00

9/1/

00

10/1

/00

11/1

/00

12/1

/00

1/1/

01

2/1/

01

3/1/

01

4/1/

01

5/1/

01

6/1/

01

7/1/

01

8/1/

01

9/1/

01

10/1

/01

11/1

/01

12/1

/01

1/1/

02

2/1/

023/

1/02

4/1/

02

5/1/

02

6/1/

02

7/1/

02

Month

CT R

atio

Data Points

UCL

A

B

Average

B

A

LCL


When and How to Re-Calculate the Center Line and Limits– Change in Process Detected– Deleting Old Data– Excel Formula Built Graphs– QI Macros Graphs

Interactive Examples– Recalculation– Questions and Answers


3.4UCL =

1.8LCL =

2.6 CL =

1.0

2.0

3.0

4.0

5.0

6.0

Jan-

00

Feb-

00

Mar

-00

Apr

-00

May

-00

Jun-

00

Jul-0

0

Aug

-00

Sep

-00

Oct

-00

Nov

-00

Dec

-00

Jan-

01

Feb-

01

Mar

-01

Apr

-01

May

-01

Jun-

01

Jul-0

1

Aug

-01

Sep

-01

Oct

-01

Nov

-01

Dec

-01

Jan-

02

Feb-

02

Mar

-02

Apr

-02

May

-02

Jun-

02

Jul-0

2

Month

CT

Rat

ios

Blood Utilization CT RatiosiX Chart



Hospital With Neither a Laboratory Nor a Blood Bank on Site

UCL=4.422779562

CL=3.157066805

LCL=1.8913540481.9

2.4

2.9

3.4

3.9

4.4

4.9

1/1/

00

2/1/

00

3/1/

00

4/1/

00

5/1/

00

6/1/

00

7/1/

00

8/1/

00

9/1/

00

10/1

/00

11/1

/00

12/1

/00

1/1/

01

2/1/

01

3/1/

01

4/1/

01

5/1/

01

6/1/

01

7/1/

01

8/1/

01

9/1/

01

10/1

/01

11/1

/01

12/1

/01

1/1/

02

2/1/

023/

1/02

4/1/

02

5/1/

02

6/1/

02

7/1/

02

Month

CT R

atio

Data Points

UCL

A

B

Average

B

A

LCL

Program Evaluation

1) Were the functions required to prepare for the E-Learning program easy to complete?

2) Did it take you more than 1 hour to prepare/train for use of the system?

3) Did it cost more than $10.00 per participant to purchase the equipment necessary for the call?

4) Would you recommend this training methodology for statistical education?

Program Evaluation

5) During the training session, were there any technical difficulties that negatively impacted the session?

6) Did you feel that during the session your ability to “interact” with the document sharing component of the software was effective and efficient?

7) When you “raised your hand” to speak, were you acknowledged in a timely manner?

Program Evaluation

8) Did the “lag time” between the time you spoke and the response from the instructor cause the training to be less effective?

9) List at least two things that could be done to improve this training system

10) What functions of the system added and/or detracted from your ability to learn using E-Learning?

PROGRAM EVALUATION

0102030405060708090

100P

erce

nt

Res

pon

din

g (n

=9)

Yes

No

No Answer

PROGRAM EVALUATION This was much easier than I anticipated The ability to answer questions and get feedback

was great What a great way to have interactive training Loved the “out of office” function and for

clapping/smiling/raising my hand icons Need another button so the participants can “ask

the presenter” to modify pace Loved the “chat box”

LESSONS LEARNED

Instructor needs to invest time in getting comfortable with the program so that they can adjust for lag time

5 minute introduction for participants to all buttons/icons with interactive practice is useful

Grouping participants by computer and content literacy would help keep the program moving at an appropriate pace

LESSONS LEARNED

Test all connections 15 minutes prior to program start

Have a vendor facilitator present for the first session to help the Presenter moderate the activity of the group

Interaction takes time, add 5-7 minutes to each interactive agenda item

LESSONS LEARNED

Unable to view powerpoint slides and work in a shared application at the same time - plan the presentation so that you can avoid multiple jumps between program applications.

Automate the program evaluation using either the voting system or survey system for immediate feedback

Avoid the tendency to go quickly in order to allow screens to update on attendee PCs

Thank You!Thank You!

Ron King: [email protected]

Patricia Bush: [email protected]

asq/asa fall technical conference october 18, 2002 ron king corporate statistician patricia bush...

Documents