Healthcare workers have to be able to react quickly to a variety of situations. To do so effectively, they must be educated in general but also informed about the specific needs of each resident or patient. Point of Care technology and software solutions, such as electronic health records (EHRs), facilitate this process. The ability of physicians and nurses to access a patient’s records twenty seconds faster in an emergency may be the difference between life and death.
It is then important for care providers to know the most recent technological developments in Point of Care and how to use them. The five basic elements that should always be addressed in Point of Care training programs are:
- Needs evaluations
- Personalized training
- Communication
- User engagement
- Follow-up and support
These are elaborated in the video below, an interview between Neal Cox, a nurse with over 30 years of experience, and Jason Long, the CEO of Experience Care. Cox has also recently begun developing EHR programs and training others on Point of Care software solutions, which means he has both the nursing experience and technological know-how necessary to understand the finer points of Point of Care modules.
Point of Care Software Solutions in Long Term Care
Long term care is not limited to the care provided in nursing homes or retirement homes. Rather, as the Administration for Community Living states, long term care covers a range of services that most will require at some point in time. That some point can be any point. Nobody knows this better than Long, who suffered crippling injuries from a car accident that landed him in a coma, then a wheelchair back in 2010. After receiving care in a long-term rehabilitation facility for a time, his life is now largely back to normal, albeit with fresh drive and purpose: to help long term care organizations and staff find success.
Long term care involves multiple interactions with residents that require varying levels of care on a daily basis. Point of Care, then, must be individualized. Point of Care software solutions combine electronic health records and medical charts to allow caretakers to quickly become familiar with a patient’s or resident’s needs.
Advantages of long term care EHR and POC for CNAs include the facilitation of communication, as testing requests and results are entered through the software, immediately updating records and allowing for effective coordination to ensure the health of the patient or resident. For example, a new CNA might be unaware of a patient’s allergies without access to an EHR; or the lab might post the results of an EKG five minutes before a nurse escorts a patient out to exercise, which may influence what sort of exercise the nurse allows before consulting the doctor.
And Point of Care software, sometimes called CNA POC, is being updated every day to meet the changing standards of care. A Point of Care training update memo issued by the CDC in February 2021 details the usage and implementation of the COVID-19 testing module on the National Healthcare Safety Network site. Long term care software and long term care EMR (electronic medical records) allow the CDC to effectively monitor outbreaks in facilities (specifically nursing homes) in order to enable rapid initiation of case investigations and, hopefully, minimize the spread and save lives.
Of course, Point of Care technology is not limited to software solutions. A 2018 article in Clinical Chemistry, a high-impact peer-reviewed medical journal, details how Point of Care hardware is crucial to PoCT integration. Some popular consumer devices are now capable of medical monitoring, storing and transmitting data, and then saving it on a cloud-based server. Examples include:
- Tablets
- Smartphones
- Smart Watches
- Activity Trackers (like Fitbit)
- Bluetooth-Enabled Health Devices (like glucometers and otoscopes)
These present opportunities to collect data in the absence of physicians. For instance, according to data from the IQVIA Institute for Human Data Science, health app use associated with diabetes prevention and care, asthma, and cardiac and pulmonary rehabilitation is estimated to lead to potential savings of $7 billion a year by reducing potential admissions.
In long term care facilities, these devices could be utilized to monitor residents for significant events, like sudden weight loss. From improved Point of Care charting to helping mitigate and manage crises, the implications for and advancements that can be made in Point of Care are boundless.
These software solutions can provide a major boost to the effectiveness of any nursing team. As with any change, however, there will be some hurdles to get over, including the initial learning curve for the staff.
5 Strategies for Successfully Using CNA POC technology
One of the challenges of using long term care software is training CNAs and other staff on the POC during EHR implementation. You are almost guaranteed to find resistance as you start working to improve your processes. CNAs and nurses will often ask what was wrong with the process that was already in place or the old way of doing things. They may complain about not understanding how to use the new CNA POC. And all of this will be exacerbated if things change too quickly or they do not see the long-term vision. Take these steps to make for an easier shift to an electronic Point of Care:
1 – Find Solutions
The first step for any change within an organization will always be communication. Ask them where they think the biggest Point of Care issues are. Ask what would help them the most. Listen to your CNA feedback, and then set priorities for which solutions get addressed first. Implementing a CNA POC solution to a popular issue will make the process easier as time progresses.
2 – Think Long-Term
Given that some solutions may not be compatible with others, make certain that you conduct thorough research to ensure that the solution for Problem A is not going to clash with the solution for Problem B. Try to establish what the extended workflow will look like before making any purchases.
3 – Find Super Users (often CNA’s that love the new POC)
Super Users, both nurses and CNAs) are your champions for the implementation process, members of the staff that the others can turn to for help. They have excellent communication skills, a positive attitude, and an aptitude for picking up new POC technology quickly. They are your beta testers and the first members of staff who get trained on any incoming implementations. With their help, transitions should be smoother and with much less fuss. Make it very clear that others can turn to Super Users as needed.
4 – Develop Communication Skills
Communication is so crucial to implementing a new CNA POC system that you should look for any and every opportunity to give refresher training on communication skills. This includes basic soft skills (manners, active listening, showing outward positivity) as well as a proper understanding of what to say and how to say it when speaking to different groups (patients/residents vs. physicians, for example; patients need positivity and reassurance while physicians need straight facts and numbers).
5 – Make Messages Clear
When asked about why this change is expected to be helpful, be clear and concise. “We expect this change in process to improve A, B, and C because…” Any uncertainty on the administration’s part will only lend credence to the idea that no change should have happened. Even if the change is largely for financial reasons, be clear that “this solution seems to offer similar results but saves us X many dollars, which is needed for…”
Finally, end with the expectation that members of staff should apprise management if the new solution isn’t having the desired effects within a certain timeframe. Remind them that the change will take time to produce results because everybody has to learn something new, but if clear results are not seen within X months, then another discussion may need to take place.
There should also be a systematic way to submit feedback. This will prevent frustration and miscommunication. It will also ensure that everyone has the opportunity to be heard and those lagging behind in EHR training do not simply go into their shells.
Fortunately, there is now an easy way to train staff members on EHR technology. No longer do you have to rely on costly outside support or Super Users for training that then needs to be repeated whenever there is staff turnover. Experience Care’s LevelUp program, which is completely free, offers online courses for training in Point of Care and other systems. The lessons are designed by experts in the industry and can be accessed anywhere and at any time of the day.
The 5 Basics of Point of Care Training
Structuring a training program requires expert knowledge and great tact. Cox provides insight gained from decades of experience in the video below in boiling down the process to five basic steps:
1: Needs Evaluation
There may be areas that can be improved (wants) but are not vital for the overall success of the program. By instead prioritizing needs, you give your training program points of focus. The needs in question refer to:
- Staff
- Residents
- Organization at-large
Some needs will fall under multiple categories. For example, if your staff claims that the current methodology or software used for Point of Care charting makes their jobs difficult, that will impact the needs of residents, who will face longer wait times. They may also complain that staff members seem to be confused.
The overall process of Needs Evaluation, though, begins at the top; documentation must be customized to meet the particular needs of a facility. “Every facility is different,” Cox said. “Every facility has their own protocols that they need to fulfill. And not just that, but state by state, there are different requirements that go along [with it]. So you want to have a robust point of care software with the standards in it that you need.”
It can be said that the Needs Evaluation step is connected to the Find Solutions step discussed above; your specific needs help you determine which solutions will and will not work for your facility. Cox provides a few attributes to look for when shopping for software solutions:
- “Customizable” – Your facility is unlike any other. You have different staff, different patients, and a different approach. The size and culture of your facility impact the care you provide, and that should be reflected in the software solution you select.
- “User Friendly” – Smart, intuitive UX (user experience) design makes it easier to teach members of staff, especially those who are not very tech-savvy.
- “Interoperability” – Will this program integrate with the rest of your systems? That will be one of the more difficult things for you to verify before purchase and implementation. Interoperability applies to other sections of the same program as well as to other programs that you might be using. You want to ensure that the information entered on one page is reflected on another so that the physician, MDS nurse, other nurses, billing team, and administrator are all on the same page as to what is happening with every single resident at all times. Any sort of disconnect can result in major financial loss.
2: Personalized Training
Using Point of Care software for beginners can be intimidating. It is important to remember that, just as no two facilities are identical, no two people are identical. This is especially true when it comes to how we learn. Because of this, you will need to personalize your approach to training your staff just as you would personalize the care of each of your residents. Put simply: personalization works better than a generic approach for the same reasons that a tailored suit looks better than the ready-made one you picked up at the department store.
But how do you personalize training for CNA POC? What factors do you consider? When do you adjust your approach?
First, you must learn how each employee operates. Managers are often the most informed about that. But Cox also suggests learning each staff member’s current approach. What are their documentation habits? What natural skills do they utilize?
Once such inquiries are made, you or your managers can note what works best for each employee in a training file that can be used to expedite the process going forward. For instance, if a member of the staff hits a snag on a particular section of the current process, then you can use that as something to highlight in the new, more effective process and the move to EHR.
Try to implement as much one-on-one or small-group training as possible. Personal training programs allow for flexibility and immediate response to inquiries, leading to better outcomes. Ultimately, this will be your most effective method of personalizing the training. A more advanced solution is Experience Care’s LevelUp program, which offers online courses for EHR training that can be viewed multiple times and help staff members get up to speed.
One long-term benefit to such inquiry and training is that you will discover those oh-so-valuable Super Users, the individuals who have a knack for figuring out new software programs or processes. They pick up new information and implement it with almost supernatural ease. And their quick understanding can be utilized to help the rest of your staff with the transition. They should be able to help with most transitions, as computer skills generally translate from program to program. If a person literate in the language of computers struggled to adapt to a new program, the issue is likely with the program itself.
Super Users do not have to be members of management or hold any sort of authority. In fact, as Cox points out the fact that they are viewed as equals who simply have a knack for tech will make them more relatable; staff members are more likely to talk to one another than to supervisors or managers when they have issues.
Oftentimes, facilities trying to successfully implement an EHR will find that some nurses have little to no computer training. In fact, Cox says, “it’s a little more frequent than you would expect.” He explained that older generations did not use computers frequently or learn how to operate them in school. Yes, they may be comfortable using tablets or smartphones and other touch screens, but typing on a keyboard or even using a mouse correctly can pose difficulties. “The trick is to recognize those users to make sure that you can make them feel comfortable,” he said. This problem can be alleviated through proper communication.
3: Communication
It is no secret that most people do not always embrace change. In fact, many will actively resist it. When it comes to jobs or careers, change can produce a fear of being terminated. These issues gain prominence as one’s age progresses.
It is vital for administrators to recognize that, for many members of staff, complaints about new processes are driven by this fear. If the perception at the employee level is that nothing was wrong with the previous system, this change may cause more issues than it fixes.
Clear communication and complete transparency are important tools that can unify the entire team and drive the facility forward. As mentioned previously, any pending changes should be communicated to staff along with a “why”. Further, feedback from staff should be accepted and reviewed with an open mind, as communication only works if it is a two-way exchange.
Members of staff who are selected for extra/basic training should be reassured that there is no reason to be concerned about their job and that the extra training will help them gain confidence that their performance will never be under scrutiny. When this messaging is delivered by an empathetic and charismatic trainer, it is empowering. Add to this a clear list of coworkers that can function as resources when faced with setbacks or confusion – your Super Users – and the people who would normally be complaining the most are now adapting just fine.
Working in healthcare or long term care means working with people. Being able to communicate clearly and effectively with teammates, doctors, supervisors, and, or course, patients, is a skill that requires daily use. Just like technical proficiency, some members of your staff will have a knack for it, while others may be a bit lacking. Thus, basic communication training will help facilitate the transition as well.
4: User Engagement
The final two basic concepts are extended, iterative blends of everything that has come before, yet they can make all the difference with proper implementation; user engagement involves clear communication that will get trainees to better engage with their training, and it begins the moment that trainees walk through the door or log into the virtual meeting.
Try to find experienced and charismatic trainers who exhibit a natural comfort in leading the session and interacting with the trainees, whether individually or as a group. Such individuals can get the trainees laughing and make participation interesting in a setting in which most staff members expect to be struggling to stay awake. It goes without saying that engaged participants will remember more than disengaged ones.
Because leaders usually do not have the opportunity to train employees themselves, they must use every trick in the book to ensure that the necessary information is absorbed. For this reason, it is also important to ensure that your trainer or whoever will be conducting training knows the new product and process intimately and can effectively communicate the why as well as the how.
An alternative is online training, like Experience Care’s new LevelUp program. Research suggests that online training is actually more effective than classroom training, as the former allows students to learn at their own pace.
5: Follow-Up, Support, and Feedback
Finally, you must ensure that there is a system or network in place to guide your employees in the long run. No matter how engaging the training is, you are always going to have something slip through the cracks somewhere. Not everybody is going to perfectly take in every detail that they need to know for their daily workload. Issues will arise that were not accounted for in training. For instance, RNs might have one workflow in the new software, while CNAs have another, but somehow the exact workflow for physical therapists was never defined and now their efficiency has taken a hit.
You will need a support system in place to follow up in the days, weeks, and months that follow training. This will ensure that issues are discovered, communicated immediately, and, ultimately, corrected. Cox mentioned three tools to use to cover all angles of long-term follow-up and support:
- Continuing education: This can take the form of additional training videos, online lessons, or a certification process. Continuing education is valuable for ensuring that details that have been forgotten or improperly utilized by employees are picked up and reintegrated to make the new process or software more efficient over time.
- A help menu or knowledge base: When employees are stuck, many will try to find answers on their own before seeking help. A help menu or a detailed knowledge base can limit the time they spend searching to five or ten minutes. This will prevent the need for them to pull others into the search and the inability to progress until they can get somebody’s attention.
- Support line: This is to be provided by your EHR vendor. Support lines may vary in terms of who is allowed to call in. Some will be open to any user who needs help, but some might be restricted to managers or system admins. Phone lines open to general users provide another solution that staff members can use to pursue solutions on their own, whereas more limited lines might be reserved only for major issues that have been escalated. Read about the fast support this MDS nurse received from Experience Care in this case study.
In addition to these three suggested tools, you must ensure that your managers and supervisors pay close attention to who has issues in the days and weeks following implementation and establish a standard method for demanding that an employee receive further training or guidance.
Finally, do not forget that this step works both ways; as mentioned earlier, members of staff should be able to give feedback to help you figure out problem areas. This can help you to fine-tune your implementation and better know what feedback and requests to pass on to the vendor for long-term quality of life improvements.
Innovations in CNA POC Training
The technology of CNA PoC continues to advance every day, making the healthcare industry more efficient and improving outcomes. In Point of Care diagnostics, there have been continuous developments in biosensors, microfluidic, bioanalytical platforms, assay formats, lab-on-a-chip technologies, and complementary technologies.
Similarly, PoC training continues to become more efficient. One recent development is Experience Care’s online training course, LevelUp, which provides the follow-up, support, and help new users will need. These courses are the product of over 1,000 hours of research by preeminent experts in long-term care who have more than 275 years of experience in the industry. Not only can LevelUp provide the initial training your team will need but it also allows them to continue their education into the future.
If you would like to learn more about Experience.Care’s products and services, or about LevelUp in particular, contact us here.
- The 5 Basics of Point of Care Training - August 13, 2021
