Many organizations already use “the cloud” -–where information is stored on an external network of servers and accessed via the Internet—to manage and deliver training more efficiently to employees. The advantages of cloud-based applications include: reduced internal IT support, lower ownership costs, more efficient upgrades, and easy access via internet connections. But many in the health care industry have been reluctant to adopt cloud-based applications, primarily because of security concerns. Akron General Health System is among the few large health systems taking advantage of the cloud to deliver learning more cost efficiently while managing compliance requirements.
For any hospital, ensuring compliance with mandatory employee training and certifications-–along with the required record-keeping—can be a significant challenge. In 2005, Akron General Health System, a network of healthcare facilities and staff serving the needs of more than a million people in northeast Ohio, found that that its ability to manage employee training was in need of urgent care. Employees were hard pressed to find time to attend traditional classroom training. In addition, mandated training was increasingly time-consuming and cumbersome for the HR development group to manage.
However, the most critical problem was that Akron General’s decades-old, homegrown learning system was consuming larger and larger chunks of information technology resources. While Akron General’s IT organization is one of the best in the healthcare industry (Akron General is often named one of the “100 Most Wired Hospitals” in the U.S. on Modern Healthcare’s “Most Wired” list), the organization found itself strapped with the federally mandated move to electronic medical records and simply could not commit additional system, budget or human resources to support learning needs.
This article describes the evolution of training at Akron General-–from paper and pencil to an internally developed system to its current cloud-based solution.
For many years, Akron General used a paper-based system for learning and testing. Employees were given reading material to study followed by a paper-and-pencil test. This process created a mountain of paperwork that had to be managed and required HR staff to manually grade thousands of tests a year. “Staff members would literally spend all day entering test scores into Lawson, our HR system of record,” said Amanda Vowles, Akron General’s HR development director.
Vowles pointed out that the HRD group also needed a better way to schedule and record government-related mandatories as well as the training required by the hospital, such as orientation programs and sexual harassment awareness. For example, Akron General requires all employees to complete a course in patient service training. The HRD group was responsible for managing registrations, scheduling and conducting classes, and recording scores in Lawson.
In 2006, Akron General began to move some content and testing for mandatory training to an internally developed, intranet-based system. Over time, the HRD team moved all mandatories online, and the IT team developed a tool to automate scoring and tracking completion. But the system was still very limited in functionality. “For example, only a few individuals actually had access to pull a report on those who completed a particular mandatory training course or determine whether a particular individual employee had met certain training requirements,” Vowles said.
In addition, verification continued to be an issue. Employees needed to print out certificates to prove they had passed a course. And the online training completions did not link up to employee records in Lawson. Vowles explained, “We needed a learning management system that would reconcile training completions with our HR system on a nightly basis so that we could be better prepared to show verification at a moment’s notice.”
In late 2006, the HR team led the effort to find a more robust learning solution. The team created an educational council of managers and directors charged with selecting a learning management system (LMS). Over the next year, the council evaluated 14 LMSs.
“While we were looking for advanced functionality, such as integration with our HR system and real-time reporting, we were also adamant that the system not be complicated for the average user,” said Vowles.
Since Akron General was accustomed to purchasing and managing systems internally, the council went into the search leaning toward an installed solution. According to one of Akron General’s IT managers, Ben Wheeler, “As techies, we were used to having a measure of control over our internal systems. The idea of putting our learning system up in the cloud-–especially as an early adopter-–took a bit of a leap for us. But once we realized the functionality and cost benefits, we were sold,” Wheeler said.
The council ultimately selected Exceed, a cloud-based system from Intellum, in June 2007. For Wheeler, the decision ultimately came down to cost, ease of use, and the ability to effectively interface with Lawson.
“The pricing model was based on usage and there were no implementation or yearly maintenance costs. And what excited us is that we could easily upload our own content to the web and interact directly with our HR system.”
Vowles noted that several LMS providers offered big catalogs of healthcare-specific training content. “Their annual costs were double the cost of the web-based solution. And we didn’t have a strong organizational push for a big catalog of training. So we thought, ‘why not just develop our own content?"
Akron General launched the web-based LMS just a few months later, in early September 2007. Vowles noted that integrating with Lawson was simple. “We sent a few test files from the LMS to make sure they uploaded correctly, and made sure our employee records from Lawson showed up in the LMS. It was all very seamless.”
To introduce the new system to all employees, Vowles and her team developed a video-based course for all employees on the topic of hand hygiene. From here, the HRD team continued to build and add courses. With the exception of a few off-the-shelf courseware purchases, such as a diversity training course form Skillsoft, nearly all of Akron General’s content is developed internally.
Using the Articulate tool, Vowles and her team have worked with internal SMEs in compliance and safety to adapt existing courses or create new ones. “Developing our own interactive content was ground-breaking for us,” Vowles said.
The new courses are also much more efficient, with many broken down into 5-10 minute nuggets. “This was a big selling point for getting buy-in from employees on the new system, and it drove employee usage way up. When people are strapped for time, they like that they can jump on and off a course,” Vowles added.
The HRD team also adapted employee orientation for the new LMS. The course previously required 16 hours of classroom time to complete; employees now complete in 5.5 hours of classroom time and 2.5 hours online. New employees are automatically enrolled as soon as they’re entered into Lawson.
But for Vowles, the real game-changer for the HRD team relates to reporting. “We have a huge choice of off-the-shelf reports in the LMS, but it’s just as easy to select our own criteria,” she said. “There is no report we can’t pull. And we can get any view we want-–by course, individual, department—all in real time.” Vowles added that managers and directors used to rely on HR for training information, but now these managers can go into Exceed and run their own reports anytime to see training data specific to their staff. This capability is a big time-saver for the HRD team.
By many other measures, the transition of Akron General’s learning system to the cloud has been successful. The hospital has achieved 100 percent compliance with mandatory training. Overall course completions for 2011 increased by 21 percent. Department-specific training (such as training for oncology and operating room staff) has increased significantly, with more than 22,000 completions in 2011. Pass rates and employee satisfaction with the learning experience are also up significantly.
Today, the entire Akron General Health System organization is using the Exceed LMS for learning. The audience includes 5,500 employees at Akron General Medical Center, its community health centers, physicians’ offices, community centers and rehabilitation facilities. As of August 2012, Akron General employees recorded 92,000 course completions using the LMS. Many of these completions are mandatories. (A typical employee is required to take 10 to 12 mandatory modules a year.) But much of the available learning is elective, such as courses on personal safety and wellness or a department specific update for staff, for example, on proper eye wash station use.
Most recently, Akron General implemented a series of educational modules as part of a credentialing process so that physicians who are not employees can gain privileges at the hospital. “Because our learning system is cloud-based, we don’t have to worry about internal systems capacity anymore,” Vowles said. “The LMS can easily scale up to accommodate new programs and users, which in this case represents about 1,000 doctors.”
Overall, Vowles said that moving learning to the cloud represents a true culture change for Akron General. Without the huge burden of all the test data entry, the HRD team can focus on more strategic HR work including a focus on investing more resources to improve the current performance management process. The bottom line, Vowles said, is that “transitioning our learning to the web has helped Akron General become a much more efficient and effective learning organization.”