Affordable Care Act: Training for Compliance

Affordable Care Act: Training for Compliance

In a recent post, we talked about compliance training… and the importance of making it memorable. We showed case studies of various approaches to compliance training for topics like avoiding bloodborne pathogens, evacuating a building and washing hands properly. The facts involved in these procedures could be communicated in a bulleted list, yes… but would people actually remember them? And most importantly, will people ultimately choose to comply?

Frontline employees make decisions every day (or perhaps multiple times a day) about whether or not they will comply or not comply with a procedure. Other times, they may forget about the procedure even though they were trained to do it. Since people will forget up to 90% of what they learn after 3-6 days without proper repetition (more on that here), memorable training with proper reinforcement is essential.

Affordable Care Act Challenges and Opportunities

Regulatory compliance recently got even more important for healthcare providers. The Affordable Care Act is reshaping our healthcare system… and recent changes to the way hospitals receive their funding make procedural excellence even more important. In April 2011, the Center for Medicare and  Medicaid Services (CMS) introduced Partnership for Patients. The initiative set a goal of reducing preventable injuries in hospitals by 40% and readmissions by 20% from 2010 – 2013. Reaching this goal would help avoid 1.8 million injuries, save 60,000 lives, and save 1.6 million patients from complications that force them to return to the hospitals.

The Partnership for Patients has identified ten core patient safety areas of focus that include nine hospital-acquired conditions. The Partnership does not limit its work to these areas, but the following areas of focus are important places to begin:

  1. Adverse Drug Events
  2. Catheter-Associated Urinary Tract Infections
  3. Central Line Associated Blood Stream Infections
  4. Injuries from Falls and Immobility
  5. Obstetrical Adverse Events
  6. Pressure Ulcers
  7. Surgical Site Infections
  8. Venous Thromboembolism
  9. Ventilator-Associated Pneumonia
  10. Readmissions

Meeting these goals is good for patients… but it now affects the fiscal health of the hospital, too. Medicare funding, once based on the volume of patients seen by the hospital, is now directly tied to how well hospitals reduce the occurrence of hospital-acquired conditions and readmissions. CMS will not reimburse the hospital if a Medicare patient acquires one of these conditions or is readmitted within 30 days.

If hospitals are unable to reduce patient harms and readmissions, they will lose money. In order to reach Partnership for Patients goals, new processes and training programs are needed.

The Challenge of Standardization

The resources available to hospitals that help them reduce patient harms do not always meet their needs. Local factors such as work environment, patient demographics and make-up of current policies make it hard to deliver one-size-fits-all information that is useful to all hospitals. Sometimes, experienced employees are too used to doing a process slightly incorrectly and find it difficult to change. In other instances, the experienced workers are deeply familiar with how to perform a process, but it is not properly documented and therefore difficult to teach new hires. With so many Baby Boomers in the workforce preparing for retirement, hospital executives have a major skills gap for which to prepare.

Training Problem vs Process Problem

A few years ago, we worked with a large pharmaceutical company that needed to implement good research principles across its organization. Their problem was not getting people to know what the principles were. Their biggest challenge was getting people to follow the principles. An eLearning course explaining the research principles was not going to do the trick. Here’s what we did:

  •  Put together cross-functional implementation teams. This enabled us to gather input from a variety of job roles and gain new perspectives.
  • Audited the current process. We took our time in the “Analysis” step of the ADDIE process to find the root cause of process problems. We also audited the new processes we implemented to gauge their efficacy.
  • Created action plans individuals could follow to help them meet the new standards. These increased accountability and also help people understand the practical steps they could take to improve.
Our approach worked… and we received a quality award from the client because of the project’s success. The challenge is figuring out when you have a training problem, a process problem, or both. Organizations shouldn’t making the mistake of deciding they need tons of training, then producing simple “tell” courses that just explain what the Affordable Care Act is without showing people what they need to do differently.

GO BEYOND THE BULLETED LIST

New generations of workers want to use technology to learn. As Millenials replace Baby Boomers in the workforce, you can expect the following mediums to be in even higher demand:

  • Mobile learning
  • Interactive eLearning
  • Video tutorials
  • Social media-enabled learning
  • Serious games and simulations
  • Gamified experiences

Setting generations aside, we still need to find better ways to communicate information and provide people ways to practice new behaviors. Reading a list of bulleted facts may tell you “what to do,” but it does not help you change your behavior… especially if an unwanted behavior is well worn and deeply ingrained.

The Affordable Care Act is still new… and healthcare systems will be working on meeting and exceeding these new standards for years. When the time comes to deliver new training and process-improvement initiatives, consider using cross-functional teams, auditing and action plans to achieve the desired results. And you need to produce eLearning, make sure you make it memorable.