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The training challenge

December 1, 2008
by Brian Albright
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Careful planning is essential when implementing new software

Implementing new software at a behavioral healthcare organization can be an expensive and time-consuming project. Providers often spend months selecting a software product, working with vendors to customize it and planning for its deployment. Yet training the staffers who actually will use the software often is treated as an afterthought.

The software vendor may conduct a few large training sessions in a couple days, often weeks before the actual go-live date. For mission-critical software systems, poorly planned user training can decrease the application's effectiveness or, worse, cause staff to resist using the software.

“If you are going to buy new technology, the rule of thumb is that you will spend as much on training and implementation as you do on the software,” says Monica Oss, CEO of OPEN MINDS, a consulting firm based in Gettysburg, Pennsylvania. “A lot of organizations are short on money and feel they can't do that, but if you underinvest in training you will see decreased productivity and billing problems, all of which have a tremendous financial impact on the organization.”

Planning is essential

It's important to establish a plan for software training early in the process, and to let the vendor know your expectations up front. Evaluate your staff's capabilities, and develop a timeline for deploying the software.

“To do this in the most effective way, the vendor should come in with the mind-set that their job is to teach the people who are leading the implementation how to effectively train the rest of the staff,” notes Dale Jarvis, a managing consultant at MCPP Healthcare Consulting in Seattle. “What normally happens, though, is that they come in and say, ‘Here's the software and three days of training.’ My experience has been that that really is not the right approach. There is so much information that is jammed down people's throats that they only retain 30% of it, at best.”

Both Jarvis and Oss recommend a phased approach to training, rather than conducting a large, one-off session typical of a “big bang” system implementation in which all users go live on the software at once.

“By getting one group up and running, you can debug and perfect the process,” Oss explains. “You use the smaller group as a test group. Once it's running well, there is enthusiasm from those initial users that the system can actually work.”

Select a project team (including both clinical and support staff) with a designated leader, and give those employees sufficient time to work on the deployment and learn how to use the system. These team members can become “super users” who help train the remaining staff and act as cheerleaders for the new system.

The Peachstate Information Network, Inc. (PIN) used this “train-the-trainer” approach successfully. PIN was formed by the Cobb and Douglas Counties Community Services Boards, Avita Community Partners, and River Edge Behavioral Health Center, all in Georgia. The agencies are jointly deploying an electronic health record (EHR) from Qualifacts Systems, Inc., to help them serve their 30,000 clients across 23 counties.

“We're training a core group of people at each agency that will train the line users,” says Shannon Harvey, River Edge's CEO and PIN's project manager. “Our subject matter experts have created the training materials in multiple formats, including PowerPoint and a written manual, because everyone learns differently.”

Harvey explains that the agencies are taking a “wave implementation” approach, with different user groups testing the application, and then going live with different segments at each agency, one at a time. Recognizing that not all staffers are equally adept at using technology, PIN also instituted basic computer skills training in advance of the EHR deployment.

Building basic skills

Change can be intimidating to many staffers, particularly those not tech-savvy. If employees aren't willing to embrace new software, they can undermine its effectiveness. One way to counter this natural resistance to change is to recruit champions within each group who can help with training and promote the new software.

Life Management Center, a behavioral health and family counseling organization serving six counties around Panama City, Florida, focused on staff's basic computer skills prior to deploying Netsmart Technologies' Avatar software in 2006, and designated project leaders to assist with training. “We had not had an electronic medical record [EMR] or anything automated in place on the clinical side, so having the clinicians interactively using computers throughout the day was a foreign concept for us,” says CIO Rebecca Smith.

Smith organized “lunch-and-learn” sessions to help employees become comfortable with basic computing concepts. “They achieved a certain comfort level with the basic idea, so when the Avatar system came along, they were more accepting,” Smith says.

Simultaneously, Life Management assembled implementation workgroups to help design and configure the software. Designated super users then helped train the staff.

“The reason we took that approach was that we could simultaneously train a lot of people all at one time, much closer to the date of the go-live,” Smith explains. “They felt comfortable, and we didn't lose a lot of the knowledge they gained in training because there wasn't a gap between the training and actual deployment.”

Productivity issues

It can be challenging to train clinicians on a new software system because of their busy schedules, and because incorporating technology into their daily processes can slow them down initially. But involving clinicians early in the process is critically important for EMR deployments.