Utilizing Blended
Learning to Improve
Efficiencies
The Story of Pullman Regional Hospital
Presented at the Dallas SUN Laerdal Conference
April 29, 2011
by: Bernadette Berney, Director of Human Resources
Donna Haynes, MSN, RN, BC – Human Resources
Objectives
At the end of this session, learners will be able to:
• Understand the alignment of blended learning
with organizational cultural traits.
• Identify decision components for blended
learning solutions.
• Review key elements of adult learners.
• Discuss attributes that contribute to highly
efficient and highly effective blended learning
programs.
• List the outcomes from effective resuscitation
training programs.
Pullman Regional Hospital
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Located in Pullman, Washington
New Hospital December 2004
25-Bed Critical Access Hospital
400 Employees
60 Medical Staff Providers
Home of Washington State University
Agricultural Region – Dry Land Farming
Pullman Regional Hospital
• 2007 – 2010 Most Wired Small and Rural
Hospitals – Hospital and Health Network
• 2009 Summit Award Recipient – Press Ganey
• #1 in Overall Patients Satisfaction in Washington
State – HCAHPS April 2009 to March 2010
• Affiliate clinical site for students
Organizational Cultural Traits
• Personal Accountability – employees are
accountable for obtaining and maintaining
their required certifications.
• Choice – employees are given a choice as
to how they would like to attain their
certifications.
• Serving Others – a high level of customer
service is provided to the users of the BLS,
ACLS, and PALS systems.
Organizational Cultural Traits
• Flexibility – employees can do their learning
either at the hospital or off-site.
• Transparent – the completion of the
modules is tracked on the HealthStream
system.
• Consistency – the instruction is the same for
each employee who takes the certification –
it is not instructor dependent.
Organizational Cultural Traits
• Personal Growth – employees have the
opportunity to obtain certifications that are
and are not required for their positions.
• Inclusive – any employee of the hospital
can take a certification course including
employees in non-clinical roles.
• Progressive – the hospital provides the
opportunity to obtain certifications using
blended learning.
Organizational Practices
• Staffing levels – by design – most areas of
the hospital have staffing levels that are
above average.
• No Mandatory Low Census – the hospital
does not low census any staff during
periods of low patient volume.
• Mandatory is a “four letter” word – it is
not a part of our organizational culture.
Audience
Infrastructure
Context
Decision
Components
for Blended
Learning
Solutions
Organization
Outcomes
Audience
• What do we know about the learners?
Organization
• Is the organization ready and supportive
of blended options?
Context
• What issues unique to this context
should be considered?
Infrastructure
• Are there any barriers to the technologybased delivery?
Outcomes
• What do the learners need to be able to
do?
The Adult Learner
• Is autonomous and self-directed
• Has accumulated a foundation of
experiences and knowledge
• Is goal-oriented
• Is relevancy oriented
• Is practical
• Needs to be shown respect
Consider Components of Best
Practices in Implementing Simulation
Education
• Contextual Learning (Kneebone)
• Mastery Learning (Bloom)
• Deliberate Practice (Ericcson)
Our Approach
• Partnered with HealthStream and Laerdal
• Embraced an “anytime-anywhere”
approach
• Knowledgeable of the programs and
manikins
• Committed to a high level of customerservice
HealthStream-Laerdal-AHA
• BLS
• ACLS
• PALS
Anytime-Anywhere
• IT Solutions
• Access outside of the organization
• Availability of the Skills Lab
IT Solutions
• Updated the Adobe Flash
Players
• Gave software download
administrative rights to
targeted computers for
PALS
• Provide a high level of
customer service to
assist the staff with
individual computer
challenges
Access Outside the Organization
Availability of the Skills Lab
• 24/7 access
• Priority for
use
Knowledge of Programs and Manikins
• Know what makes the manikins thrive
• Pearls that reinforce proper technique
• What constitutes a repeat of the
simulation
• Know where the resources are in the
programs
What Makes This Approach Efficient
and Effective?
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Certification Tracking
Staff satisfaction scores
Decreased organizational costs
Increased confidence in competence
Certification Tracking
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Use payroll system tracks certification dates.
Staff call and ask for courses to be loaded.
HLC Administrator reviews expiration date.
BLS automatically loads every 2 years.
Certification tracked through annual
performance reviews.
Staff Satisfaction Scores
• BLS – 227 total employees
– Overall content of program – 90% appropriate/very
appropriate
– How likely are to you recommend this program to
your colleagues? – 64% somewhat likely/very likely
• ACLS – 63 total employees
– Overall content of program – 65% appropriate/very
appropriate
– How likely are to you recommend this program to
your colleagues? – 56% somewhat likely/very likely
Staff Satisfaction Scores
• PALS – 13 total employees
– Overall content of program – 85% appropriate/very
appropriate
– How likely are to you recommend this program to
your colleagues? – 77% somewhat likely/very likely
Staff Comments - Positive
• “Learning is easy at my own pace and
review is also easy.”
• “I was pleased with the learning styles
utilized within this program.”
Staff Comments - Positive
• “I liked doing this on the computer. It gave
me time to think without pressure.”
• “I prefer self-directed study over classroom
teaching. I can learn at my own pace and
focus on the areas I need more
knowledge.”
Staff Comments – Challenges
• “I prefer a class setting with instructors so
that when I have questions, I have someone
present to answer them.”
• “I am not very good at using computer
simulated tools and would prefer a live class
by far.”
Staff Comments – Challenges
• “More time is spent trying to locate
appropriate actions/interventions in the
program then actually reviewing or learning
from it.”
• “I am little disappointed that I could not
download or print the educational
materials. I think they should come with
the course either hard copy or the option to
save them on a zip drive.”
Decrease Organizational Costs
• Estimated Average Savings per Employee
– BLS $117.00 per employee
– ACLS $1,062.00 per employee
• Estimated Average Savings Total
– BLS $26,559.00 for 227 employee
– ACLS $66,906.00 for 63 employee
• Total Estimated Savings $93,465.00* over 3 + yrs
*salary expense is using 2011 wages
Increased Confidence in Competence
• C.N.A. Story
• Nursing students
• First-time takers
• “Can’t pass unless you do it right”
Putting it All Together
• Blended learning
should include the
opportunities to:
–Reflect
–Apply
–Build Team
Putting it All Together
• Mock Codes
• Monthly Skill Focus
• Continuing Education
QUESTIONS?
References
• Bloom, B. (1987). The Mastery of Learning: notes from a Benjamin
Bloom lecture. Retrieved April 2, 2011 from:
http://learn.midsouthcc.edu/learningObjects/masteryLearning/prin
tout.pdf
• Kneebone, R (2005). Evaluating clinical simulations for learning
procedural skills: A theory based approach. Academic Medicine,
80, 6, 549-553.
• Kolb, D. (2009). David Kolb on experiential learning. Retrieved April
2, 2011 from: http://www.infed.org/biblio/b-explrn.htm
• Merrill, M.D. (1994). Instructional design theory. Englewood Cliffs,
N.J.: Educational Technology Publications.