Utilizing Blended Learning to Improve Efficiencies | Donna

Utilizing Blended
Learning to Improve
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
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
• List the outcomes from effective resuscitation
training programs.
Pullman Regional Hospital
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
• 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
• 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.
for Blended
• What do we know about the learners?
• Is the organization ready and supportive
of blended options?
• What issues unique to this context
should be considered?
• Are there any barriers to the technologybased delivery?
• What do the learners need to be able to
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
• Contextual Learning (Kneebone)
• Mastery Learning (Bloom)
• Deliberate Practice (Ericcson)
Our Approach
• Partnered with HealthStream and Laerdal
• Embraced an “anytime-anywhere”
• Knowledgeable of the programs and
• Committed to a high level of customerservice
• IT Solutions
• Access outside of the organization
• Availability of the Skills Lab
IT Solutions
• Updated the Adobe Flash
• Gave software download
administrative rights to
targeted computers for
• Provide a high level of
customer service to
assist the staff with
individual computer
Access Outside the Organization
Availability of the Skills Lab
• 24/7 access
• Priority for
Knowledge of Programs and Manikins
• Know what makes the manikins thrive
• Pearls that reinforce proper technique
• What constitutes a repeat of the
• Know where the resources are in the
What Makes This Approach Efficient
and Effective?
Certification Tracking
Staff satisfaction scores
Decreased organizational costs
Increased confidence in competence
Certification Tracking
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
– 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
– 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
– 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
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:
–Build Team
Putting it All Together
• Mock Codes
• Monthly Skill Focus
• Continuing Education
• Bloom, B. (1987). The Mastery of Learning: notes from a Benjamin
Bloom lecture. Retrieved April 2, 2011 from:
• 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.