clinical system upgrade

When a childrens medical center in a major city underwent its annual clinical system upgrade, it was anything but routine.

The the innovative 406-bed childrens hospital was in deep. In addition to the standard annual Cerner Millennium software application upgrade, they participated in the Alpha implementation of Cerners CareMobile. CareMobile is a hand-held, point-of-care solution. It uses bar codes on the patients identification wristbands to track medication administration and online clinical documentation.

This advanced technology aids patient safety. It does so by ensuring correct medication administration to the patient, both dosage and time.

Clinical Impact

The impact these integrated technologies had on the day-to-day operations and patient care was far-reaching. Correspondingly it required a substantial workflow change in many departments.

At that time, the go live deadline is only six months away. The IS training department has an imposing task; Training a large majority of the hospital staff and doctors on the new systems.

The childrens medical center information systems advanced development director knew the end result would further enhance the childrens center operations and patient care. In this case by creating workflow efficiencies, clinical business data and process integration and operational improvements. She also knew the training department was faced with a significant challenge to meet the overwhelming training need.

Finding a Solution Provider

The development director turned to Houston-based Solo Learning for a training solution. Noting that the are,”a high-growth, learning management company that provides solutions for some of Americas leading companies”. The solution would first, assess the current training department. And then develop and implement all aspects of training for this mammoth-scale system roll-out.

Solo began working with the development director to develop a training strategy. One that would efficiently teach users to maximize the benefits of the technology in multiple departments. The new training structure would have to satisfy several requirements including:

  • Quickly familiarizing employees with the aspects of the technology they would most often utilize
  • Providing realistic training scenarios prior to the new software launch on a department-by-department basis
  • Allowing employees to review elements of the program quickly on an as-needed basis
  • Structuring the training to enable the hospital to fully function while training a majority of its employees and doctors
  • Completing the entire process within a few weeks

To promote the process, Solo consultants also helped the center screen potential IS training department new hires. These new hires would support training on an on-going basis.


After the initial assessment of the training department, Solo analyzed the data. We recommended a unique, blended training strategy for the childrens medical center.

Blending a computer-based-training (CBT) strategy with focused instructor-led classes, Solo Learning was able to maximize efficiency by covering the system basics in the CBTs and more detailed, department-individualized material in a classroom setting.

Solo Learning created nine intricately detailed simulation training modules to replicate the software. In this case, every user received relevant training scenarios based on their use of a particular aspect of Millennium and CareMobile. Additionally, a wide variety of training scenarios and interfaces required development for multiple user groups. Groups such as physicians, nurses, lab technicians and even dietary aides, trained with specific information pertinent to their individual jobs.


Employees would be able to complete online training from their own computers at their own pace. As a result, the length of time away from their departments decreased. This method also allowed employees to review lessons multiple times if necessary. Once individual training was complete, instructors conducted multiple one- to two-hour classes on the specific, detailed functions for each department.

Said the development director; “The CBT was great. Because even though they covered system basics, much of the training was complex. Using a CBT gave the employees more than one shot to learn the material.”

In view of the constraints, it is necessary maintain efficiency and adhere to a tight schedule. Solo recommended that CBT training be a prerequisite for attending the more advanced instructor-led classes.  This prerequisite policy allowed the instructor-led training to focus on the more complex aspects of the programs at the center.

The development director had strong feelings on this decision. Stating that; “Requiring and enforcing the CBT classes as a prerequisite to the instructor-led classes was an excellent decision. In doing so, it ensured that all employees had some basic knowledge before they attempted the more advanced classroom training.

Management Perspective

According to the director; understanding there would be strict enforcement of pre-class preparation prompted the people to come to class with the CBTs completed.

“It was a very wise use of everyone’s time. And I think those who did prepare for the class were pleased to learn they hadn’t wasted their time.”

One of the most critical user groups, was the nursing staff. We knew that they would have the heaviest usage of the new systems. To properly address this vital group, Solo set aside special areas on the various floors for a clinical educator. Various controls, such as timed staffing, helped maintain efficiency in these areas.As an example, when an employee requested additional training on a certain function. The clinical educator would work with the employee right there in the department. The educator explaining the steps as they worked through a problem.

These specialty training areas and classes really helped to minimize the disruption to normal hospital operations. Which, as it turns out, is really important to us, said an IS manager.

Clinical Response

Response from employees was very positive”despite the change in many employees workflow and duties, according to the development director.

I credit that positive response to the training and the various formats we used, she said. The CBTs, clinic educators and the detailed classroom instructions combined to create a very thorough training program for us.

Solo Learning’s blended training module was the right prescription for the childrens center. Using that formula, Solo Learning helped the center quickly assess the training needs. Then, use those needs to develop a plan structure that would work around the demands of a busy childrens hospital. With an overall goal to provide realistic training for individualized users in an extremely tight time frame. From start to finish the entire training project, including full-simulation software development and classes, only took 14 weeks. Solo Learning completed the project on time and on budget, which was just what the doctor ordered.

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