Communicating heart health education to staff
After reading this article, you will be able to:
- Describe how unique combinations of skill sets can help implement improvements to quality and staff education
- Explain how Indiana Regional Medical Center improved participation by nurses in its heart health education initiative
- Discuss how program coordinators were able to improve physician outreach and involvement
Shelley Lockard, RN, BSN, physician marketing coordinator at Indiana (PA) Regional Medical Center (IRMC), first encountered the HeartCaring® program, which she now coordinates, by finding a note on her desk telling her that it was to be one of the facility’s newest programs. A nurse with clinical background in cardiac care, Lockard was charged with finding a way to maximize the potential of the women’s cardiac health education program (see the sidebar below for more details on HeartCaring).
Participation in the HeartCaring program, a cardiovascular extension of the Spirit of Women® national program, was intended to allow IRMC to provide evidence-based cardiovascular education to its community members through many consumer events. Since initiating the program in 2008, IRMC has designated 12 HeartCaring physicians and their office staffs.
Because of successful community outreach events and positive feedback from physicians, the facility now has a waiting list of interested clinicians to be educated. To increase its capacity to reach more primary care physicians and hospital staff with the curriculum, and to assist in efficiently updating care providers, IRMC needed a strategy to maximize educational outreach, explains Lockard. Disrupting busy physician practices for designations and finding time to educate direct care staff at convenient times has been a great challenge, she says.
Lockard was uniquely suited to the job. Not only did she have a clinical background in heart health, but she was also a nurse working in the organization’s marketing department.
“This was my glass slipper,” says Lockard. “My clinical background has been cardiology my whole career. It was great to have a chance to educate outside the hospital and get different perspectives, both clinical and nonclinical.”
When she first encountered the program, the question was outreach. HeartCaring is a multifaceted program that needs to reach not only physicians and staff in-house, but also physician offices and patients in the community.
The easiest connection was with the in-house staff. “The initial timing was perfect,” says Lockard. “Just as the program went live, the State Board of Nursing Services in Pennsylvania started requiring nurses to have [continuing education credits (CEU)] to continue their licensure.”
IRMC marketed the program to nursing staff by highlighting the benefit of free CEUs—they needed the credits anyway, and the organization was footing the bill.
“However, in order to have those credits count, the program couldn’t be required by the hospital, so we made it a self-enroll program,” says Lockard.
A number of unit heads voiced a preference for making the program mandatory, but Lockard urged them to stick with the concept of self-enrollment.
“Let’s make it mean something to them,” she says.
This process led to the development of a new educational platform in the hospital. Departments began contacting Lockard and her staff to ask whether different educational offerings could be handled through HeartCaring.
“Is there anything you can’t squirm [the components of] heart care into?” says Lockard.
Access to the program
IRMC employees had the benefit of the heart heath educational offerings through the facility’s own communication system.
“I was allowed to load the program into our internal system,” says Lockard.
As with any technological change, there were steps to development, but a few meetings with the appropriate representatives from information services (IS) and the people development coordinator brought the HeartCaring modules online. A few of the modules were less simple to load than others, but with the help of IS, the entire program was soon available on the internal network.
Granted, going “paperless” offers its own set of challenges.
“It’s a rough generation right now,” says Lockard. “We’ve got the tech-savvy and the non-tech-savvy.”
For those who were not comfortable with online learning, Lockard loaded printable step-by-step instructions directly onto the intranet so that those less comfortable with online learning could have the instructions right in front of them through the whole process.
Getting it in the right hands
As to getting the appropriate nurse involvement, it had everything to do with knowing who to target.
“That’s the advantage of knowing the whole hospital,” says Lockard.
Each unit has a nurse educator; Lockard presented the program to all of them to hit all the major nursing lines in the hospital.
“It was a wonderful way to infiltrate the nursing side of things,” she says.
To reach out to clinical staff, Lockard’s department advertised heavily around the building and through e-mail, and sent out a blast of information when nursing licensure renewal dates came up.
In terms of numerical success rate, as of year-end 2010, 200 of the 1,400 employees at IRMC had taken advantage of the HeartCaring program. Another 50, roughly, had been educated via the commercial (patient/community) modules, which includes nonclinical, ancillary support staff. These numbers do not include physician involvement.
Reaching the physicians
Lockard is also a physician liaison at IRMC. Reaching physicians with educational modules, especially reaching those physicians who are primarily based externally, can be a tough nut to crack, but “fortunately that was a nutcracker I had in my pocket already,” says Lockard.
The organization offered the educational modules to physicians right out of the gate and had the good fortune to have a fantastic champion of the cause, a female cardiologist who presented the module at Indiana’s county medical society meeting. These physicians in turn helped get the word out to their colleagues; meanwhile, Lockard’s office sent letters home to all physicians as well.
The organization now has 12 clinicians who are designated through the HeartCaring program.
In terms of what kinds of physicians are most drawn to the program, it’s a pretty wide range, says Lockard.
“New-timers just get it, and the old-timers we’ve got to bait the line a little more heavily,” she says.
In terms of making the program more approachable to physicians, the “free” tag has been beneficial—the program provides free continuing medical education (CME) for physicians as well. “They just wonder what the catch is!” says Lockard.
Her office has expanded the program for physicians, advising them to ask if there is something they need in terms of teaching and education for patients. Lockard provides a simple order sheet for physician offices to request additional educational materials. “You don’t break through to physician offices without it being [brief],” she says.
The most challenging part of the program on the physician side has been keeping the physicians in the loop and up to date.
Interestingly, it has not been just cardiologists involved and interested in the program. Several specialist physicians have requested the education as well.
“One endocrinologist was in the program, and we have interest from a pulmonologist,” says Lockard. “A gastroenterologist voiced interest in the program and we paused for a moment to wonder what the hook was, but stress is a major part of preventing ulcers,” and HeartCaring looks at stress prevention as well.
The physicians get quite a bang for their buck, too, she says—education, CME credit, and educational materials for their offices.
Other uses abound
HeartCaring has made its way into other areas of the facility as well through Lockard’s outreach.
“There was a need for patient education within the facility,” she says. “I met with unit-based educators, and specifically the telemetry unit wanted to package this for their patients.”
The educators picked the modules and materials they wanted and made a teaching package for heart and stroke patients. Diabetes, cardiac rehabilitation, and other departments followed suit.
“I sent the materials everywhere I could think of,” says Lockard. This included talks as well as external and internal health fairs.
Implementation was not without a few hurdles. For example, the decision to go with both CEUs and CMEs was a daunting prospect.
“At first we just went with CEUs, but then I met with our medical director of quality who suggested that we get the physician credits available as well,” says Lockard. “I was a little nervous for that because the application process is lengthy.”
Overall, though, the program has been a huge success.
“People are now enabled to educate on something they’re not versed on,” explains Lockard. “I have a lot of nurses from the OB unit who have completed the modules. By offering it to them, even though it’s not their specialty, we help them provide better care to women, and that is very near and dear to my heart.”
What is HeartCaring?
The national HeartCaring® program, developed in partnership with the National Heart, Lung, and Blood Institute’s The Heart Truth, is powered by Spirit Health Group® and activated by U.S. hospitals that ascribe to the highest standards of excellence in women’s health, education, and community outreach. HeartCaring is sponsored in part by The Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership and Philips Healthcare, with educational support from the Vascular Disease Foundation, the Peripheral Arterial Disease Coalition, and the Venous Disease Coalition.