Assess carefully before proposing training solutions
Assess carefully before proposing training solutions
Direct education toward root causes, not symptoms
By Patrice Spath, RHIT
Brown-Spath Associates
Forest Grove, OR
Monitoring of incident reports suggests that caregivers are not performing up to patient safety expectations. People seem to make many of the same types of mistakes over and over again. Cautionary memos and discussions in staff meetings haven’t really changed the situation. What should your organization do to reduce patient incidents? Train your employees better? Not necessarily. Be careful to assess the cause of the problem before spending time and money on training programs. When education solutions are directed toward treating the symptoms and not the underlying root causes, nothing will be resolved.
Too often, health care organizations prescribe training solutions for problems that, when properly diagnosed, turn out not to be training-related problems. As a result, people are inundated with training and monies are expended, yet significant problems remain unresolved. It’s no wonder that employees begin to question the credibility of performance improvement initiatives that often rely primarily on training solutions. Many times, a quality or patient-safety concern is a symptom of an organizational design or management problem and not the result of skill deficiencies in the workforce. What may be missing is a systematic process for managing the performance of all employees. Focusing on a few individuals’ apparent skill deficiency will not solve the performance problem if the problem is the failure of fundamental management and supervision systems.
There are various reasons why people don’t follow procedures properly or fail to meet performance expectations. When designing solutions to noncompliance problems, start by investigating the cause. Through interviews and surveys, discover the causal factors that affect people’s decision not to follow generally accepted patient management practices. The knowledge gained through this analysis will lead to the right solutions. Make efforts to determine why people don’t do what is expected of them and the possible root cause of those actions.
With budgetary allowances for staff training and education shrinking, the need to spend training dollars wisely is more important than ever before. Accreditation standards and other external requirements consume lots of training resources, leaving very little for specially focused education. When determining the best way to solve noncompliance issues, don’t assume training is always the solution. Digging deeper into the causes of noncompliance may unearth systematic problems with the organization’s management systems that require more than a quick-fix training session. Your training resources should be preserved for those situations in which knowledge or skills deficits are at the core of the problem.
[Editor’s note: Patrice Spath and a panel of health care experts have written a new book titled Guide to Effective Staff Development in Health Care Organizations: A Systems Approach to Successful Training (Jossey-Bass/AHA Press, 2002). To order the book, visit the Jossey-Bass web site (www.josseybass.com) or call (800) 956-7739.]
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