BHR University Hospitals NHS Trust achieves over 90% compliance to improve patient care standards

Barking, Havering and Redbridge University Hospitals NHS Trust (BHR) run two hospitals, both with emergency departments serving clinics across North East London.

They have 6,500 clinical and non-clinical staff and volunteers caring for a diverse community of 750,000 people, making it one of the largest in the country. Services include neuroscience, cancer and acute stroke specialist care wards.

The Challenges

Since a visit by the Care Quality Commission (CQC) in 2013, the Trust’s compliance with the Core Skills Training Framework (CSTF) has been under scrutiny, along with the processes in place across the organisation.The Trust had multiple methods for their 6,500 staff to view, manage and book training which caused confusion and placed a huge strain on HR and Learning and Development (L&D) resources at the hospitals. The L&D team were inundated with phone and email enquiries to book staff on mandatory training. There was no central policy or framework for learning and development to provide guidance to staff on requirements.Separate Learning Management Systems (LMS) and compliance reporting systems resulted in excessive time being spent creating reports to make decisions on compliance, staff training and development.The absence of a management hierarchy in legacy systems led to a lack of accountability and engagement for the completion of mandatory and personal development training. Training costs were escalating as a result of a high DNA rate.The key project outcomes were to:

• Increase operational efficiency – To have a single, efficient and easy to use processes for staff to book directly onto classroom-based training and access elearning. To reduce the time spent by L&D teams on centralised administration.
• Achieve a sustained increase in mandatory training compliance – To increase the clarity around mandatory training requirements and be able to report accurately and efficiently allowing proactive management of risks.
• Ensure elearning is easily accessible, relevant and easy to use – To provide remote access to elearning to be compatible with staff schedules enabling mandatory training to be completed at the most convenient time and location.
• Embed Personal Performance Review processes – To embed and support Personal Performance Review processes across the Trust, including the ability to manage nurse and midwifery revalidation processes effectively.
• Improve centralised reporting and line manager reporting – To report accurately and efficiently centrally and to give managers real-time access to reports to help them to manage more effectively.

The Solutio

The Trust recognised the need for a user-friendly LMS, that was flexible enough to be customised to healthcare-specific needs. They initiated a rigorous selection process, which resulted in a partnership with Think Associates to implement and support Totara Lear.BHR recognised Think Associates’ market-leading healthcare LMS experience, and the ability of Totara Learn to manage all of their needs including compliance training, elearning content, classroom training, nurse and midwifery revalidation, personal performance reviews centralised and line manager reporting.Think Associates and multiple stakeholders in BHR collaborated to deliver essential improvements to the organisation’s learning technology infrastructure, as well as incorporating their end-to-end training and reporting process into Totara Learn.

Organisational Hierarchy

A clear organisational hierarchy was developed to enable managers to support, manage and report on their teams’ learning. This management hierarchy was bulk uploaded to the LMS, known in the organisation as BEST (BHRUT Education & Staff Training).The management hierarchy (BEST) was vital to the configuration of the Personal Performance Review created using the e-appraisals functionality in Totara Learn.

“BEST has enabled staff to take responsibility for their own education and development, whilst providing easy to use records for managers. It has enabled the Trust to rapidly develop and deploy education across the organisation when specific issues are highlighted.” – Kathryn Halford, Chief Nurse

Training Policy

A training policy was developed to target learning in line with the organisational hierarchy. This work meant that Totara Learn could be used to successfully target specific staff groups with learning appropriate to their roles. A clear and concise policy encouraged accountability for the completion of mandatory training.All of the courses within this policy, as well as the Core Skills Training Framework (CSTF) were incorporated into Totara Learn, making it easy for learners to see exactly what they needed to complete and when.

Custom Development – Study Leave

The Trust commissioned the development of additional functionality to manage their study leave booking process so that this can be completed through the Totara Learn.

Single Sign-On for Learners

Think Associates collaborated with the Trust’s IT team to integrate BEST with the organisation’s Active Directory, enabling single sign-on for learners at work and at home, along with the auto-creation of new starter LMS accounts.

E-learning

Think Associates worked with BHR to rigorously test that local elearning content played and reported properly on and off site.

The Results

Totara Learn is now BHR’s go-to portal for all learning and development, nurse revalidation and booking study leave for specialist courses.

Rapid Full Self Service Implementatio

More than 4,600 clinical and non-clinical staff accessed the system in the eight weeks after going live.Staff have responded very positively to the following:

• Single sign-on across the organisation has significantly improved the learning experience.
• Single point of access for all learning and development needs.
• Simplified approach.
• Ease of use of core learning and development processes – viewing, managing and completing mandatory training.
• Simple and accessible way of viewing and booking a wide range of personal development resources.

Line managers are newly empowered to support and manage their team to complete their mandatory training and personal development.

Reporting

As a result of targeting training in line with the organisational hierarchy learners, managers and the organisation as a whole have clear and concise reports of compliance within the Trust.

Increased Compliance

The Trust have increased their compliance rate (across all Core and Essential Training Skills) from 84% in March 2016 to 92% in November 2016.The increased rate of compliance has been attributed to the ease of access to training and the transparency of requirements.

As a Trust we have to ensure that all our staff are trained to deliver their responsibilities. This includes a host of mandatory training standards that cross disciplines. The BEST platform has transformed how we enable staff to easily access elearning wherever they are, be it home, on a bus or at work, making on-boarding and updating easy. That is what the staff tell us. – Dr Nadeem Moghal, Medical Director

Financial Savings

The Trust have estimated a significant annual cost saving since the implementation of the Totara LMS. This saving is made up from:

• Time savings – easy access for staff, means no time is spent managing forgotten user names etc.
• Transparent requirements – staff know what courses they need to complete and by when. They are no longer spending time completing the wrong course or following incorrect processes.
• Increased use of elearning – now that it is simpler to access and complete, it is more widely utilised.
• More efficient course attendance administratio.

The Future

The Trust are excited about starting the following projects using Totara Learn:

• Building on the successful management of Nurse and Midwifery Revalidation, BHR are looking at extending this to manage Medical Revalidation.
• Developing a mentorship and preceptorship programme and enhancing content resources to support student learning.
• Integrating study leave processes with staff e-rostering systems. This will support the Trust’s mission to become a paperless organisation.

Developing creative insight into the Trust for induction training by using vox pops as well as gauging how much staff understand about the organisation and its values.

“The introduction of BEST on the Totara Learn platform has transformed our elearning making it so much more accessible for all our staff. BEST has ensured that our compliance to Core and Essential Skills has risen to over 90% and stayed there, which has to be good for our patient care as we can be assured our staff are trained. BEST is easy to use and being able to access it offsite has meant that we can  book and do courses at times to suit us. The layout of BEST is easy to use and is visually attractive; from the first time of logging on to it you are hooked!” – Gill Perry, Associate Director of Education, Training, Learning & Development