Category: Professional Posters
Purpose: Implementation of an oncology module within the existing electronic health record (EHR) system provides a challenge for organizations. It is often difficult to make decisions on workflows and functionalities for a system that is not yet in place. We provide a framework for the development of inpatient pharmacist training across the pharmacy system by clinical informatics and information systems.
Methods: Provision of a generic curriculum template of a new EHR module was provided by the clinical informatics-education department. Nurses who worked in the clinical informatics-education department believed that curriculum development would be improved by a pharmacist. Subject matter experts provided context for workflows specific to a hospital or clinic within the health system. The training curriculum was revised by a clinical informatics pharmacy informaticist and an information systems pharmacy specialist, with additional help from an oncology pharmacy informaticist. The new functionality was demonstrated by the information systems pharmacy specialist to provide the knowledge needed to revise and customize the curriculum for pharmacy services. This activity facilitated questions to ensure key concepts were understood and added to the curriculum. It was imperative, as the first draft was missing key elements due to the lack of knowledge of the new module. The final draft of the curriculum was reviewed by the information systems pharmacy specialist to ensure accuracy. Test patients were created in the training environments and testing of workbook case exercises in the different environments were completed. The training environment was dependent on other roles, for example nurses or physicians, which complicated the ability for end users to work through the workbook case exercises and see the new functionality. A survey was completed by pharmacists who received the training to assess the usability of the curriculum.
Results: Collaboration between clinical informatics and information systems was crucial for the development of a training curriculum. Pharmacists on each team were valuable, as they previously worked within pharmacy services and could better integrate the training content to existing workflows. In addition, the oncology pharmacy informaticist provided relevant feedback and asked helpful questions regarding the curriculum that may have been asked during end-user training.
Seventy-three pharmacists were trained over 5 weeks, which comprised of 16 classes for 3 hours each. A pharmacy informaticist taught 14 classes. A nurse informaticist taught 2 classes and provided classroom support for several pharmacist-led classes. Sixty-eight pharmacists completed surveys rating the usability of the information in the course: 68% rated as excellent; 27.5% rated as good.
A number of challenges were identified: addressing the impact to pharmacy operations during the transition to electronic chemotherapy ordering; standardizing chemotherapy preparations between inpatient and outpatient pharmacies; duplicating new functionality with current workflows in the training environment; acknowledging other operational pharmacist workflow issues identified during training classes; empowering operations to troubleshoot post go-live; and ensuring enough training materials and support were available for large classes ranging from one to twelve trainees.
Conclusion: The development of training curriculum was dependent on pharmacists in clinical informatics and information systems. Both areas brought expertise and knowledge necessary to create pharmacist training curriculum for a new EHR oncology module, which included past experiences in the current hospital pharmacy service and in the oncology service line. Knowledge of the build and functionality combined with application of the module for end users were essential for successful training. The valuable lessons learned from this process will be used as more EHR modules are implemented in the future.