Situation

Certification on the American Heart Association’s Basic Life Support (BLS) is a requirement for all RNs at Boston Medical Center (BMC). Prior to the implementation of HeartCode BLS, BMC’s nursing education department did recertification for approximately 1,300 nurses every two years. To meet this need, we offered 66 classes over the 2 year period, with 4 instructors for every class, and registration by telephone. We tracked expiration dates in HealthStream. Staff did have the option to attend outside American Heart Association courses and get reimbursed. Not only did we struggle to staff classes, but often attendees would register, the class would fill, we would turn away other staff, and then we had many no-shows. At times we were paying BLS instructors to teach half-empty classes, and we also paid RNs their hourly wage for the 3-hour class. Another issue was the need for diverse class times to accommodate staff who work per-diem, part time, and off-shifts. We started looking at online options and were excited when we heard HealthStream had a HeartCode course. We were using HealthStream for many other educational needs and reviewed pricing for using HeartCode to meet our certification needs.

Approach

We decided to adopt the cognitive component of HeartCode, delivered via HealthStream. The American Heart Association was already our standard for CPR, and their having developed this program made this choice a natural one. The HeartCode skills portion was not implemented, however, due to space issues. To implement HeartCode BLS, we ran a report both to see how many people were delinquent and to estimate our future need to recertify people. We divided the staff into 2 groups, based on expiration date, which created a December group and a May group. We now offer three 12-hour skills days twice a year. Staff takes the online course during work prior to coming to class. If they can't get that done, they must make arrangements to do it after work hours. Staff then comes to the training class for an hour to demonstrate their skills. Once staff opens the course they have 30 days to complete the hands-on skills component, and we are charged, even if they do not finish the skills portion of the course. Anticipating issues, we are very specific on notifications to staff that they should open the course only if they are able to attend a skills session. Otherwise, they need to go elsewhere for CPR recertification. Staff can sign up for skills or just drop in—we set up stations, and the process takes less than an hour. Not only have we saved money but the staff evaluation of the new system has been overwhelmingly positive. We implemented this quickly over the past year as we already had a process in place (an assignment made for BLS to staff); it was really an easy process.

Impact

• Saved significantly, $32,000 over two years, using HeartCode BLS on the HealthStream Learning Center, both in terms of training costs and paying for staff during time spent training
• Gained scheduling flexibility for meeting the certification needs of staff with varying schedules and availability
• Received very positive evaluations from staff on the new BLS skills recertification system
• Eliminated the manual registration and tracking process, saving the education department staff’s time
• Eliminated the unnecessary expense of half-empty classroooms being taught by expensive instructors
• Identified staff with low levels of computer skills proficiency who could benefit from additional training

Results

The savings from this project were huge. We had a $32,000 savings over 2 years, but more importantly the staff and trainers love the new system. Our compliance has improved as we only need to review it twice a year instead of monthly. Staff does not need to be paid, nor do they have to come in for an extra four hours, leaving their floors short staffed. Staff actually also are learning more as they can spend more time concentrating on retaining the skills, not worrying about the test. It has been great for our staff with time constraints, as they can do the online portion when it is convenient and stop by the skills center before, during, or after their shift. The staff also appreciates the ability to complete the test at their own pace and the opportunity to review areas they may have difficulty understanding. We also found that those with below average computer skills have difficulty with the online portion and spend too much time doing it. This is a hidden benefit enabling us to identify staff who would benefit from improved computer capabilities. The education department is putting the saved time to good use on other projects.

“HeartCode is truly a lifesaver for our department!”
-Meg Grande, MS, RNC; Boston Medical Center (Boston, Massachusetts)