ACVP Management Corner

Cardiovascular Education and Training: An Investment… Not Just an Expense

Voncile Hilson-Morrow, BS, AS Healthworks, Inc.
Voncile Hilson-Morrow, BS, AS Healthworks, Inc.
Building a top cardiovascular program is not a matter of simply throwing open the doors and announcing to the world that you are providing these services. Climbing to the top or staying there requires keeping up with the latest advances in technology that improve not only patient care, but a facility as a whole. When it comes to improving patient care, education is a must-have technology. To get the most from your other technology investments, you must invest in acquiring the needed skills to make the most of that technology. There must be a continued, ongoing effort to both coordinate and oversee the efforts to ensure a high-quality workforce that delivers healthcare that is second to none. A high-quality and well-motivated staff is essential to building excellence. Learning and knowledge both have enterprise-wide implications and have to be aligned directly and firmly to an organization’s goals in order to develop a successful cardiovascular program. Traditionally in employee development, learning was seen as a budget expense and peripheral to the organization’s development and growth. In today’s world, education and training must be focused on the organization’s needs and result in measurable changes in knowledge, skills and ability. Organizations need a highly-skilled workforce to stay competitive. People are an organization’s greatest asset, and the training and education of those assets must be viewed as an investment in human capital and not just an expense. The benefits of training and education in any organization include increased productivity, fewer errors, higher staff moral, lower turnover rates, product consistency and customer advocacy, amongst others. The quality of employees and their development through training and education are major factors in determining long-term profitability. If you hire and keep good employees, it is good policy to invest in the development of their skills to increase their productivity. Training is often considered for new employees only. This is a mistake. Ongoing training for current employees helps them adjust to rapidly-changing job requirements. Employees frequently develop a greater sense of self-worth, dignity and well-being as they become more valuable to the organization. Why focus on education and training? * Work has changed: high-tech, knowledge-intensive, dynamic, lean, outsourcing; * Workforce has changed: demographics, aging, skill gaps, top-heavy, temps, loyalty; * Solutions are expensive: recruiting, incentives, teams, training, high-performance work systems. Value of education and training: * Creating a pool of readily-available and adequate replacements for personnel who may leave or move up in the organization; * Enhancing the organization’s ability to adopt and use advances in technology because of a sufficiently knowledgeable staff; * Building a more efficient, effective, and highly-motivated team, enhancing the organization’s competitive position and improving employee morale; * Ensuring adequate human resources for expansion into new programs. Determine how the training is connected to a business need: * What to teach: what skills are needed to meet current and future business goals? * Who to train: who needs to be trained in the role that contributes best to meet business needs? * What specifically must an employee learn in order to be more productive? Determining Return on Investment in Training/Education Education is really not a cost — more accurately, it is an investment in human capital. An investment in education and training helps form the human capital — the skills and abilities — that is a vital element in assuring economic growth and individual advancement. Some of the returns on this investment can be measured; others cannot, though they are no less important. Management wants to know that the money they are spending on training is getting a sufficient return. How do they prove that training and education are worth the investment? An evaluation study may be necessary to justify the investment of time and capital in training and education. Experts in the field identify several methods for evaluating training and education that provide a measure of the value, utilizing a cost/benefit approach: 1. Benefit-cost ratio; 2. Return on investment. The information provided by following these models can be used to compare one to another based on the contributions to the overall return to the organization. The methodology for the benefit/cost ratio (BCR) and return on investment (ROI) is similar in that both require determination of costs and benefits and using that data to calculate the ratio or return. However, the results in the calculations are expressed differently and lend themselves to alternative presentations. For example, the results from a BCR analysis can be presented in a ratio, but are also easily communicated in a narrative. The results from a ROI analysis are always presented in percentages. Benefit-Cost Ratio BCR analysis allows decision-makers to determine the financial return on a training/education program by comparing benefits and costs. The BCR is calculated by taking the program benefits and dividing those benefits by the program’s cost. Benefit-Cost Ratio Formula Program Benefits Benefit-Cost Ratio = ---------------- Program Costs Program benefits can be one or more of the following financial gains for training/education: * Time savings; * Increased productivity; * Improved quality of output; and/or * Enhanced personnel performance. Program costs can include the following expenses related to training/education offerings: * Course development or purchase; * Instructional materials; * Equipment and/or facilities; * Salaries of instructors and staff; and/or * Lost productivity due to training attendance. The result of the calculation is expressed as a ratio. Return on Investment ROI analysis allows decision-makers to determine the financial return from training by comparing net program benefits — benefits minus costs — to costs. The ROI is calculated by taking the net benefits of training, also non-financial value, dividing by training/education costs, and then multiplying the product by 100. The ROI is always expressed as a percentage. Return on Investment Formula (Total benefit - total costs) = ___x 100 = ROI Total Costs Total benefits include money saved by the organization, money made and anything that adds directly or indirectly to the bottom line. Total costs include the obvious and the not-so-obvious: development costs, learner’s time away from doing something else, overhead for education, physical materials, meals/refreshments, facilities, cost of coordination, and cost of job coverage during training. The greatest factor to measure ROI for education and training is the defining what the training aims to achieve. Education and Training Aims: * Improved employee retention; * Lower turnover rates; * Higher staff moral; * Increased productivity; * Increased efficiency, resulting in financial gains; * Reduction of waste and fewer errors; * Customer advocacy; * Product consistency; * Decreased need for supervision. Healthcare industry employers are struggling to find enough qualified workers to fill their vacancies and are challenged to retain workers in the industry. Without an effective plan of action to address the shortage now and train workers, it is certain that the quality of patient care will deteriorate. What Do Employees Value? A pleasant environment? An appreciative manager? Motivation? While these things are important, the key ingredient shared by all successful employees is confidence. Confidence comes from ability and results in productivity. Employees who have the skills and knowledge needed to perform their duties — and whose accomplishments are recognized — will out-produce, both in quality and quantity, employees who are uncertain or struggling with their assigned job tasks. Since confidence begins with competence, it follows that employee education and training are crucial components in molding a productive workforce. The Training Process Steps necessary in the training process: * Determine training objectives; * Conduct needs assessment; * Select the trainees; * Select the training methods and mode; * Choose a means of evaluating trainees; * Administer training; * Evaluate the training. Training Objective: The programs should have a learning objective, which is some observable and measurable behavior at the end of the process. Identifying Training Needs: This analysis will provide some benchmarks against which the effectiveness of a training program can be evaluated. Selection of Trainees: Once you have decided what training is necessary and where it is needed, the next decision is determining who should be trained. Training Methods: There are two broad types of training: on-the-job and off-the-job techniques. Individual circumstances and the “who, what and why” of your training program determine which method to use. On–the-job-training is delivered to employees while they perform their regular jobs. In this way, they do not lose time while they are learning. On-the-job techniques include orientations, job instruction training, apprenticeships, internships, job rotation and coaching. Off-the-job techniques include: * Lectures; * E-learning; * Television conferences or discussions; * Case studies; * Role-playing; * Simulation; * Programmed instruction; * Laboratory training; * Outsourced learning. Outsourced Learning Increasing pressure has been placed on training budgets and senior management, with an emphasis on an improved ROI for training infrastructure. Outsourcing proves to be the answer for many organizations. Reasons to consider outsourcing employee education: * Provides access to highly skilled individuals in a particular specialty; * Provides significant quality improvements, such as consistent instructional design and ongoing content maintenance. A program structured with the company’s strategy and objectives in mind has a high probability of improving productivity and other goals that are established in the training mission. Formulating a cardiovascular training strategy requires addressing a series of questions: * Who are your customers? * Why do they come to you? * Who are your competitors? How do they serve the market? * What competitive advantages do they enjoy? What segments of the market have they ignored? * What strengths does the organization have? What weaknesses? * What social trends are emerging that will affect the program? Set-up requires: * Awareness — a familiarity with terms, concepts, and processes; * Knowledge — a general understanding of concepts, process or procedures; * Performance — an ability to demonstrate skills on at least a basic level; * Applications — What do we expect you to do differently? * Impact — What business measure will you drive if you do this? * Hard data — output, quality, cost and time. Soft data includes customer service, work climate and work habits. Define the Program: * Basic; * Intermediate; * Advanced. Without employee education and training, your cardiovascular program could easily slip behind the competition, because no amount of savvy technology can compensate for employees who make mistakes because of a lack of knowledge. “The key competitive difference in the 21st century will be people. It will not be process. It will not be technology. It will be people — the stakes are high.” – David Walker U.S. Comptroller General The author can be reached at: