Presentation given at the CELSTEC, Learning Network plenary 22.03.2011. Besides presenting the Handover project and the involvement of CELSTEC, we focused in this presentation on the evaluation approach we followed to create a customized Learning Network. The methodology offers a very effective set of evaluation tools to customize a Learning Network to the needs of a target domain in this case health.

1. The project
Improving the continuity of patient care through identification and implementation of
novel patient handoff processes in Europe
Hendrik Drachsler, Wendy Kicken, Slavi Stoyanov, Marcel van der Klink,
Els Boshuizen
Tue, Mar 22, 2011 Week: 1

2. The HANDOVER project
Shorter hospitalizations, more frequent patient transitions
 high demands on the quality of clinical handovers
• Missing information
• Incomplete information
• Delay
• Wrong address
• Wrong medication
• ...
Tue, Mar 22, 2011 Week: 2

3. Failures in communication are the most common root cause
for near misses and adverse events in the medical domain
Tue, Mar 22, 2011 Week: 3

4. The tasks for CELSTEC
The objectives of workpackage 4 (CELSTEC) are:
1. To identify and validate factors determining the success
of integrating the optimal patient care micro-system
continuum;
2. To develop training tools to assist a successful
implementation of the communication model
Tue, Mar 22, 2011 Week: 4

5. The tasks for CELSTEC
“Actually just a checklist and a
course design.”
Tue, Mar 22, 2011 Week: 4

6. The tasks for CELSTEC
“Actually just a checklist and a
course design.”
“An e-learning environment like
BlackBoard so that students can
study at any time.”
Tue, Mar 22, 2011 Week: 4

7. The tasks for CELSTEC
“Actually just a checklist and a
course design.”
“An e-learning environment like
BlackBoard so that students can
study at any time.”
“Something that creates an e-
learning course when exporting the
collected content.”
Tue, Mar 22, 2011 Week: 4

8. The tasks for CELSTEC
“Actually just a checklist and a
course design.”
“An e-learning environment like
BlackBoard so that students can
study at any time.”
“Something that creates an e-
learning course when exporting the
collected content.”
“An awareness raising medium to
disseminate importance of handover
training; the toolbox is the actual
intervention.”
Tue, Mar 22, 2011 Week: 4

9. Tools to improve Handover procedures ?
Tue, Mar 22, 2011 Week: 5

10. So, what is the solution?
Kaptain Kobold
http://www.flickr.com/photos/
kaptainkobold/3203311346/
Tue, Mar 22, 2011 Week: 6

11. Methodology
Phase Methods
Interviews
1.The problem Focus group
Process mapping
Literature review
Training needs analysis
2.The training Questionnaire
Writing Persona
Requirement
3. The toolbox
analysis
PMI – rating
4. Evaluation Cogn. Walkthrough
Think aloud
Tue, Mar 22, 2011 Week: 7

12. Phase 1. Problem analysis and solution generation
Question
Why are handovers problematic and what could we do
about it?
Aim of this phase
Identification of facilitators and barriers for effective
handover
Tue, Mar 22, 2011 Week: 8

13. Interviews and focus groups
• 222 interviews with medical professionals and with 92
patients
• Focus group with medical profesionals
– Experience with problematic handovers
– Possible solutions
 Code-book, Atlas.ti
Tue, Mar 22, 2011 Week: 9

14. Process mapping
Tue, Mar 22, 2011 Week: 10

15. Process mapping
Tue, Mar 22, 2011 Week: 10

16. Process mapping
Handover
info
Tue, Mar 22, 2011 Week: 10

17. Systematic review – Ishikawa diagrams
Tue, Mar 22, 2011 Week: 11

18. Conclusion of phase 1
High diversity of
- handover practices
- problems
- solutions
Training is needed…but on what and how?
 We need to gain more insights of the
training to address the diverse solutions
Tue, Mar 22, 2011 Week: 12

19. Phase 2. Content and design of the training
Question
What are the needs of the trainees (i.e, med. professionals)
regarding the content and the design of a training?
Aim
Gain insight into the needs of the trainees
Tue, Mar 22, 2011 Week: 13

20. Methodology
Phase Methods
Interviews
1.The problem Focus group
Process mapping
Literature review
Training needs analysis
2.The training Questionnaire
Writing Persona
3. The toolbox Requirement
analysis
PMI – rating
4. Evaluation Cogn. Walkthrough
Think aloud
Tue, Mar 22, 2011 Week: 14

21. Writing persona
“Creation of an archetypal user of a website that represent
the needs of larger groups of users, in terms of their
goals and personal characteristics. They help guide
decisions about functionality and design.”
(Alan Cooper)
Although personas are fictitious, they are based on
knowledge of real users.
Tue, Mar 22, 2011 Week: 15

22. Maria, Barcelona (ES)
Coordinator of continuous education institute
“ People often think, that it is training in
handover that is the major issue. It is not.
We need to put necessary structure,
regulations, guidelines policy, and tools in
place. We need to create a culture of
handover.”
Tue, Mar 22, 2011 Week: 16

23. 17
Tue, Mar 22, 2011 Week: 17

24. Great what a nice
website!
There is already
quite a lot of
information
about handover
and how to
design
a training for this
topic. 17
Tue, Mar 22, 2011 Week: 17

25. Great what a nice Yeah, nice website but
website! there are some things
There is already missing with respect to
quite a lot of our particular medical
information domain.
about handover
and how to There are very
design interesting materials on
a training for this the internet already
topic. that should be added
17
to the website.
Tue, Mar 22, 2011 Week: 17

26. Great what a nice Yeah, nice website but
website! there are some things
There is already missing with respect to
quite a lot of our particular medical
information domain.
about handover
and how to There are very
design interesting materials on
a training for this the internet already
topic. that should be added
17
to the website.
Tue, Mar 22, 2011 Week: 17

27. 18
Tue, Mar 22, 2011 Week: 18

28. Hi Maria and Dirk,
you have very
interesting
information in that
ToolBox. We still
have systematic
challenges with
handover in
Poland. Maybe, I
could translate
some of your
content to our
needs. 18
Tue, Mar 22, 2011 Week: 18

29. Hi Maria and Dirk,
you have very
Hi Janusz, let’s try to
interesting
change the system
information in that
from bottom upwards.
ToolBox. We still
We could create a
have systematic
Special Interest Group
challenges with
on handover between
handover in
Krakow and Nijmegen
Poland. Maybe, I
in the ToolBox. Let’s
could translate
invite persons from
some of your
both institutions and
content to our
exchange experiences
needs.
on handover.18
Tue, Mar 22, 2011 Week: 18

30. Conclusion phase 2
Diversity of training needs and solutions
 A standardized training is not suitable
We will need something like a TOOLBOX
Tue, Mar 22, 2011 Week: 19

31. Phase 3. Creation of the toolbox
Questions
• How should the toolbox look like?
• What should be its content?
• How should it be structured?
• How to meet the needs of the users?
Aim
Develop an environment in which training specialists can
find all kinds of solutions to create themselves a training
that fits the needs of their trainees
Tue, Mar 22, 2011 Week: 20

32. Methodology
Phase Methods
Interviews
1.The problem Focus group
Process mapping
Literature review
Training needs analysis
2.The training Questionnaire
Writing Persona
Requirement
3. The toolbox
analysis
PMI – rating
4. Evaluation Cogn. Walkthrough
Think aloud
Tue, Mar 22, 2011 Week: 21

33. Requirement analysis
Tue, Mar 22, 2011 Week: 22

34. Requirement analysis
1. Writing personas
Tue, Mar 22, 2011 Week: 22

35. Requirement analysis
1. Writing personas
2. List of functionalities
Tue, Mar 22, 2011 Week: 22

36. Requirement analysis
1. Writing personas
2. List of functionalities
3. Comparison of potentional
online environments
Tue, Mar 22, 2011 Week: 22

37. Requirement analysis
1. Writing personas
2. List of functionalities
3. Comparison of potentional
online environments
4. Customization of the
selected environment
Tue, Mar 22, 2011 Week: 22

38. Conclusion phase 3
A toolbox is also not fully adequate.
 it does not address the awareness of the target group for
the diversity of the problem
A learning network is more suitable to reach this aim.
Most important features of this LN
- is the sharing of knowledge and experiences
- Customizing solutions for problematic handovers to local
needs and conditions
Tue, Mar 22, 2011 Week: 23

39. Result phase 3
The European Handover Learning Network
(a.k.a. Handover toolbox)
…which we will show you in a minute
Tue, Mar 22, 2011 Week: 24

40. Methodology
Phase Methods
Interviews
1.The problem Focus group
Process mapping
Literature review
Training needs analysis
2.The training Questionnaire
Writing Persona
Requirement
3. The toolbox
analysis
PMI – rating
4. Evaluation Cogn. Walkthrough
Think aloud
Tue, Mar 22, 2011 Week: 25

41. Phase 4. Evaluation
Question
What is the first impression of the toolbox of
experts in the medical domain?
Aim
Gather feedback to further improve the
handover learning network
Tue, Mar 22, 2011 Week: 26

42. Plus Minus Interesting rating
Look at and listen to the presentation
of the Handover Learning network
Meanwhile…create notes on
P: Plus
M: Minus
I: Interesting
Write down everything that comes to your mind, generate
as many ideas as possible, do not filter your ideas!
Tue, Mar 22, 2011 Week: 27

43. Conclusions
Tue, Mar 22, 2011 Week: 28

44. Most important feedback
STRUCTURE GUIDANCE
USABILITY
TARGET GROUP Content
Technology platform Purpose
Tue, Mar 22, 2011 Week: 29

45. Toolbox make-over
Helping the user
Structuring the toolbox
Both static and dynamic content
Tue, Mar 22, 2011 Week: 30

46. Structuring the toolbox – 8 main groups
Tue, Mar 22, 2011 Week: 31

47. Structuring the toolbox – 8 main groups
1. How do I use this toolbox ?
Tue, Mar 22, 2011 Week: 31

48. Structuring the toolbox – 8 main groups
1. How do I use this toolbox ?
2. How do I determine what to train during a handover training?
Tue, Mar 22, 2011 Week: 31

49. Structuring the toolbox – 8 main groups
1. How do I use this toolbox ?
2. How do I determine what to train during a handover training?
3. What skills, knowledge and attitude of the individual
professionals should I train to improve handover?
Tue, Mar 22, 2011 Week: 31

50. Structuring the toolbox – 8 main groups
1. How do I use this toolbox ?
2. How do I determine what to train during a handover training?
3. What skills, knowledge and attitude of the individual
professionals should I train to improve handover?
4. What standardized process, protocols or tools should I train?
Tue, Mar 22, 2011 Week: 31

51. Structuring the toolbox – 8 main groups
1. How do I use this toolbox ?
2. How do I determine what to train during a handover training?
3. What skills, knowledge and attitude of the individual
professionals should I train to improve handover?
4. What standardized process, protocols or tools should I train?
5. How can I empower the patient in handover through a
handover training?
Tue, Mar 22, 2011 Week: 31

52. Structuring the toolbox – 8 main groups
1. How do I use this toolbox ?
2. How do I determine what to train during a handover training?
3. What skills, knowledge and attitude of the individual
professionals should I train to improve handover?
4. What standardized process, protocols or tools should I train?
5. How can I empower the patient in handover through a
handover training?
6. How do I handle external and organisational factors that can
influence my training?
Tue, Mar 22, 2011 Week: 31

53. Structuring the toolbox – 8 main groups
1. How do I use this toolbox ?
2. How do I determine what to train during a handover training?
3. What skills, knowledge and attitude of the individual
professionals should I train to improve handover?
4. What standardized process, protocols or tools should I train?
5. How can I empower the patient in handover through a
handover training?
6. How do I handle external and organisational factors that can
influence my training?
7. What training activities should I use and what practical issues
should I consider when implementing the training?
Tue, Mar 22, 2011 Week: 31

54. Structuring the toolbox – 8 main groups
1. How do I use this toolbox ?
2. How do I determine what to train during a handover training?
3. What skills, knowledge and attitude of the individual
professionals should I train to improve handover?
4. What standardized process, protocols or tools should I train?
5. How can I empower the patient in handover through a
handover training?
6. How do I handle external and organisational factors that can
influence my training?
7. What training activities should I use and what practical issues
should I consider when implementing the training?
8. How do I evaluate and adjust the handover training?
Tue, Mar 22, 2011 Week: 31

55. www.handover.ou.nl
Tue, Mar 22, 2011 Week: 32

56. Users of
Tue, Mar 22, 2011 Week: 33

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70. Tue, Mar 22, 2011 Week: 42

71. 3 overall messages
Tue, Mar 22, 2011 Week: 43

72. 3 overall messages
1.Other domains have still very limited experiences with
Web2.0, Research2.0, Learning Networks and informal
learning.
Tue, Mar 22, 2011 Week: 43

73. 3 overall messages
1.Other domains have still very limited experiences with
Web2.0, Research2.0, Learning Networks and informal
learning.
2.There is a lot we can learn from non-TEL domains as they
apply different procedures and background information to
the project.
Tue, Mar 22, 2011 Week: 43

74. 3 overall messages
1.Other domains have still very limited experiences with
Web2.0, Research2.0, Learning Networks and informal
learning.
2.There is a lot we can learn from non-TEL domains as they
apply different procedures and background information to
the project.
3.Powerful set of methods to created customized Learning
Networks - A golden way?!
Tue, Mar 22, 2011 Week: 43

75. Many thanks for your interests
This silde is available here:
http://www.slideshare.com/Drachsler
Email: hendrik.drachsler@ou.nl
Skype: celstec-hendrik.drachsler
Blogging at: http://www.drachsler.de
Twittering at: http://twitter.com/HDrachsler
Tue, Mar 22, 2011 Week: 44