Improving Data Quality and the ESR e-learning Experience for Employees

A Case Study by Liverpool Women’s NHS Foundation Trust

With a vision to be the recognised leader in healthcare for women, babies and their families, Liverpool Women’s NHS FT professional team of 1,400 people takes care of more than 50,000 patients from Liverpool, the surrounding areas and across the UK. As well as delivering care within the hospital we work in the heart of the community, providing care for patients at various clinics across the city. 

Embarking upon Improving Data Quality

Our Challenge

In early 2019 we recognised that we had some significant challenges in relation to the accuracy and completeness of the training data captured and stored within the Electronic Staff Record Learning Management System (ESR LMS).  This was leading to poor reporting and subsequently to a lack of confidence and engagement with the ESR LMS from both management teams and colleagues alike. 

Individual managers and areas were keeping their own records, which invariably lead to further challenge of the centrally held data.

We undertook our ESR Annual Assessment with our NHS ESR Functional Account Manager, David Bromilow, and this underscored our challenge and helped us to identify a number of gaps in our processes. 

The Trust had a clear ambition to drive improved compliance with mandatory training at core, clinical and local levels, but without one centralised system for recording and reporting – one version of the truth. It was proving hard to build momentum and without accurate and complete records it would be difficult to raise the levels of confidence we needed to drive the engagement.

It was a catch 22 – and a challenge to be met!

Our Approach

We took stock – we got a clearer picture about the mandatory training needs across the Trust, at all levels and for all colleagues.  We gained clarity on the records held centrally within the ESR LMS, versus those held locally and on paper.  It became clear that data already in the system needed cleansing and the system itself rebuilt in many aspects.

We appraised our skill level – we realised we didn’t have an abundance of skill to support the ESR LMS – particularly it’s linkages with our data warehouse and the potential to develop easy to use reporting tools for our managers.  We reached out to our regional ESR colleagues and internally to our performance information team and asked them to work with us.

We developed an action plan – armed with clarity of understanding about our starting point, and the support and collaboration of our colleagues, we developed a plan. 

The actions needed were too numerous to think about all at once, so we categorised firmly, and set ourselves ambitious but workable timelines at every step. 

We identified three members of our team to lead on different aspects of the plan – Jeanette Chalk, our Head of Talent & Culture, acted as Project Manager, keeping us on track and ensuring deadlines were met, Janet Hinde, our Workforce Information Manager, lead on the technical system aspects of the project, and Anne Bridson, our L&D Facilitator, lead on the internal stakeholder involvement – working closely with our clinical educators and subject matter experts (SMEs) - their involvement was crucial at every step.

Sponsorship from Michelle Turner, Chief People Officer, was essential in ensuring we had the necessary support at a senior level, and also in challenging us to innovate and develop wherever possible.

Helen Christophorou: Practice Educator, Maternity Department:

Where we were and where we are now has meant we have made massive strides forward. The interdepartmental working has made a vast improvement with the system.

Our Action Plan

Our key areas of focus included:

Collaboration & Learning

• Introducing monthly meetings with our regional ESR colleagues to raise queries, develop skill and increase our understanding of ESR LMS and its linkages to ESR.
• Participating in regional streamlining events to gain a greater understanding of the Core Skills Training Framework (CSTF) and the importance of assigning the appropriate CSTF competencies on ESR to report on training.
• Upskilling our Workforce Information and L&D teams to grow our understanding and knowledge around the LMS build and development requirements – key building blocks to reaching a successful outcome to our project.

Joe Nightingale: Practice Educator Gynaecology Department:

The work that has taken place has ensured a more streamlined competency framework for the Gynaecology Division, it has ensured the right competencies are assigned to the right staff.

System Building & Developing

• Correcting and creating the competence requirements for each element of mandatory training we needed to store within ESR LMS, whilst removing any incorrect legacy data that was causing confusion to colleagues when viewing their requirements through Self Service.
• Aligning the appropriate CSTF competencies in ESR to the relevant training.
• Swapping paper workbooks for e-Learning packages wherever possible, and ideally for the national e-Learning packages. Where this wasn’t possible, the development of a local e-Learning package was encouraged and the use of another national competence if available. Collaboration with the SME’s was crucial here.

The following courses are now delivered by the national e-Learning available within ESR LMS:

• Health & Safety
• Risk
• Moving & Handling
• Fire
• Information Governance

Looking to the future we plan to also deliver the following national e-Learning packages within ESR LMS:

• Safeguarding Adults Level 1 and 2
• Safeguarding Children Level 1 and 2

Data Capture & Inputting

• Developing and introducing clear and concise processes for the submission of training data by managers and/or trainers, including monthly deadlines to ensure reports produced match the data supplied.
• Of particular importance here was ensuring trainers submitted attendance registers for face to face training, and that attendance for study days was broken down into its constituent parts to ensure all elements of the training were captured and reported. Processes to achieve this were tightened.

Reporting

• As noted above, collaborating with our internal IT colleagues enabled the introduction of reporting through our local Data warehouse solution. This information is now being fed directly from ESR.  This solution allows our managers to be able to easily see the overall compliance for their staff at individual, team, departmental or divisional levels.
• This change has now facilitated some significant reduction in the manual manipulation of spreadsheets for reporting purposes – not only creating time for other things, but also reducing the opportunity for human error.

Data Validation

• Introducing validation sessions with departmental educators, working with them to improve the accuracy of training requirements for every role across the Trust - cleansing and improving the ESR LMS following each session.

Issue Resolution

• Introducing a process for line managers and colleagues to report queries or issues, and a further process for the L&D team to review, resolve and report back to the colleague raising the query.
• Simple statistics are produced on a monthly basis, tracking how many issues have been raised, the percentage resolved within the month etc. This also allows us to capture and focus on any repeated reasons for the issues raised.

Governance

• It became clear that a process was needed to ensure stakeholder involvement prior to any new element of mandatory training being introduced to the Trust. Our Education Governance Committee introduced such a process to ensure that any future attempts to add additional elements of mandatory training to the current Trust requirements had to be approved at this Committee and go through some level of scrutiny.

This ensured that only approved courses and competencies could be added to ESR LMS and allowed discussion and debate by all of the required stakeholders before any changes were formally agreed.

• It was also important for accurate compliance reporting that the correct employees were located in the correct hierarchy in the system. In order to keep the staff hierarchy as accurate as possible, managers were encouraged to submit position change forms on time and highlight rotations so that the monthly compliance reports would be accurate.  We managed compliance data in a pragmatic educated way to ensure we could always provide assurance that the training percentage compliance rates were as accurate as possible.

Danielle Smith, Practice Development Facilitator, Theatres:

It has given me a greater insight into ESR Learning Management and how it works, so now I feel confident to use the system, and I actually input now. Also, I am able to support the staff in the use of e-Learning. I trust the figures produced by ESR, they are an accurate record of my training figures.

Our aims in the development of these focus areas were clear:

• To restore confidence in the ESR LMS, changing the negative perceptions around data quality to positive views of a system that is valuable in tracking and reporting mandatory training, thus supporting patient safety.
• To minimise paper based training materials and maximise e-learning wherever possible, reducing the admin burden at every opportunity.
• To provide assurance to the Board that the monthly reporting was accurate, and that any areas of non-compliance could be quickly identified to ensure ongoing patient safety.
• To initiate a process for approval of Statutory and Mandatory Training Requirements within the Trust.

Employees Access to ESR e-learning

We had already implemented Employee Self Service a number of years ago.  However the usage had been historically low as employees didn’t feel the need to log into ESR.  It was therefore important that we had to make a positive change to encourage employees to log into ESR.  

We decided that to increase the number of employees going into ESR then we would switch off the production of paper payslips. This had a number of benefits; it was safer for employees, it had a positive environmental impact by reducing paper but more importantly it gave them a reason to access Employee Self Service.

We saw more and more employees were accessing the system, as we saw an increase in the number of people calling our support line to help with ESR queries. This included re-setting passwords.  We were able to help them by showing them the password re-set functionality in ESR. Once employees started to access Employee Self Service this meant that they became more familiar with the landing page and the various portlets including the My Compliance and My e-Learning portlets.

As we had more and more employees accessing ESR it was now an opportunity to make more training accessible through ESR LMS and we took the decision to remove workbooks. This proved extremely successful as the earlier issues around access had already been resolved and employees could now re-set their own passwords following the guidance that we had provided.

E-Learning has now become the accepted training delivery mode of choice within our Trust and both employees and managers can see the benefits of utilising ESR e-Learning.

Additional Benefits

During the recent months and with the impact of COVID-19, delivery of training via e-Learning has proved invaluable as we would have struggled to deliver classroom based courses with required social distancing measures.

As the Trust is now signed up to some of the CSTF courses we are now in a position to take advantage of the ESR Pre-Hire Inter Authority Transfer (IAT).  This gives us the opportunity to accept CSTF training completed by new successful applicants prior to their arrival at our Trust.  Therefore they do not have to repeat this training when they become an employee with us.

Lessons Learned

• Be honest about your starting point – it was tempting as we began this journey to believe that we had more in place than we actually did. Being honest and recognising that for the most part we needed to start at the beginning helped us to gain a more effective outcome.
• Be ambitious, but realistic – clearly there were pressures to make improvements as quickly as possible, and we swiftly developed our plans with all activities having deadlines and timelines attached. But we also recognised how important it was, for the credibility of the project, not to over-promise.  If an activity will take 6 weeks, we said so – of course, it’s was then imperative to deliver on that timeframe.
• Be resilient – we have had times over the course of our project where it felt like weren’t moving forward at all. It’s important to stop, reflect and realise that much has been achieved.  When things don’t go to plan, it’s something to be learned from, and move forward.
• Be collaborative – collaborating and engaging with experts and end users has been invaluable at every step. Sometimes to build our knowledge, sometimes to check our thinking and sometimes to validate our progress.  Key for us was the inclusion of regional ESR colleagues who understood the technical aspects of what we wanted to achieve and who helped us see the art of the possible.

Looking to the future

Whilst we have achieved much, there is still more to do. 

We remain focused on our original challenges and in finding new and improved ways to capture, record and report on our mandatory training.  We firmly believe that having accurate data available, in a timely manner, will support the ongoing drive within the Trust to improve compliance levels and ensure patient safety.

We want our management teams to have data at their fingertips to support their planning and decision making processes, and finding ways to update our reporting more regularly is definitely on our agenda now.

Building our knowledge and understanding on the systems and its potential uses, we have already embarked upon the next stage of our ESR journey and have a number of exciting plans ahead. As part of our response to COVID-19 we have had to make a number of changes to our virtual Induction via ESR e-Learning.  This has now commenced and gives new employees joining the Trust the opportunity to take part in a virtual induction and record that they have done so via ESR e-Learning.  This has transformed the way that we undertake induction for new employees.

To add further prominence to the success of this project,  the Trust now has the confidence to use further ESR functionality and we have started to record Appraisals via HTML questionnaires and the Appraisal Template,  this is testimony to how far we have come with ESR in the last few months.

For more Information

If you would like to talk to us about our ESR journey please contact: Anne Bridson, Learning & Development Facilitator Anne.Bridson@lwh.nhs.uk