9/24/2015. What is GNOSIS? Agenda. Do we need a coach? How GNOSIS meets the needs of adult learners. What is Andragogy?

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1 Agenda Using Data to Drive Improvement 6 th Annual Avera Women s Conference for PCPs Lora Sparkman, VP Clinical Effectiveness October, 05 What is GNOSIS? How do Adults learn? How is GNOSIS different? What is the evidence? What is GNOSIS? Do we need a coach? GNOSIS is a patented assessmentdriven education and analytics solution that uses data to transform how doctors and nurses learn. It embeds Adult learning principles to ensure learning is effective and efficient. THE NEW YORKER Oct, 0 Personal Best: Top athletes and singers have coaches. Should you? by Atul Gawande No matter how well trained people are, few can sustain their best performance on their own. That s where coaching comes in. Barry Blitt What is Andragogy? Andragogy is the study of how adults learn and the lead theorist that developed and studied adult learning principles is Malcolm Knowles. Knowles four principles of adult learning: Be involved in the planning and evaluation of their instruction Learn best through actual experience that includes making mistakes as the basis for learning activities Are most interested in educational topics that have immediate relevance to their job Learn best when the instruction is problemcentered, not just contentcentered, and is experiential How GNOSIS meets the needs of adult learners Assessment, Individualized Learning, Analytics: Assessment Testing varying forms of knowledge (concepts, skills, judgment) Learning path is prioritized from most to least need Provides selfawareness (strengths & areas to improve) Questions assess Knowledge and Judgment through case scenarios, script concordance theory, evidenced based national standards, expert experience, etc. Relevant, selfdirected, & respectful of learning principles Analytics provide immediate feedback to the clinician with Knowledge is not like a hard driveit is a benchmarking once assessment is completed and year over process of building circuitry in the brain. year learning with milestone/tracking of progress Mike Connell, Learning Expert Opportunity for Mastery that allows time & repetition in key areas 6

2 What is GNOSIS? Clinicians complete a comprehensive assessment 0+ hospitals are now using GNOSIS and GNOSIS evaluates their level of knowledge and judgment. The data is used to benchmark, their proficiency scores. 0,000+ assessments of doctors and nurses,000+ assessments & learning paths are completed monthly Clinicians complete a comprehensive assessment GNOSIS delivers a personalized learning path and GNOSIS evaluates their level of knowledge and judgment. The data is used to benchmark, their proficiency scores. based on their proficiency in each practice area, with content prioritized by the level of learning need. Clinicians test out of the material they have mastered based on the assessment. GNOSIS delivers a personalized learning path Clinicians begin learning based on their proficiency in each practice area, with content prioritized by the level of learning need. Clinicians test out of the material they have mastered based on the assessment. where they want, when they want, and only what they need. The content is delivered in 8 minute content snacks while addressing a variety of learning styles designed for active adult learners.

3 Clinicians begin learning GNOSIS generates competency data where they want, when they want, and only what they need. The content is delivered in 8 minute content snacks while addressing a variety of learning styles designed for active adult learners. for the individual and the team, by practice areas in each course. Reports are available to identify specific areas of risk as well as clinical areas that need education and training. GNOSIS generates competency data for the individual and the team, by practice areas in each course. Reports are available to identify specific areas of risk as well as clinical areas that need education and training. How will you use the data?. Measure engagement. Measure proficiency. Measure learning. Measure risk 5. Measure outcomes 7. MEASURE ENGAGEMENT Engagement increases by nearly 5 times when clinicians learn on GNOSIS. MEASURE LEARNING Improve proficiency in lowest performers by 7 percentile points Nurses Physicians Engagement increased by times 5% 75% Engagement increased by 6.7 times % st Assessment After learning on GNOSIS +7 nd Assessment Percentage of accredited course time spent on learning in long form Percentage of accredited course time spent on learning in GNOSIS *Sample based on 700+ physicians and nurses completing personalized learning path for GNOSIS Obstetrical Hemorrhage. Performance gains result from assessment compared to assessment.

4 . MEASURE PROFICIENCY Compare clinician s competency in knowledge and judgment. MEASURE RISK Reduce risk by over 5 with targeted learning All U.S. YOU YOUR FACILITY YOUR TEAM YOUR GROWTH JUDGMENT 0 Team Facility U.S. U.S. Facility. Team KNOWLEDGE claims/000 deliveries BEFORE APS 5.8 WITH APS 55% avoided in claims exposure *Data provided by BETA Healthcare Group representing over 00 healthcare care facilties in California. 5. MEASURE OUTCOMES Individual Performance Dashboard Shoulder Dystocia Reduce clinical costs by improving outcomes by nearly John Nurse # of Massive Transfusion Protocols (MTP) BEFORE GNOSIS WITH GNOSIS Reduction of 5 MTPs 8 Apr Oct Nov Apr 5 *Data provided by Texas Children s Hospital at AWHONN annual convention Healthcare system performance is. Individual Nurse Assessment Results Judgment Ave. Score Hospital A APS Hospital Knowledge Ave. = 7 Hospital B Hospitals APS Facilities System Hospitals Clinicians Nurses Hospital Average System Average APS 7 Hospital C Hospital System Average APS Hospital Judgment Ave. = 6% Judgment 5 Hospital D Hospital G Hospital F Hospital E Knowledge Knowledge Ave. Score, Nurse, st time Assessment scores only n=99 Nurses in hospital; Source: APS GNOSIS database

5 Same Hospital and Nurse Average Score by Practice Area Fetal Assessment & Monitoring Individual Provider Assessment Results Clinicians Providers For Your Consideration Practice Areas Because there is a wide pattern of variation and some outlier scores the comparison to National Peer group is below the 50 th percentile. This speaks to the wide pattern of variation so the first task is to understand the variation and have individuals complete their Learning Paths timely. Then reassess at a defined time in the future to monitor improvement. Judgment Hospital Average System Average APS Knowledge Data as of 0//5, Source: APS GNOSIS database, Nurse, st time PPM scores only n=0 Nurses; n=8,965 nurses in 57 national hospitals. Note: Only facilities with >5 PPMs are included. 5, Providers, st time Assessment scores only n=5 Providers in hospital; Residents are not included Source: APS GNOSIS database 6 Same Hospital and Provider Scores by Practice Area Fetal Assessment & Monitoring Nurse Individual Results for st Assessment Overall high scores but there is a wide variation among individuals for both Knowledge and Judgment For Your Consideration Practice Areas The majority of Providers are in the high scoring quadrant with a minority in the lowest scoring quadrant. The three areas that show the greatest variation are Practice Areas,, 5 and 8. Focus on the lower scoring individual and insure they complete their learning paths timely. Reassess at a point in the future and monitor progress. Data as of 0//5, Source: APS GNOSIS database, Providers, st time PPM scores only n= Providers at Hospital ; n=,667 Providers in 09 national hospitals. Note: Only facilities with >5 PPMs are included. 7 8 Nurse Individual Results for nd Assessment Second assessment results show less variation and higher scores 9 5