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 Table of Contents  
Year : 2019  |  Volume : 5  |  Issue : 1  |  Page : 3-5

A resource to share work procedures with the medical staff

Prosperius Institute, University of Perugia, Perugia, Italy

Date of Web Publication29-May-2019

Correspondence Address:
Paolo Milia
Prosperius Institute, University of Perugia, Neurorehabilitation and Robotic Area, Umbertide, Perugia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/digm.digm_4_19

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How to cite this article:
Cusco E, Cencetti S, Caserio M, Milia P. A resource to share work procedures with the medical staff. Digit Med 2019;5:3-5

How to cite this URL:
Cusco E, Cencetti S, Caserio M, Milia P. A resource to share work procedures with the medical staff. Digit Med [serial online] 2019 [cited 2023 Mar 29];5:3-5. Available from: http://www.digitmedicine.com/text.asp?2019/5/1/3/259308

  Introduction Top

Quality management in health care is a critical requirement for health-care organizations. Over the past 20 years, there has been a constant update on health law and standards. This global change has brought, on the one hand, a general orientation to a more patient-centered health-care system and to the measurement of patients' perception of health-care quality. On the other hand, it has brought a timely response to professional quality. In this scenario, Joint Commission International (JCI) is “the world's leader in health-care accreditation and the author of the most rigorous international standards in quality and patient safety” (JCI, nd).[1] JCI identifies, measures, and shares best practices in quality and patient safety. To collect them, JCI uses its panel of experienced physicians, nurses, administrators, and public policy experts to guide the development and revision process of the JCI accreditation standards. These standards are grouped into three major areas (JCI, 2017):[2]

  • Those related to providing patient care
  • Those related to providing a safe, effective, and well-managed organization
  • Those related to medical professional education and human subjects' research programs (for academic medical center hospitals only).

These international standards can be used and followed to guide the efficient and effective management of a health-care organization, to improve the quality and efficiency of its own services, and to become aware of those standards that all organizations must meet to be accredited by JCI (ibidem).[2] The Prosperius Tiberino Institute aims to guarantee its brand as an excellent national and international center of rehabilitation and as a reference center for high technology in the rehabilitation field. To achieve this aim, a complex training path has begun in 2016 toward the continuous improvement of the organization and to the accreditation with Joint Commission. The result of the past 2 years has been the definition of an inventory of the procedures and applications of the best practices to reduce risks and manage human, technological organizational resources. According to the latest technological development, the traditional education is supported or replaced by distance learning, which allows learning remotely without being in regular face-to-face contact with a teacher in the classroom. In this scenario, at the end of 2018, the Prosperius Tiberino Institute has set up a learning management system (LMS) platform to make staff aware of the organizational procedures. The objective was to train the staff (120 professionals) and make them aware of the work completed and of the documents produced.

  The Platform and Shareable Content Object Reference Model Standards Top

The e-learning needs to lean on platforms designed specifically for the transmission of the information. These platforms are like virtual classes equipped with software for analyzing user activities. The institute had chosen to set up an LMS platform for a faster distribution of the documents. An LMS “is a software application that is used to administer, track, report, and deliver training or educational courses” (Ellis, R. K., 2009, p. 1).[3] It is a kind of virtual class that promotes the exchange of information through forums and chat groups and has support available from a content tutor and a technical tutor. The main features of the platform are as follows:

  • Feedback and interactivity

  • The ability to interact among stakeholders (teachers, tutor, and students…) in a training context is essential. The two-way communication allows students to have appropriate and timely feedback about their activities. In the project's platform, there is a chat group, and the option to contact a content tutor about any questions regarding procedures and technical assistance. This possibility guarantees constant support and guidance for a more effective and motivational learning experience.

  • Content accessibility

  • The content accessibility feature makes it possible to pause the viewing and reading of content and return to them later.

  • Monitoring

  • The monitoring feature makes it possible to check the progress of the activities completed by the registered users.

To achieve good monitoring, Shareable Content Object Reference Model (SCORM) standards have been implemented. SCORM is the acronym of “SCORM” and is a set of standards and protocols that guarantee that given training content is traceable and reusable in various LMS training environments or platforms (“SCORM, the reference standard for e-learning content,” 2014).[4] It standardizes the way in which e-learning courses are created, and how they are launched. Technically, SCORM consists of content packaging and all of the resources needed to deliver a course into a single file. It also consists of runtime communications for communicating student information to and from the LMS.[5] It is possible to have information that help to achieve platform's characteristics:

  • Whether the course has been completely viewed or not
  • The time taken during the various sessions of access
  • The number of accesses or attempts
  • A bookmark of progress within the course
  • Whether or not the test has been passed (if the course has a final quiz).

  Context and Method Top

The Prosperius Tiberino is a neurologic and orthopedic institute of rehabilitation in Umbertide (Italy). It has 112 rehabilitation beds and treats on average 1600 patients a year (66% of whom are orthopedic patients and 33% are neurologic patients). The institute has 120 employees within rehabilitation (doctors, nurses, physiotherapists, and psychologists) and administrative staff. Last year, small groups of five or six members were formed to research the best practices about different areas of health care and to write down procedures to describe the process studied. About 30 procedures have been written and distributed in 10 “chapters” uploaded to the platform. The 10 modules based on JCI's standards are as follows:

  • Access to Care and Continuity of Care
  • Medication Management and Use I
  • Medication Management and Use II
  • Risks Prevention and Management I
  • Risks Prevention and Management II
  • Prevention and Control of Infections I
  • Prevention and Control of Infections II
  • Management of Information I
  • Management of Information II.

These 10 modules involve different procedures and protocols which describe health-care processes of the institute.

All of the staff's E-mail addresses were collected to send instructions for how to use the system, as well as the corresponding username and password to access the platform. It is possible to access the platform for 3 months. At the end of every module, there is a questionnaire to assess the knowledge of users and to consider whether to repeat or to clarify unclear information. To achieve a more targeted distribution of the procedures, a distribution list indicates which documents are required for a specific role and which are optional. In this way, it is possible to read all the procedures, but some modules are mandatory depending on the professional's role. In addition, a self-report questionnaire is delivered to assess the quality and the perceived utility of the training. The questionnaire will provide relevant data about the platform for modifying and projecting new functions. At the end of the year, a final survey will be done by experienced professionals to verify the actual implementation of procedures and to plan an eventual retraining. This survey will produce a final report to highlight the actual implementation of the procedures read and learned.

  Indicators Top

The main objective is to train the staff about all of the new procedures and to consequently improve the quality of health assistance. To achieve this, it is important to verify the actual access of all professionals of the institute and the use of the platform in general. The indicators are shown in [Table 1].[6]
Table 1: Quantitative and qualitative indicators

Click here to view

  Conclusions and Future Implications Top

This training plan provides a useful tool for the institute. The platform can be used to share a variety of information. In addition, it provides accurate tracking of users' activity. This characteristic gives greater security and helps the management to have a first impression about new employers. In this pilot project, PDF documents have been used to give the planned information. A future implication can be to implement more structured organizational training using different types of content (such as videos, slideshows, and images….). Using more attractive formatting of material can also ensure a more effective approach to the learning.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Joint Commission International. What Sets Us Apart; (n.d.). Available from: https://www.jointcommissioninternational.org/about-jci/what-sets-us-apart/. [Last retrieved on 2019 Feb 07].  Back to cited text no. 1
Joint Commission International. Joint Commission International Accreditation Standards for Hospitals. 6th ed. USA: Joint Commission International; 2017.  Back to cited text no. 2
Ellis RK. Field Guide to Learning Management Systems. ASTD Learning Circuits; 2009. p. 1-8.  Back to cited text no. 3
Sharable Content Object Reference Model. The Reference Standard for E-Learning Content. Sharable Content Object Reference Model; 4 April, 2014. Available from: https://www.skilla.com/en/blog/scorm-the-reference-standard-for-e-learning-content_40/. [Last retrieved on 2019 Feb 07].  Back to cited text no. 4
Jones ER. Implications of SCORM™ and Emerging E-learning Standards on Engineering Education. In: Proceedings of the 2002 ASEE Gulf-Southwest Annual Conference. The University of Louisiana at Lafayette; March, 2002. p. 20-2.  Back to cited text no. 5
National Commission of Lifelong Learning. Agenzia Nazionale Peri Servizi Sanitari Regionali. Manuale Nazionale di Accreditamento Perl'Erogazione di Eventi ECM. National Commission of Lifelong Learning; 2018.  Back to cited text no. 6


  [Table 1]


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