14 March 2023

CASE: How LUMC NICU uses video to support ward staff and promote learning in the workplace.

The Challenge 

The Neonatal Intensive Care Unit (NICU) in LUMC Leiden (hospital) started a GPAL pilot in November 2020. In this department, prematures (babies who are born too early) and babies with problems around their birth are cared for. 

In attending to prematures, employees often have to work with complex equipment and must have a lot of medical knowledge directly at their disposal. 

“For us, GPAL’s main role is really that extra bit of performance support. Whether an employee is dealing with complex equipment or critical issues, the short instructional videos give nurses exactly the information they need at that moment. This really makes people feel a lot more confident in doing their jobs.”
– Lisette, ICN nurse and training & equipment expert 

For some time, the NICU had already been trying to improve the working and learning climate in the department. One of the main objectives was to facilitate better support for employees in carrying out more complex tasks. The NICU therefore introduced the Neon-wise project, in which staff critically assessed what could be improved in the workplace on the basis of four pillars. For example, employees could use a survey to indicate where they encountered inefficiencies in the workplace. 

In response to the Neon-wise project, several targeted improvements have been initiated, including GPAL. GPAL is a new way of training in which information is made easily and directly accessible to the employees via short instructional videos, whenever the need arises!

The Approach 

Many videos are already being made in the NICU by the various teams and departments. For example, the NICU doctor’s assistants have already enthusiastically made videos on how to make an ECG and one of the doctors has made videos on the new defibrillator. 

Furthermore, Lisette and two colleagues work one day a month to make instructional videos about the various equipment used in the department. Everyone in their ‘film crew’ has their own task; one person reads out the instructions, another performs the actions and the last one films.

“When we are making video instructions we want to follow the   steps of the official protocol, but you don’t always know the protocol by heart. We therefore decided that one person clearly reads out the steps of the protocol, a second person performs the actions and a third films the action.” 
– Lisette, ICN nurse and training & equipment expert 

Two examples of instructional videos made by LUMC

Filming the transport incubator

A good example of the usefulness of instructional videos can be seen in the case of the transport incubator. Within the NICU, there are two different transport incubators, one of which is only used occasionally. It is therefore difficult to keep knowledge up to date for this transport incubator. As Lisette explains: 

“There are extensive protocols and brief instructions available for the transport incubator, but some parts are difficult to describe in words. A video with accompanying explanation is much clearer. The various parts are now filmed step by step and placed in the app. This way, the employee can easily choose which part to watch for support.”
– Lisette, ICN nurse and training & equipment expert 

Videos are also made in cooperation with other departments, such as the Geboortehuis Leiden (a maternity centre), who have also been using GPAL for some time. Especially during the COVID-19 pandemic, video instructions were used to quickly inform staff of the adjusted measures and to install standardised work instructions. The videos made by Geboortehuis Leiden were also shared with the employees in the NICU and vice versa. This is not only convenient, but is also a lot of fun for employees, who suddenly get a peek behind the scenes at a different department. 

“Everything that had to be changed because of COVID-19 was discussed, explained and recorded on video. The GHL then mainly made videos about the treatment of the mother and we made the videos about the child care. We did that in collaboration with each other. It was efficient, but it was also a good time to coordinate the various protocols and to clear up any uncertainties, because it had to look good on the video!
– Lisette, ICN nurse and training & equipment expert 

The Results 

A few months after the start, a general survey about GPAL was conducted among the nurses in the NICU department. 

“We conducted a survey in March and it really generated a lot of positive responses. Nurses and doctors are really happy with the videos.” 
– Lisette, ICN nurse and training & equipment expert 

The ability to quickly look up relevant information and the possibility of keeping the short videos on hand, were often mentioned as positive in the survey. Most NICU employees also want to be more involved in improving the videos. From the survey, helpful tips on filming and topic suggestions were used. 

Standardisation of work with video 

Another advantage is the standardisation of work tasks, which is facilitated by the shared instructional videos.

“What I certainly like about GPAL is the cross-departmental nature of instructional videos. Everyone gets the same instructions, for example learning to dress for protection in the COVID period. This standardisation is, I think, difficult to achieve in any large organisation, but visual material works very well for this and can always be looked back on.” 
– Lisette, ICN nurse and training & equipment expert 

The big difference with the past, Lisette explains, is that previously procedures were taught one-on-one by different trainers, which often meant that different working methods were taught to new employees. You can imagine that one trainer is more focused on a certain aspect, while another trainer might draw attention to something else. Written job instructions work well, but also very time intensive. With videos, the instructions are recorded according to the protocol. If the video is not good or unclear, then you can make it again very quickly. 

From E-learning to personal and accessible learning

Previously, workplace learning was mainly facilitated by E-learning and theory- and practical-tests. “But we wanted to do that differently,” Lisette explains, “we wanted more variety and to facilitate learning when it’s really needed.” With E-learning, you learn something and only get to deal with it in practice much later. By then, a lot of knowledge has already been forgotten by employees. 

“E-learning is useful as back-up information, but you often don’t have the time to look it up when you need the information, for example when a child is admitted to the ward acutely. You actually want nurses or doctors to be able to watch short videos, at the moment of need.”
– Lisette, ICN nurse and training & equipment expert 

A good example is the thoraxdrainage, a procedure to treat a collapsed lung. The nurses, as Lisette explains, learn the thoracic drainage during their basic training and then keep this knowledge up to date via an E-learning module and a practice test 1x per year. However, in the field nurses come across this produces very little, especially if you work part-time. In this case, it is very valuable to quickly watch a short instruction video to refresh that knowledge. Watching an instruction video is sometimes also more fun than going through an E-learning module. Thus, you create more diversity in the learning methods available to staff.

Give more confidence to employees in performing their work

Video instructions do not only make learning more fun, the visual aspect also makes the explanation clearer and more precise. A major benefit of this is that most nurses feel more confident in doing their job. The videos are also sometimes watched at home by employees to refresh the knowledge they might need in the upcoming weeks. 

“You can start reading 20 pages of protocol, but you often lose the overview after just two pages. Therefore, we have now partly converted that protocol into short instruction videos. Especially to clarify the things that happen less often.”
– Lisette, ICN nurse and training & equipment expert 

In the future

In the future, the NICU wants to make many more videos with the GPAL app in terms of training, such as instructions about the Patient Data Management system and the alarm system. The NICU also sees other possibilities with GPAL, such as making onboarding for new employees. Lisette furthermore adds that she recommends GPAL to other hospitals and departments. She often already shares her own positive experiences with GPAL in national meetings or training sessions and hopes to enthuse others in the process.