By Steven Kawczak, Ph.D., Director, Professional Development, Cleveland Clinic, 2017 Alliance Vice President
Managing and administering a continuing education (CE) program for healthcare professionals takes a unique skill set. It requires skills in continuing education, in management and leadership, which is a distinct combination of competencies. Planning CE activities or maintaining an education program have many complexities and take significant resources. Content experts — no matter how brilliant or in tune with emerging science, gaps in practice or educational needs — cannot effect the development and implementation of educational content without the support of CE professionals who can manage CE activities or administer an educational program that provides mechanisms for disseminating content and an infrastructure to manage the learning.
Creating continuing education requires human resources, and it takes budgets, technical systems, regulatory adherence and project management. Even development of highly needed CE content that has negative financial results in its implementation or does not show a return on investment to stakeholders will likely not be sustained. CE programs must have quality and effective education design, but they also need alignment with institutional goals, and require regulatory, accreditation and legal adherence through the development and implementation of unique processes to ultimately demonstrate compliance. For these reasons, the management and administration of the CE program is a critical competency.
It’s wise to begin fiscal oversight by examining overall cost accounting the deliverables of the CE program. Starting here will help you to determine the scope of investment in your human resources necessary to administer CE activities, and such accounting will form the basis of activity and program budgets. Understanding the financial and human resources required to develop an activity is key to determining whether activities need to be funded by external or internal sources.
If your activities obtain or pursue grant funding, understanding the costs of production will help you to formulate budgets to share with prospective funders. Know well in advance if your program charges back production or accreditation fees to areas within your organization, across departments or contracts externally. Knowing the true costs will help you develop those fees.
When building activity budgets, be sure to consider all costs, whether they are internal or external to your organization, so you have an accurate understanding of the costs of producing education. Some key categories to consider are program development, fundraising, audience generation, content development, logistics, evaluation, venue, audio visual, accreditation, editing and faculty/speaker costs. Having a handle on activity costs will help you build and defend an annual budget, as well as determine how to allocate resources according to your needs, goals and production capacity.
One lesson we can learn from our continuous improvement colleagues is the importance of leveraging a process map to maximize efficiency, eliminate waste and improve effectiveness. You can use process maps to diagram any of your educational implementation processes, such as course accreditation/certification, disclosure and resolution procedures, or learner registration. You will likely be surprised at how complex a simple concept can become; developing a process map can expose ways to improve processes. Process maps are also useful for identifying costs of production if you are not time tracking your team’s efforts.
Ask your internal audit team or department heads for periodic reviews of aspects of your operation. Whether it’s your IT systems, financial controls or accreditation adherence, auditors can conduct a thorough review and help you identify areas of risk or opportunities to improve efficiency or compliance.
Partnering to Obtain Expertise
Becoming a leader in CE often feels like you must become a jack of all trades (while mastering them all, too!) because of the diverse nature of our profession and wide range of needs in a CE program. CE requires expertise in education, technology, finance, healthcare, law, medicine, nursing, accreditation, outcomes assessment and event planning. It’s hard to go it alone, and learning to collaborate effectively might be the most important trait for effectively administering your program.
It’s often unreasonable for any one person to be intimately involved in each detail of these diverse functions. Sometimes these services exist outside of the CE office. Knowing when to partner and with whom is key for ensuring adherence to sound business practices. Who are your key partners, both internal and external? Do you need to grow your network for the health and stability of the program?
Take care to align your CE program with stakeholders inside your organization. Leveraging expertise within your organization ensures alignment with institutional expectations and interpretations of governance expectations. For example, navigating legal issues relative to CE can be daunting; CE professionals often need to consider issues of copyright, stark law, property and personal liability, intellectual property, contracting and even visa issues, among others. Draw upon internal counsel whenever possible for help with these issues.
Build stable relationships. By working together repeatedly, you have an opportunity to teach other experts about the intricacies of CE, allowing them to provide better advice. Over time, you too will learn their “language.” Most importantly, maintaining relationships with the right resources (in my example, with your law representation) is foundational for successful management. The principle of partnering applies to your own staffing relative to program needs. As the needs of your CE program expand, you may find that the expertise or technology needed for meeting your goals are not within your existing team or infrastructure. Finding the right external partners can help you meet these business and educational goals. Good managers are great partners.
One caution about external partners: It’s critical to ensure alignment on expectations and interpretations of regulatory implementation with prospective partners. The last thing you want is to agree to create content together or jointly obtain a grant award and then realize that you don’t agree completely on processes for implementing regulatory standards or methods to document compliance.
CE Team Competency
Human resources are your most important asset. Tending to the engagement and development of your team is the key to building their professional satisfaction, creating a healthy work environment and maintaining overall competency. One strategy, particularly for developing leadership and specialty positions, is encourage team members to seek advanced education and certification.
Be smart about your systems (and reference NLC 8: Systems Thinking for skills in system development). You need technology (e.g., databases, IT/web solutions) to disseminate content, manage learners, complete registrations, collect feedback, manage finances, administer outcomes assessments, implement disclosure/resolution and document accreditation compliance. You will rely on these systems to report on activity and program progress, and likely need them to integrate with other platforms like electronic medical records, external content hosting, reference materials, etc.
It is vital to be strategic about technological needs. Research the marketplace so you make the right choices on technology. If you don’t find a suitable “off the shelf” solution exists, or are blessed with robust internal resources, you may consider building custom or modified systems to meet your needs. A word of caution: These solutions can be major investments and technology changes frequently. Be smart with your selection and think of the future as much as possible.
Remember that systems are tools and should not define your program. Ensure that you’re using technology to advance and administer your program, not that you’re implementing something in your program arbitrarily.
Accreditation and Regulatory Expectations and Adherence
A leader of a continuing education program should develop a clear understanding of accreditation and other regulatory expectations.
There are two reasons this is important:
- As a leader, it is your responsibility to obtain and defend the program’s accreditation. Having intimate knowledge and involvement in accreditation matters is expected. Even if you delegate the responsibility of accreditation implementation to members of your team, leaders should design and integrate accreditation standards into the CE program.
- Accreditation expectations can set you up for success. Requirements ensure that standards for education design, learning, independence and engagement with the healthcare community are woven into your program.
Accreditation serves as a foundation for implementation and guardrails on the type of education you will and won’t develop — the types of partnerships and providerships your organization allows. Your implementation of these standards will ultimately determine systems and processes, how you’ll track data and document compliance. Be heavily involved in your accreditation process and leverage standards to help design the way your program will work.
Establish clear and definitive interpretations of accreditation standards throughout the program so they can be easily and uniformly implemented across activities. Align these interpretations with your institutional goals and work hard to reach consensus with clinical and education leadership. For example, as you decide on an approach for obtaining disclosures and resolving potential conflicts of interest (COI), see how your internal COI is managed and align processes as much as possible. This reduces redundancy and minimizes the (all too frequent) perception that the CE office adds bureaucracy. The last thing you need is contention and debate with your content experts over accreditation interpretations. These issues distract, cause delays and can damage the perception of the CE office in your organization.
Benchmarking is a useful method for developing and validating approaches for implementing accreditation standards. Get to know the CE community and learn how others implement accreditation standards or document compliance. Members of the Alliance and sister societies can help you understand the spectrum of interpretations, defend your positions and provide information to share with internal stakeholders.
Identify and Manage Expectations
Effective leaders know how to identify and meet the expectations of stakeholders.
- What do your internal stakeholders value in CE?
- How can CE contribute to organizational goals?
- Are there unmet needs that the CE program could address today?
This understanding should be the foundation of your goals and priorities and should inform your messaging about CE. Your leadership needs to know what you do, why you do it and that you need their support.
Engage your organization’s leadership with key points about the value of CE and how CE is vital for achieving organizational goals. Whether through existing forums like an annual review process, annual planning or leadership forums, find ways to spotlight the work going on, the trends in your environment and the issues you are facing.
When communicating expectations to your teachers and planners, it’s important not to let your process, forms and tools speak for you. The tools to document compliance or administer a program do not actually create the program; communicate with your content developers and planners of CE in ways they can understand expectations of the CE office. Consider creating live training forums, tool kit reference materials or holding one-on-one orientation meetings. Remember that CE compliance or adherence to educational standards, while important, does not necessarily result in effective education or help educators improve their teaching skills. Part of your communication plan should be to teach your content experts and planners about CE and how your tools and processes the CE office provides can help position them to be successful in educating.
Managing Engagement in the CE Team
A healthy team environment involves shepherding personnel, developing skills and succession planning. Encourage staff to engage in the CE community to build their professional skills and networks. Interacting with peers helps to build skills in CE administration and identify best practices that can be applied in your setting. Develop a department engagement plan so your team remains focused on the mission of CE helping improve care, identifies ways to improve teamwork and individuals set goals around their own professional development.
Set aside regular time for team-building. You can use retreats, skills building workshops or even community service projects, which gets your team outside of their routines and provides a chance to build a better repertoire. Help your team members learn and grow. Set professional development goals together and help enable your team to achieve them. Expose team members to the full operation, accreditation and business processes of CE. This can help members to see how their role contributes to the operation and achieving the mission.
Finally, cultivate talent. As you see leaders emerge, help to position them for career growth and advancement. This develops an internal pipeline for leadership succession. These strategies can help keep the team culture healthy and ensures continuing and long-term success of your CE operation.
These tips and strategies around effectively managing and administering the CE program can help you meet business goals, ensure compliance, and better engage your team and stakeholders. Leading CE is a process, and remember, as a leader, you can also keep learning and improving. Being teachable yourself might be the most important part of this competency; it will help you adapt, embrace opportunities and improve your team.