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IPGems
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This contest entry describes the performance support intervention prepared for Hurley Medical Center, Flint, Michigan, in the spring of 2000.

Hurley Medical Center manages hospital administration using a mainframe-based system called "Invision," supplied by SMS. Hurley has been using this system for about 18 months, and realized that further performance support was required to assist primary registration staff ("registrars") who are responsible for recording the details of every patient who comes into the hospital before treatment can be provided.

Following an analysis of the performer audience and the technical operation of the mainframe software, it was decided to concentrate on less experienced performers, and to provide a mixture of explanation and direct intervention to support their learning the Invision system and the registration procedures carried out at the hospital. The resulting tools are able to be used by inexperienced performers directly, and also by trainers/senior staff to provide more structure to the learning process.  Experienced performers would be able to make use of the support tools in order to learn new system functionality, particularly related to insurance processing.

The Performance Issues Addressed

The key performance issues identified were:

• the challenge of getting information about a patient in the distracting hospital environment (and when patients may not have all necessary documents with them) that would be reliable for treatment and for insurance/billing
• prompting the patient to make decisions about such things as which insurance plan to use and who secondary guarantors for bills would be, when the reasons for requiring the answers might be unclear
• performers finding themselves having to interpret medical, insurance and legal language into terms recognized by the system
• needing to process patients very quickly at peak times, where introduction of a full Windows-based user interface could possibly slow down processing time and lead to inaccurate "short-cuts" being taken
• needing, over time, to transition performers away from support tools towards direct use of the system as their experience grew
• users stratified into three main types with very differing needs – one group of users, in particular, required support because they rarely performed the task (a few times a week)
• ultimate users of the data (medical staff and billing) had quality needs that were not clearly understood by data input staff