Staff development is an ongoing, never-ending event. New practices, new equipment, new treatments, and new ways of doing the work are evolving, sometimes faster than we as practitioners can assimilate. Having tools for successful just-in-time learning is essential in our environment of health care on steroids. This column offers some tools to consider as you expand your thinking about the use, development, and dissemination of new technology-based professional development delivery methods.
What Are QR Codes?
Quick response (QR) codes are now an essential tool for the professional development specialist. If you have not yet started using QR codes, consider this tool as an essential tool, similar to a keyboard or old-fashioned pen. QR codes, which first appeared in 1994, were invented in Japan for the automotive industry. QR codes are the small, black-and-white squares that you scan with your smartphone.
QR codes work by creating a bar-code that points to a website or application. Until recently, a special app was needed to read these codes; however, newer camera phones now have the ability to read the code and go to the linked site. It is as simple as point and click. It is this simplicity that transforms just-in-time learning.
QR codes are in the public everywhere, from wine bottles, to movie tickets, to Snapcodes that act as a form of social media that garner more than 8 million codes a day (Pierce, 2017). The use of these codes within health care also can be educators' answer to the essential Lean question, “How does the work tell you what to do?” Case use of these codes follows, starting first with the specifics of how to make your own QR codes, which is relatively simple.
Initial considerations for creating your own QR codes include the ability to store videos and teaching material on your internal website, web-based, or cloud-based sites, partnership with your hospital IT/IS team, and clinical staff access to their devices or technology in the work setting. It would be a rarity if your staff did not have access to smartphones, at least their own. In fact, recent reports from Educause Center for Analysis and Research (2018) found more than 95% of undergraduate students own a smartphone. This is a must have for the majority of our frontline workers who grew up with technology.
Creating QR Codes
To make a QR code, you need to have access to a software app that will convert your link, or website location, into a unique QR code. There are free QR code maker apps available with an option for you to trial, or you can purchase a higher-level software app for a minimal cost. Free QR code apps might limit the number of “hits” or might allow you only to make a certain number of unique QR codes.
You also will need either an app on your phone that is a QR code reader or a phone that includes a QR reader in the camera function. A software program that allows you to make changes to your material if needed without having to generate a new code is recommended. Free QR code apps are available; however, you will lose the ability to change your material linked to that code.
There are many use cases for QR codes, such as class registration, newsletters, equipment videos, and just-in-time learning. Bradley and Godin, in their February 2020 article, describe how QR codes were used on new equipment during orientation of all clinical staff to the new television system within patient rooms. Staff would scan the code, placed on a flyer or a button worn by the preceptor, to access a short video explaining the functionality of the new equipment.
This technology also was used for new ceiling lifts. Not only did staff have access to this learning during orientation to the new building, but this information and link also served as just-in-time learning at the moment they needed it. This makes this technology a game changer. Imagine what your staff might want to have QR coded for easy reminders.
Once you start down this path, it will be important to create the structure to prioritize requests coming forward. You might consider use of QR codes for efficiency within your own work stream, such as linking to electronic registration systems. This is a high-use item that if done consistently will provide you with more time to make more QR codes for other functions. You also might consider using these QR codes for high-risk situations. For example, the code team at Stanford Children's Health has QR codes placed on the code carts for immediate access to the sepsis protocol—a game changer.
New Technology for a Pandemic
Use of this technology has been in place for the past several years at Stanford Children's Health in northern California and was an essential tool for the recent ongoing just-in-time learning environments. QR code technology was used extensively to manage the revolving door of training updates required during the recent health care crisis with the COVID-19 pandemic. Information and new training tips were urgently needed to inform and train staff on the obtainment and proper use of personal protective equipment (PPE).
The information was changing so rapidly with guidance coming from the Centers for Disease Control and Prevention (CDC) and local health departments that at times, training material and communication needed to be updated daily to coincide with equipment and supply changes. This meant the typical method of paper flyers or printed materials would not work. There would never be the ability to distribute, collect, and redistribute in a manner that was accurate and up to date. The only option for immediate access, up-to-date current information and training material was through a tightly controlled electronic platform.
Normally, leaders, educators, and staff are given time to evaluate, educate, and prepare for changes in supplies and equipment. During a pandemic, new rules apply; you use and train on what you have and what you can get through your supply sources. This meant new PPE and equipment were coming in through the supply chain that might look different to staff or have different steps and processes for use. Technology and QR codes became a key method, along with the hospital intranet, for staff to access information around use of new equipment and supplies.
For staff use, the education team was able to have QR codes located next to the new equipment readily available for them in the moment they needed it. The codes linked either to a tip sheet or to a short 1- to 2-minute video. On the back end, a designated educator ensured the information was the latest version of instruction, based on updates from the CDC or health department. The QR code remained the same, but the material on the back end could be changed to reflect the most up-to-date information.
Flexibility, adaptability, and access are essential for training our current health care workers. Having a tool-kit of technology-based tools is our future. Starting with QR codes is an easy first step.