Cross-train Employees Using the ADDIE Model
Create successful cross-training programs using this time-tested instructional design model.
ADDIE is an instructional design model that helps instructors, trainers, facilitators, and educators plan and create courses and training programs. It is the most well-known framework for instructional design and is used both as defined and as a base component in other models.
The ADDIE model includes five phases:
To illustrate the ADDIE principles and what they can do for your organization, let’s walk through the process of conducting a cross-training session to transition 20 outpatient coders to inpatient coding within 20 business days.
1 – Analysis: Explore All Avenues and Lay the Foundation
First, what is analysis? Analysis is the process of examining something in an organized way to learn more about it. During this phase, you will assess why the course is needed, what you are going to achieve by offering the course, and the characteristics of the learners. From a strategic perspective, the training is assigned by some possible environmental aspects like market demand, business needs, or customer requests.
Set a Goal
As part of due diligence, the first and foremost action should be to set a goal, which is SMART (Specific, Measurable, Achievable, Realistic, and Timebound). Here, the goal is that a team of 20 outpatient coders needs to know how to code inpatient records within 20 business days.
After setting the goal, the next step is to create a curriculum to flesh out all the steps necessary to carry out the goal. You should already know that the learners have coding certifications at this point, but they need more information and instruction regarding inpatient ICD-10-CM official coding guidelines; determining principal diagnosis; sequencing secondary diagnoses; assigning complications and comorbidities (CC) and major complications and comorbidities (MCC); present on admission (POA) indicators; ICD-10-PCS official coding guidelines; identifying correct root operation of procedures; building ICD-10-PCS codes of principle procedure and secondary procedures; and deriving the correct Medicare Severity-Diagnosis Related Groups (MS-DRGs). These are all basic steps, but each step has its own guidelines and conventions.
After analyzing this, you must then find out what your learners already know about the subject about to be taught and analyze their experience and level of coding expertise. Bring your most seasoned, brightest, and best outpatient coders (professional/facility coders) to the table. This can be done by sending out a survey or choosing coders who ace the pre-assessment test. Knowing where your coders stand regarding your subject helps you know how much or how little to teach them.
Set Learning Objectives
Next, you must set learning objectives and knowledge and skill gaps. Learning objectives are what the coders should be able to do when training is completed. They are usually in the form of skills, attitude, and knowledge. You should establish ground rules and clear expectations regarding the acceptable behavior for each individual coder. A good way to write a learning objective is to fill in the form of this sentence: “By the end of this course, the participants should be able to (fill in the blank).” This is another time you must be very specific and use strong verbs that specifically define performance. You can use Bloom’s Taxonomy to create measurable learning objectives. Here is an example:
By the end of this course, the participants should be able to:
- EXPLAIN the ICD-10-CM and ICD-10-PCS Official Guidelines for Coding and Reporting.
- DESCRIBE how to select a principal diagnosis and sequence additional diagnoses with POA indicators.
- DEMONSTRATE how to build ICD-10-PCS codes for the principal procedure and secondary procedures.
- DEVELOP the correct MS-DRGs for inpatient records.
By setting the learning objectives, you have analyzed the training needs and can now create the course. Next, we progress to the design phase.
2 – Design: Never Take a Trip Without a Map
Design means to plan. You should plan to define how the training will be executed. During this phase, you will create a road map for accomplishing goals and objectives. You will have a timeline of 20 business days to complete the training program.
Always keep in mind that scheduling is the most common source of conflict in a training. For the delivery method, the training should be virtual. Take all the information gathered during analysis and incorporate the findings into the design of the training. Your knowledge, expertise, and attention to detail all come into play during this phase.
First, decide on the structure and break down the training into five parts:
1. Introduction to training
2. Case scenario-based pre-assessment
3. Coding guidelines with coding examples and exercises
4. Q&A session
5. Case scenario-based post-assessment
With the structure in place, you can now outline the assessments, plan the case scenarios that will be used in the exercises, and utilize a feedback form to gather input from the learners. Next, you will plan the interface for the training program and create storyboards/prototypes of the course. By working on all these details, you and other stakeholders should never lose sight of the big picture.
Calculating assessments, choosing the right course format, and carefully putting together a game plan will make developing the course content a lot easier and more effective.
3 – Development: Readiness
Now that the planning phase is completed, it’s time to get the training off the ground. During this phase, seek approval from the key stakeholders for the storyboards and structure before you create the course content. This ensures that all are on the same page before you start the ball rolling. Most of your time will be invested in this phase because this is where the course materials are created.
Below are the requirements to create a course:
- Display the topic and introduce the presenter.
- Specify the learning objectives.
- Create clear and concise content.
- Provide a summary/conclusion.
- List resources/reference materials used.
You will finalize the syllabus and the course content by the end of this phase.
4 – Implementation: Live Session
After you have done your due diligence in the analysis phase, strategized your target training approach in the design phase, and transformed your plan of occurrence into reality in the development phase, it is time to deploy the training. This is the phase where knowledge is presented and deliverables become tangible.
The training should be delivered via a video conference platform such as Zoom. But what will that look like? First, give out the pre-assessments. Next, give an introduction and provide training based on the course created in a PowerPoint presentation. The learners will make their way through the training and exercises. Then, you can have a Q&A session that gives attendees a chance to clarify any questions they have. Once the course is distributed and users start taking the course, pay close attention to see if any issues arise. You should always have a backup plan to manage unforeseen circumstances.
5 – Evaluation: It’s Time to Measure Success
Anything that cannot be measured cannot be improved. You should monitor and validate whether the training has worked properly and goals have been achieved — from goal setting to goal getting. Verify that the training was conducted per the plan.
Evaluate the performance of the learners based on the scores from the post-assessment tests; and determine if they can meet the goals and objectives stated earlier.
You should also evaluate the lesson to determine how well the process worked and what needed more focus. The attendees should be asked to fill out a feedback survey form (see “Ask for Feedback” below for an example), and you should incorporate all the feedback into their next training program. Identify any gaps you need to fill and address them right away. Revise or modify the training system when necessary to improve it.
Finalize this survey prior to the closing stage. The training program cannot be considered complete unless the lessons learned are also completed. The training is considered successful only when stakeholders’ needs and expectations are met or exceeded.
TIP: Effective communication is essential. If you anticipate that you will miss the timeline/deadline, then you should communicate effectively and efficiently, which will help the team to minimize the friction and misunderstandings between the stakeholders.
Success Is at Hand
Continuous learning is essential to maintaining accuracy and remaining successful in the coding industry. Inpatient coders are in demand. By creating a cross-training course using the ADDIE training model, you will not only educate your outpatient coders but do so effectively and with high engagement. This will help outpatient coders successfully transition to inpatient coding — a win-win situation for both employers and employees.
AAPC's annual salary survey gives a good understanding of the earning potential within the medical coding profession.
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