The UNOS professional education team's strategy started with envisioning, moved to executing, and ended with evaluating results.

United Network for Organ Sharing manages the US national transplant waiting list and matches donors with recipients 24 hours a day, 365 days a year. In addition, the nonprofit organization brings transplant community leaders—ranging from coordinators to surgeons and everyone in between—together to develop policies that make the best use of a limited supply of organs and monitors every organ match to ensure adherence to organ allocation policies.

As the only organization in the US doing that work, UNOS fields requests for educational resources from healthcare professionals from across the country. Educational products can manifest in the form of live webinars and recorded presentations, videos, documents, and e-learning modules. Such resources serve to educate and inform transplant professionals about industry policy developments and best practices.

Trying out different structures

Since 2017, the process by which the professional education department fulfills requests for resources, as well as the department's structure, has seen three iterations in as many years. In 2017, the department's leadership team, comprising the director, instructional manager, and two team leads, managed five curriculum development instructors and three instructional designers. The instructional manager assigned one CDI and one ID for incoming requests, and both team members billed their time accordingly.

In that arrangement, the CDI acts as the project manager and is responsible for identifying target audiences, defining instructional objectives, engaging subject matter experts, analyzing relevant material, and writing content and scripts. The ID selects appropriate instructional methodologies; creates storyboards; proposes e-learning solutions; and uses design tools to develop engaging, interactive educational programs. During that iteration of the department structure, the professional education team completed 30 projects.

In 2018, when the department began working with HR to deliver internal training, the demand for educational products increased. Department leadership addressed the bigger demand by adding two new IDs to the team and modifiying the approach to the assignments.

Although the instructional manager continued to pair teams and dole out assignments, no longer did the CDI act as project manager. Instead, pairs adopted a team approach in which both the CDI and ID are accountable for the project, but each is still accountable for their own tasks. During that iteration of the department structure, the five CDIs and five IDs created 45 projects.

The leadership team recognized the progress the team achieved in 2018, but leaders also saw opportunities for improvement when analyzing billing hours. According to research the Association for Talent Development conducted in 2017, the industry's average billing time for a limited-interaction e-learning module was 71 hours. Comparing that figure with the department's time per project average of 125 hours, the difference was stark—and it was hard for leadership to ignore.

In that iteration of the department structure, where there was an equal number of CDIs and IDs, the instructional manager did not always assign projects to the same pairs. That had the potential to result in one CDI working on two different educational offerings with two different IDs or vice versa, which sometimes caused confusion among team members. And naturally, some pairs worked better together than others, so instead of working as partners, some IDs offered to complete projects by themselves.

A change was needed. Therefore, the department's leaders set out to find a more efficient way to develop instructional offerings.

Envision

Without any regard to existing department structure, the leaders began envisioning how the team needed to look and identified four objectives toward achieving their goal:

• Decrease billing time per project to be more in line with the industry standard.

• Increase the number of instructional offerings produced per year.

• Retain current employees.

• Continue providing quality products and maintain learner satisfaction.

After some thought, department leaders reasoned that having two roles assigned to each project contributed to billing time totals. The solution? Combine the CDI and ID roles and create a new ID position that took on the responsibilities of both roles. With the thought that the new structure would be more efficient, leadership planned for eight full-time ID positions. The leaders documented what they envisioned for the department and penned a new job description for the ID role. They later vetted the idea with HR and secured the appropriate approvals from the executive team.

Fortunately, eight existing employees could transition to the new role, and two other employees took on different roles and responsibilities in the organization. The eight employees moving forward needed upskilling, and leadership needed to provide support and resources—all of which became part of the execution phase.

Execution

Internal communication from department leadership to the team about the planned changes marked the beginning of this second phase. The leaders, joined by HR representatives, held a meeting with the entire team to explain the planned changes and discuss next steps.

Initially, tensions were high. However, once the team saw the new organizational chart with enough boxes for everyone's names, the feeling in the room relaxed. Team members became enthusiastic about the planned changes and looked forward to learning new skills and transitioning to their new roles.

Given the varied backgrounds of the eight IDs, skill development would be critical to their success. The instructional manager met with each person to discuss and identify what skills they needed to be successful in the newly designed role. Generally, learning objectives for the previous CDIs centered on rapid instructional design tools proficiency, while the learning objectives for the previous IDs focused on project management.

The instructional manager tasked all team members to complete their learning objectives within a six-month transition period. Based on those learning objectives, IDs enrolled in training courses and other learning opportunities to upskill while continuing to gain practical experience by working on instructional projects.

UNOS has a robust professional development focus, and IDs could access courses using existing accounts with an online learning content provider. And because the reorganization took place in 2020, amid the pandemic, all learning was virtual. By the end of the six-month transition period, each ID invested approximately 80 hours of training, not counting on-the-job projects to practice their learned skills.

To support their learning, IDs created collaborative channels on Microsoft Teams, participated in twice-monthly teach-back sessions with each other, and met with their manager weekly to talk through the process of becoming an instructional team of one instead of two. At the end of the transition period, the instructional manager met with each of the IDs to discuss their progress and determine whether any skills gaps existed. During the one-on-one meetings, the ID and the manager openly shared strengths and opportunities for improvement.

While the IDs were busy learning new skills and producing instructional offerings, the leadership team worked on a communication plan for internal partners on the new department structure. Because the reorganization was not intended to have an impact on outside partners or with learners, the focus was on describing the new role to internal partners so that IDs could establish partnerships with those who worked closely with the team.

Evaluation

Using the specified criteria for success, department leadership developed an evaluation plan. To determine whether billing time decreased per project, the leadership team gathered 2019 data from the time management system on time billed with the CDI and ID model. After the initial transition period, leaders gathered data for an additional year with the ID-only model in 2020.

The data shows a significant decrease in the hours billed after the department's reorganization and upskilling (see table). Moreover, the IDs' performance now more closely aligns with the industry standard.

During the first year of designing and developing instructional offerings, the IDs increased their output from 45 to 83 offerings in 2020. Of note, the department remains at eight IDs despite the increase in volume of projects produced. Although there was some turnover during the year, it was due to promotions and not a dissatisfaction of the new ID role. The IDs continue to look for ways to improve efficiencies and work closely with their manager and each other to elevate the look and feel of instructional offerings.

Despite clear improvements, the leadership team is mindful that the transplant community's satisfaction is the chief success criterion. A recent needs assessment revealed learners on average rated these course features between 4.0 and 4.4 on a five-point Likert scale: timely, relevant, current, engaging, motivating to change behavior, and helpful for the overall success of their organization.

In addition, comments learners provided in the free text responses confirmed their satisfaction with the offerings. "Courses are well developed and the content is well prepared. It appears a lot of effort and consideration goes into each one," one client wrote. "I can tell that things are getting better and better and there is more focus on quality and engaging ways of presenting topics," shared another.

Ultimately, the success of the professional education department's reorganization proves that there is more than one way to do the work and that challenging the status quo can lead to big improvements. By envisioning a better way, executing a well-thought-out plan and evaluating pre- and postdata, the department's reorganization created a more efficient structure while maintaining quality offerings and high learner satisfaction.

United Network for Organ Sharing

Industry:

Nonprofit

Workforce Size:

400

L&D Staff Size:

10

HQ Location:

Richmond, Virginia