Result card

  • ORG4: What is the process ensuring proper education and training of the staff?

What is the process ensuring proper education and training of the staff?

Authors: Valentina Prevolnik Rupel, Taja Čokl, Eleftheria Karampli

Internal reviewers: Ulla Saalasti - Koskinen, Elle Kisk, Ricardo Ramos

To answer the questions in the assessment elements we mainly used the basic literature search provided for the whole project. Additionally, two more systematic searches were used: one performed by ORG and ECO domains (described in methodology of ECO domain) and one perfomed by EFF, SAF and ECO domains (described in SAF domain).A qualitative handsearch (google; keywords: structured telephone support, heart failure, telemedicine, telehealth consulting for professionals) was done adding further information for this question. The results are provided in descriptive way.

Proper education and training of the staff is ensured through the courses for nurses on HF (formal HF certification) and on RM, which is assured by telemedicine providers in case any devices for home symptoms measurements are included. As far as the STS, no specific training were found to be offered to staff in the literature.

Stork et al claim {200} that education of HF nurses is very important and was carried out at the University of Würzburg. The concept of training followed the strict standardized documented and verbal concept and the content concentrated on pain, sadness, depression and anger. All the modules used in STS calls with patients were worked through. All the contents was discussed with the cardiologists and phsychologist. The training was alo carried out later, at the place of STS provision, where the work of the nurses was supervised and the education was structured, based on discussion of weekly problems that might have arisen.


Nurses typically spend the most time with patients and can best evaluate educational needs as well as identify barriers to learning, and should therefore lead patient education efforts. Therefore, formal HF certification provides nurses with advanced knowledge and demonstrates their commitment to a higher level of care for their patients. In addition, it provides nurses with a sense of accomplishment as well as enhances personal credibility and accountability. Health system support for HF nurses to provide patient education should include {7}:

  • Programs that enhance nurses' knowledge of HF self-care through a sound educational curriculum
  • Encouragement for nurses to become HF certified
  • Provision for adequate staffing that includes sufficient time for discharge teaching
  • Evidence based/HF guideline-directed content for HF patient education curriculum
  • Ability to provide multimodal education in several languages
  • EMR for easy documentation of the education plan and evaluation of learning
  • Models that integrate comprehensive patient education as part of overall HF management within a DM structure
  • Provision for a multidisciplinary approach to patient education by those who are experts in HF care using nurses, physicians, pharmacists, social workers, dietitians, cardiac rehab specialists and other health care professionals.

As far as the STS itself is included (and not HF), no specific training were found to be offered to staff in the literature.

Browsing the official different telemedicine providers’ websites, the following information were found:
The telemedicine providers offer the following to medical professionals {11}:


  • Program support
    • Defining your program goals and metrics
    • Program scheduling, operational timeline and logistics planning
    • Inventory management (installation, deinstallation, and cleaning processes)
    • Clinical workflow and business process consulting
  • Resource planning
    • Defining the right operational model for your program
    • Evaluating clinical readiness and measurements needed
  • Clinical support
    • Defining patient selection criteria for telehealth
    • Patient stratification tools, including surveys on medication compliance, nutrition, depression, etc., to identify patients at risk for hospitalization
    • Reporting for program administrators and physicians
  • Training and e-learning:
    • Online CEU courses and telehealth resources
    • Clinical staff education and training on telehealth devices, clinical and administrative software, protocols, best practices, and management of surveys
    • Patient education, user manuals, and training videos
    • Telehealth Certification Program to credential your clinical staff
    • Managed through regional field supervisors. 
Rupel V et al. Result Card ORG4 In: Rupel V et al. Organisational aspects In: Jefferson T, Cerbo M, Vicari N [eds.]. Structured telephone support (STS) for adult patients with chronic heart failure [Core HTA], Agenas - Agenzia nazionale per i servizi sanitari regionali ; 2015. [cited 5 July 2022]. Available from: