Intermountain Healthcare


The government, both state and federal, requires health care facilities to comply with a laundry list of training requirements. Everything from medical procedures to cleanliness is regulated. For example, federal privacy regulations not only require notifying patients about their privacy rights but also training employees so they understand privacy procedures. In addition, hospitals themselves, to ensure quality care and retain their certification, continually educate and test staff members such as nurses on a wide range of skills and then document the fact that they have done so.

One such hospital chain, Intermountain Health Care, is no exception. This organization, with 21 hospitals in Utah and Southern Idaho as well as numerous clinics and care centers, had been providing compliance and certification courses to employees in the traditional manner through stand-up presentations and paper tests. However, IHC found that manually documenting training for 25,000 employees required ever increasing resources, costing the company nearly $1 million annually.

The old educational system required that employees expend valuable work time to attend class. That forced the hospitals to hire additional staff to cover the time when these professionals were attending required courses, another added expense and a scheduling nightmare.

Using Questionmark

IHC decided to confront this challenge by developing and then offering short computer-based course modules and then testing students immediately afterwards using computerized assessments. The courses consist of over 350 modules that employees can take on the hospital floor during downtime or when there is satisfactory coverage. Some of the modules provide information about state, federal, and corporate regulations. Others review critical procedures such as blood-borne pathogens. Interactive training modules run for three to five minutes.

Each nurse/employee reviews a short CBT program or a video and then takes a computerized test or survey using Questionmark to ensure both that they have actually taken the course – an important compliance requirement – and have understood the material. This allows immediate tracking for subsequent employee surveys.

Some of the hospitals have set up small training areas where the employees can take courses and complete the tests. Others use computers right at their nursing stations. The critical factor is that nurses can take courses while they remain near patient rooms.


Using online courseware and testing with Questionmark has had profound effects upon Intermountain Health Care, some intended and others serendipitous. As the hospital chain hoped, the technique has saved the institution a great deal of money. Not only does the system dispense with paper and stand-up presentations but it also frees up supervisors from having to document participation by employees. Supervisors can, using Questionmark together with the Pathlore Learning Management System, quickly discover who has and who hasn’t taken – and passed – any particular course. The nurses themselves also learn what they’ve completed and what remains to be taken.

IHC was surprised to discover that using Questionmark has actually forced test authors to really think about what they are doing and, therefore, create better tests.

“Some people can get a bit lazy when they write tests and create questions such as fill-in-the-blank,” said Scott Wilde, senior consultant for documentation and training at IHC. “We discovered that using Questionmark caused people to actually make better tests. They have to think about the questions more and, in the long run, came up with an improved assessment.”

Since all of the hospitals in the system utilize the same electronic materials, the organization has been able to better align all of its policies and procedures and keep those policies current, something the manual system didn’t encourage. That’s particularly important because regulations and procedures change continually and using computer-based training in conjunction with Questionmark enables IHC to easily keep pace with those changes.