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using microlearning in healthcare settings

Are we already in a recession? Are we headed towards one? Regardless, all of us have felt the effects of rising inflation, when we are purchasing our weekly groceries, dining out at restaurants or planning a trip. But one area consumers aren’t seeing an increase in is healthcare. 

Unlike other sectors, payment rates are set ahead of time and can’t be adjusted once they are locked in. “The 2022 projections were finalized in the first half of 2021, before general inflation really took off,” Tami Luhby reports for CNN. “Also, many forecasters at the time felt the price increases would be temporary.”

While this is welcome news for consumers, hospitals are seriously struggling to keep their doors open to serve their communities. According to the American Hospital Association (AHA), “Most of the nation’s hospitals and health systems were operating on razor-thin margins prior to the pandemic; and now, many of these hospitals are in an even more precarious financial situation.” 

So, what else is contributing to this growing crisis? Let’s have a look at what our healthcare system is currently up against.

Lack of COVID-era financial relief & rising inflation leave nearly one-third of hospitals operating on negative margins

That nation’s hospitals received numerous rounds of financial relief to care for patients throughout the pandemic but that government funding has since stopped.

CMS reports that in 2021, spending for other federal programs and public health activity (the NHE accounts for categories that include the federal COVID-19 supplemental funding) is expected to have declined from $417.6 billion in 2020 to $286.8 billion. That nearly halves the government funding received in 2020. 

“Hospitals and health systems have repeatedly confronted a range of financial and operational challenges, including historic volume and revenue losses, as well as skyrocketing expenses,” The American Hospital Association (AHA) reports. “When coupled with rising inflation and growth in input prices, these expense increases have been severely detrimental to hospital finances, leading to billions in losses and over 33% of hospitals operating on negative margins.”

Drug and medical supply prices have also risen, respectively increasing 36.9% on a per patient basis compared to pre-pandemic levels and 20.6% through the end of 2021.

A growing staff shortage & resulting rising labor costs threaten patient care 

According to AHA, labor costs account for more than 50% of hospitals’ total expenses. So when the cost of labor rises, profits take a huge hit. This increase is attributed to a few factors, including hiring costly contract nurses to offset the staff shortage. And while these contract workers were already pricey pre-pandemic, staffing agencies raised their rates due to the high demand for travel nurses in certain areas. 

A frequently cited stat is that 1 in 5 healthcare workers have left their jobs. While many have left the industry as a result of the pandemic, others have opted for higher-paying agency jobs that provide them more flexibility and don’t come with the high levels of burnout that were rampant throughout the pandemic.

Shane Jackson, president of staffing agency Jackson Healthcare, told Becker’s, “They can choose to go where they’re needed most and ensure that their assignments are in alignment with their other priorities, whether personal or professional.” 

“Hourly billing rates that hospitals pay staffing firms for contract employees increased 213% compared to pre-pandemic levels and led to a 62% profit margin for contract staff agencies, i.e., the difference between what the firms charge hospitals and what the firms actually pay the contract employees,” an AHA report states.

High turnover and being forced to hire agency workers is detrimental to hospitals in more ways than one.

First, it’s extremely expensive. A 2021 NSI Nursing Solutions report found that the average cost of turnover for a bedside RN is $40,000. The turnover rate also rose 2.8% from 2019 to 2020. Plus, today, many hospitals are being forced to fill these vacancies with even more expensive contract workers.

Secondly, high turnover and being short staffed compromises quality and continuity of care. New and agency staff don’t understand the intricacies of the hospital in the way tenured workers do. And getting acquainted with policies, procedures as well as coworkers and longer-term patients takes time. 

A larger issue is at play: Direct-care workers are overwhelmed & stressed

Let’s take a step back and ask, why are these workers leaving and/or demanding higher pay? Well, many might argue that despite hospitals’ dwindling funding, they deserve it. The pandemic added increased pressure to their already demanding jobs. Doctors and nurses work in highly regulated environments, where one small misstep could result in a patient’s injury or death, potentially costing them their career. In many cases, these mistakes also blemish the hospital’s reputation, incur hefty fines and lead to numerous lawsuits. 

All of the above can result from something as simple and unintentional as failing to recall information the precise moment it’s needed. To put it plainly, this situation is often a result of human nature getting the best of us. We know this as the forgetting curve. 

Highly skilled and knowledgeable workers are the lifeblood of our healthcare system, however rising costs, loss of COVID-era financial relief and serious staffing shortages due to burnout are putting healthcare providers in a precarious situation and negatively impacting the quality of patient care. While microlearning can’t solve all of the challenges healthcare is facing, we at Qstream believe our powerful and scientifically proven technology can help providers more efficiently and effectively onboard, train, and upskill their workforce to both help reduce costs and mitigate risks associated with lack of knowledge. 

Born in healthcare, Qstream blunts the forgetting curve, reduces training time & mitigates risk

Forgetting is a natural, physiological occurrence and must be factored into learning new information to ensure it’s remembered long term. This phenomenon was documented as early as 1885 when German psychologist Hermann Ebbinghaus published his findings about learning.

The forgetting curve describes the dramatic drop off in knowledge retention over time. Studies show that in as little as 30 days, 79% of knowledge is forgotten. It is simply a matter of how the human brain works.

Qstream co-founder and Harvard Medical School Professor Dr. Price Kerfoot set out to prove this theory among his medical students. He used Qstream’s signature principles; the spacing effect, which delivers information at key intervals of time when the brain is likely to forget to significantly improve long-term knowledge retention; and the testing effect, which promotes active learning and offers immediate information. The latter essentially primes the brain to take in and remember new information. 

Learn more about the science behind Qstream here.

After more than 20 peer-reviewed clinical trials, the results were clear. Qstream’s methodology was far more effective at blunting the forgetting curve than typical learning methods such as the restudying of material, leading to a 170% increase in knowledge retention. And, these results were achieved in just minutes a day, which is ideal for not only busy medical students, but the dedicated doctors they will become. What’s more, Qstream’s approach not only significantly improves knowledge retention, but is also proven to durably change on-the-job behavior.

I see Qstream’s microlearning and knowledge reinforcement software addressing the problems that healthcare organizations are facing in a few ways.

Building long-term knowledge retention to mitigate risk: Our technology helps medical workers recall essential knowledge to successfully perform their jobs. Additionally, microlearning analytics give management insight into proficiency levels across teams, so knowledge gaps can quickly be corrected before costly mistakes are made on the job.

To this day, our customers see up to a 170% increase in knowledge retention as well as a 35% increase in knowledge proficiency. That proficiency stat is critical for our healthcare clients since it offers a real-time snapshot of what learners know and don’t know.

Reducing training time: Brief, mobile microlearning challenges can be completed on the go from any device. Our mobile app even notifies busy medical professionals when a new challenge is available. They can complete it on the spot or defer to a time that fits in with their schedule. Either way, this eliminates the need to pull doctors and nurses off the floor to complete all of their training. 

Qstream’s microlearning technology can also easily be leveraged to onboard and train new hires and agency workers on critical pieces of information. Our customers have seen a 60%+ reduction in training time.

Boosting learner engagement: We’ve heard from a number of our happy customers that doctors and nurses are a competitive bunch. Participants rave about our leaderboards and management says they play a critical role in keeping learners engaged with the program. We see 90%+ engagement with microlearning challenges which shows that people are not only learning, but they’re having fun doing so. And when workers are engaged with learning and feel their employer is committed to their growth and development, they are more likely to stick around. In that way, Qstream can also help reduce turnover.

While Qstream is applicable in all industries where knowledge matters, we continue to expand our presence in healthcare. Today, we are proud to work with Providence, Dartmouth Health, Baylor College of Medicine, Boston Children’s Hospital, Children’s Hospital of Atlanta and more and have achieved results that include:

  • $12 million saved annually
  • 66% reduction in nursing administration errors that contributed to serious glucose events
  • 60%+ reduction in training time
  • Increased HPV vaccination rates by 10%
  • Reduced falls in patients with MS from 54.7% to 34.1%
  • $650,000 savings; 40% improvement in adherence to cancer screening guidelines


If you’re interested in learning more about how Qstream’s microlearning and knowledge reinforcement software can help your organization weather these challenging times and come out stronger, let’s chat. Feel free to email me at

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