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PSJH Uses Qstream to Boost Learner Engagement and Save Millions of Dollars on Compliance Training


Providence St. Joseph Health is a not-for-profit health system with 119,000 caregivers and employees nationwide. At PSJH, the learning and development team provides award-winning learning content to their workforce. However, learning leaders discovered engagement still proved to be low.

The Challenge

When exploring KPIs, staff knowledge retention was measured at 76%. As part of the initiative, leaders set a goal to increase proficiency by 16%, a lofty target but one they felt was achievable. Additionally, another key objective of implementing a new solution included drastically reducing the cost of compliance education – mandatory training that organizations like Providence St. Joseph Health spend over a million dollars per year on. Finally, learning leaders demanded a solution that would enable frontline managers to support caregivers with actionable, real-time learning data, something that’s missing from their current learning strategy.

In order to boost engagement and proficiency, PSJH described the need to transform their programs to provide a more learner-centric experience.

The Solution

In 2019, PSJH deployed Qstream’s award winning mobile knowledge reinforcement solution, aimed at helping caregivers review and retain critical compliance education content through a ‘Caring Reliably’ challenge. Using Qstream, caregivers respond to brief scenario-based challenges pushed to their smartphone, tablet or laptop. Built-in game mechanics help keep users engaged as they compete against their peers for points on the leaderboard while strengthening key concepts of the behaviors, tones and tools of ‘Caring Reliably.’ The software’s analytics engine synthesizes response data in realtime to track performance and proactively identify knowledge and skill gaps. Developed at Harvard Medical School, the solution is clinically proven in more than 22 peer reviewed studies to increase retention by as much as 170% and durably change behaviors for improved patient outcomes.

The Results

  • Average engagement rate of 93%
  • 90% increase of key content retention
  • Reduce training time by 84%
  • Average initial proficiency = 76.8%
  • Final initial proficiency = 90.7%
  • 18.1% proficiency increase across all Qstreams


“However, the biggest win for us are the actionable analytics at a managerial level. When managers can see real-time data of their team members on compliance issues AND have tools at their disposal to quickly and easily reach out to their specific team members that are struggling or succeeding – it changes the conversation.”

– Johnny Hamilton, Senior Learning Designer and Innovation Consultant

Participant and Manager Reviews

Caregivers found the experience to be both enlightening and enjoyable! “From a learner’s point of view, being able to take required compliance education in half the time and in one minute increments is a huge win,” said Johnny Hamilton, Senior Learning Designer and Innovation Consultant at PSJH.

“These questions and this process is a great learning tool.”

“I am just overwhelmed that I attended the seminar or this class because I have learned a lot of things that are new to me.”

“This is cool.”

“Very helpful on learning our strengths and weaknesses & how we can improve to prevent errors.”

“Very educational.”

“It was a great program, it refreshed my mind about why it is importance of take care of every one. The purpose and mission of our organization. I really enjoyed it because it was educative and I will give it the highest star. I hope, this is not the last but more will come our way to make our organization the best.”

What was the biggest accomplishment for learning leaders at PSJH? According to Hamilton, “from an enterprise point of view, receiving detailed analytics on the learners and the questions themselves helps us refine our learning design as well as validate our results that are aligned toward strategic business initiatives.”

What is the price of learning?

Implementing Qstream’s spaced learning solution enabled Providence St. Joseph Health to execute high quality compliance training delivered at a fraction of the cost. In the chart below, Johnny Hamilton breaks down the “price of learning” which details exactly how implementing Qstream in place of traditional learning programs equates to a cost savings of over a million dollars through spaced learning.


“Now, learning is not a “one-and-done” extra thing that needs to be checked off – rather, learning is now the means by which localized strategic change happens in real time. Learning is now an essential driver of business impacts.”

– Johnny Hamilton, Senior Learning Designer and Innovation Consultant

About Providence St. Joseph Health

Delivering services across seven states, Providence St. Joseph Health is committed to touching millions of lives and enhancing the health of the American West to transform care for the next generation and beyond. Our 119,000-plus caregivers and employees serve in 51 hospitals, more than 800 clinics and a comprehensive range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.

PSJH is dedicated to finding unique, innovative solutions to improve workplace learning and impact business results. Want to learn more? Download their latest research brief.

Watch this free on-demand webinar where PSJH shares their story on how they transformed workplace learning by replacing traditional learning with spaced learning to support the needs of executives, managers, and learners.


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