How UCSF Benioff Children’s Hospital Oakland Cut Nurse Training Time and Costs (While Increasing Learning Quality) For New ICU

Escalating labor volatility has driven supplemental-nurse hourly costs up to 266 percent above pre-pandemic baselines, according to a 2024 Government Accountability Office analysis.(gao.gov) That economic pressure framed the argument in “Microlearning Transforms Frontline Care,” which demonstrated why on-demand education now underpins patient-safety strategy, and in the follow-up Q&A “Burnout to Breakthrough: How Elemeno Health Redefines Frontline Training,” where Dr Arup Roy-Burman detailed metrics from early adopters.

The case study below extends that narrative from concept and testimony to audited financial performance, showing how UCSF Benioff Children’s Hospital Oakland compressed training for 75 pediatric-ICU nurses from three days to one through bite-sized, mobile-ready modules. By converting vendor walk-throughs and workflow maps into asynchronous microlearning, the hospital opened a 23-bed unit on schedule, avoided premium backfill labor, and saved more than $136,000, results that confirm microlearning’s place alongside budgeting models and payer-mix projections when leadership approves high-acuity expansions. The operational blueprint that follows offers readers an evidence-based template for recouping orientation costs while safeguarding clinical rigor.

The real challenges of mass staff orientation 

UCSF Benioff Children’s Hospitals (BCH) comprise the largest network of pediatric care providers in Northern California. With two main campuses in Oakland and San Francisco, as well as satellite locations throughout the region, UCSF Benioff Children’s Hospitals serves tens of thousands of infants, children, teens, and young adults from around the world. The hospital network consistently ranks among the nation’s best for children, treating all pediatric conditions, including rare and serious illnesses.

In September 2021, the hospital campus in Oakland (BCH-OAK) opened a new 23-bed pediatric intensive care unit (PICU). To staff this new unit, BCH-OAK needed to provide training for 75 nurses. 

BCH decision-makers knew what such a process entailed. Six years earlier, when the San Francisco hospital moved cross-town to their new campus with a 20-bed PICU, a four-day staff training period was required. 

Such a mass orientation poses several challenges. For starters, training staff is costly: Nurses receive full pay and benefits during the orientation period while being unable to simultaneously perform typical work duties. This forces the hospital to find temporary replacements by deploying travel nurses or paying staff overtime, which involves logistical overhead to reorganize staffing and ensure coverage, as well as more budget. 

Training time crunch

A poorly executed orientation can result in under-trained nurses, staffing shortages, and overworked employees, ultimately leading to burnout and a lower standard of care for patients. Inadequate training also reduces staff morale and promotes inconsistencies between nurses, a problem amplified by transitioning to a new unit. Learning something new while also confronting an unfamiliar environment means that under-trained staff are not confident in their new setting, which can lead to negative patient experience and safety issues.

BCH-OAK was initially allotted time and funds for three days of training to orient their 75 nurses to the new PICU. However, due to budget cuts, a reduction in in-person classes due to COVID, and a national shortage of traveling nurses who could fill in for staff, training was reduced to a single day. The hospital suddenly had to deliver education and orientation in a significantly shorter amount of time than originally anticipated while maintaining high quality of information, retention, and engagement. 

BCH-OAK was already using Elemeno Health’s cloud-based solution for other types of hospital training, including new product education, introduction to new workflows, and Skills Day annual updates. For these trainings, the software had helped decrease time, cost, and inconvenience involved in their delivery, while increasing effectiveness of learning. It made sense, therefore, to follow the same process to meet the new PICU training requirement.

A flexible staffing platform

Elemeno implemented a solution designed to deliver training material that was easily consumable by staff, reduce the time required by nurse educators to distribute the information, and eliminate backfill and overtime needs. Training topics included patient care equipment, monitors, communications systems, and workflows (patient movement throughout the unit). 

This mobile-friendly solution enabled nurses to complete and process the information in small bites when it was convenient for them, rather than the hospital having to take a large group of nurses off the floor at once to conduct an extended in-person training. 

Further, the solution did away with burdensome classroom sessions that would have to be conducted more than once to accommodate multiple groups of nurses. Time-consuming vendor demonstrations could be transformed into on-demand, bite-sized pre-work suitable for a radically shortened on-site training. 

BCH-OAK and Elemeno collaborated to deconstruct the training material into concise, asynchronous microlearning modules, supplemented by brief video tutorials. All content was tailored to meet the unique needs of the BCH-OAK PICU.

Educators routinely consulted with equipment vendor reps on-site and then created microlearning content in collaboration with Elemeno’s virtual support team. This ensured the training information was delivered correctly and consistently to all nurses, eliminating possible variation caused by multiple classroom deliveries and reducing future support requests.

Successful training, huge savings 

Using Elemeno’s platform, BCH-OAK was able to train its PICU nursing staff over eight total hours, only four of which were in-person. The cost savings were dramatic. The initial anticipated cost of training these 75 nurses in person was $176,400 plus an additional $18,816 or more in backfill or overtime cost, for a total of at least $195,216. 

With Elemeno providing four hours’ worth of asynchronously consumed pre-work, followed by four hours of focused in-person training, BCH-OAK spent only $58,800 total, without resorting to backfilled labor or overtime costs. It was a 70% reduction in cost compared to the initial estimate, or a savings of $136,416.

There were other benefits. The solution facilitated a 66% faster training completion time, with staff being trained in one day instead of three. For BCH-OAK, this meant the new PICU could open quickly and begin delivering care to its patients. Providing the training in this flexible manner allowed nurse educators and managers to focus their time where it’s most needed, increasing the quality and efficiency of work. Removing the need to backfill positions reduced managerial complexity, and the shortened classroom hours meant that educators could devote themselves to high-impact activities. 

In addition, staff reported that the more engaging, independent learning structure left them feeling more involved in the training and transition process. The hospital and staff assessed the training to be at least as high in quality and retention as the more traditional method, while delivered at a fraction of the cost.

Educators said the quality of questions from staff was more in-depth and well thought-out when staff used Elemeno’s orientation materials before their in-person training, and there were fewer follow-up questions than expected after the completion of training. 

Benefits have extended well beyond the initial training. Over the next two years, individual nurses remaining from the original orientation cohort have returned for refresher training up to 40+ times each, accessing support on-demand, at the point-of-care. The same orientation content was also delivered to over 40 new staff joining the PICU after the original cohort. Total orientation resource views have totaled over 1,200. 

Conclusion

Faced with the prospect of delivering education and orientation to 75 PICU nurses in just one day – without sacrificing quality of information, retention, and engagement – BCH-OAK leveraged a cloud-based training platform that met the hospital’s stringent time deadline while cutting costs by 70%. Automation of training on the Elemeno platform has enabled the PICU to sustain and spread learning over time and across new staff, ensuring consistent practice and driving ongoing cost savings.