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I have nothing new to add to the advice given by others. Perhaps when you get over this hurdle, you can do a cost analysis to assist in your justification for a LMS. I would include factors such as development cost and time; distribution methods and time; grading, posting, and filing time; lost productivity time of employees' travel time to the class, the time and difficulty in producing aggregate complete and incomplete reports for mandatory education vs automated on-demand reporting; and potential penalties for non-compliance to OSHA, JCAHO, and other regulatory requirements. OSHA can fine companies up to $10,000 for every infraction. No money for a LMS?...if the organization gets a couple of infractions, the LMS would have been quite affordable! Also benchmark your organization to other hospitals similar in size who are utilizing a LMS. My recomendation would be to start with the basic features needed to get your company's education records and processes automated and include online regulatory courses. LMS vendors that focus on healthcare organizations typically will have a JCAHO/OSHA curriculum that includes required lessons one can customize to the organization's policies and procedures. Typically, these lessons are included with the LMS purchase. Let me know if further information is needed. By the way, I'm not a salesman. Just a training manager who has been in your shoes! I've learned that if you continue to make do of bad situation, nothing changes. But if you start waving the flag, along with essential facts and quantitative data--you're likely to get "an ear." Best of Luck.
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