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Sunday, September 26, 2010
Title: It's Not Rocket Science...Simulation Makes It Safer
Discipline: Women’s Health (WH), Newborn (NB), Childbearing (CB), Advanced Practice (AP)
Learning Objectives:
Submission Description:- Discuss the correlation between the principles of Crew Resource Management and simulation drills.
- Describe innovative mechanisms to involve staff in simulation drills in mother baby and labor and delivery.
- Identify ways to evaluate learning effectiveness of simulation drills in an obstetrical setting.
Even a facility delivering 6,000 babies a year has opportunities to improve clinical practice and outcomes. The literature shows us that when emergencies are rehearsed, clinical practice and knowledge improves. The literature however does not prove how knowledge is measured but only that it is perceived to be improved. Simulation leads to reduction of error, improved communication and better patient outcomes. In creating "real life" situations, the staff in this organization saw the benefit of working together to create a safer environment. This organization took simulation one step further and measured learning pre and post simulation drills to ensure that actual knowledge was gained.
Mission Control...Leading the Norton Healthcare Community
Norton Suburban Hospital 's Labor and Delivery was chosen as the pilot unit for "high reliability team training". Several staff members, physicians and leadership were trained on the concept of Crew Resource Management (CRM) which parallels between aviation and healthcare focusing on high volume, high risk and high stress environments.
Houston we have a problem...Creating a Culture of Safety
Prior to CRM training, the work environment focused on individual goals and desires of the staff and physicians. The facility has over 80 obstetricians and 80 pediatricians all with varying practice patterns needing to come together to reach the common goal of patient safety. One of the concepts of CRM is simulation drills which lead to reduction of error, improved communication and better patient outcomes. Teamwork is crucial and in order to reach the goal, the staff and physicians needed to be able to practice clinical patient scenarios in a controlled non-threatening environment. Suburban added the simulation mannequin NOELLE to their team in 2008 for labor and delivery, post partum, and newborn drills.
We Have Lift Off…Conducting Simulation Drills
Simulation drills with NOELLE were centered around obstetric emergencies including emergency c-section for umbilical cord prolapse, eclamptic seizure, post partum hemorrhage, shoulder dystocia, maternal and neonatal mock codes. Each drill included a pre-briefing and debriefing to ensure that the staff receives immediate feedback.
Lift off is a success…Evaluating Effectiveness / Lessons Learned
Limited research has yet to create a standardized tool to measure learning effectiveness. In the OB simulations conducted atNorton Suburban Hospital , we measure the clinical skills and teamwork used during the drill through checklists and through pre and post tests. A 10 question quiz was created by the Educator and administered prior to the simulation and again at the conclusion of the debriefing. A 20-36% increase in knowledge has been demonstrated post simulation.
One Small Step for Man…Sharing the Vision with the Community Served.
In an effort to show our commitment to patient safety, the team was featured on the local news during a health briefing. As simulation drills are becoming the community standard, this team felt it important to ensure that the community understood the commitment to quality and safe patient care.
Upcoming Missions…Next Steps
There is currently a grant in progress to create a simulation lab and the purchase of a more advanced simulation model for Norton Healthcare.
Prior to CRM training, the work environment focused on individual goals and desires of the staff and physicians. The facility has over 80 obstetricians and 80 pediatricians all with varying practice patterns needing to come together to reach the common goal of patient safety. One of the concepts of CRM is simulation drills which lead to reduction of error, improved communication and better patient outcomes. Teamwork is crucial and in order to reach the goal, the staff and physicians needed to be able to practice clinical patient scenarios in a controlled non-threatening environment. Suburban added the simulation mannequin NOELLE to their team in 2008 for labor and delivery, post partum, and newborn drills.
We Have Lift Off…Conducting Simulation Drills
Simulation drills with NOELLE were centered around obstetric emergencies including emergency c-section for umbilical cord prolapse, eclamptic seizure, post partum hemorrhage, shoulder dystocia, maternal and neonatal mock codes. Each drill included a pre-briefing and debriefing to ensure that the staff receives immediate feedback.
Lift off is a success…Evaluating Effectiveness / Lessons Learned
Limited research has yet to create a standardized tool to measure learning effectiveness. In the OB simulations conducted at
One Small Step for Man…Sharing the Vision with the Community Served.
In an effort to show our commitment to patient safety, the team was featured on the local news during a health briefing. As simulation drills are becoming the community standard, this team felt it important to ensure that the community understood the commitment to quality and safe patient care.
Upcoming Missions…Next Steps
There is currently a grant in progress to create a simulation lab and the purchase of a more advanced simulation model for Norton Healthcare.
