Objectives. Kathleen Gallo Ph.D, MBA, RN, FAAN Senior Vice President Chief Learning Officer. Statement of the Problem.

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1 Objectives At the completion of this session the participant will be able to: Kathleen Gallo Ph.D, MBA, RN, FAAN Senior Vice President Chief Learning Officer Discuss the paradigm shift in healthcare education= Why Simulation? Identify the need for interprofessional education using simulation as a learning method Articulate the link between clinical simulation and patient safety and quality Describe the key operational components of a simulation center Statement of the Problem It is estimated that each year between 44,000 and 98,000 patients die as a result of medical errors making it the eighth most common cause of death According to a report from the Institute of Medicine in the United States: -Healthcare is a decade or more behind other high risk industries in its ensuring basic safety Medical Errors Over 70% of these preventable deaths are due to lack of communication and teamwork Medical community has been slow to respond and implement changes -Errors are caused by faulty systems, processes, and conditions that lead people to make mistakes or fail to prevent them Perhaps The root of the problem may lie more in education than practice 1

2 Important part of the Solution Limitations of Traditional Training Use simulation whenever possible for healthcare education Train in teams, those who are expected to work in teams Create new and realistic methods of learning without putting patients at risk Variable clinical experience amongst individuals during training Limited experience of managing rare events Ethical considerations of using patients for learning Current environment difficult to discuss and learn from mistakes Limited opportunities to acquire proficiency of skills in procedures PSI Mission The Patient Safety Institute, through education, collaboration, research and interprofessional simulation, assists members of the patient-care team in achieving excellence in the delivery of quality and safe patient care. The Patient Safety Institute promotes a culture dedicated to caring, excellence, innovation, integrity, teamwork and improving the health of the community. PSI Vision The Patient Safety Institute will be an internationally recognized leader in interprofessional simulation and a model provider of clinical education, promoting the practice of safe and effective patient care. The Fundamental Belief All participants at the Patient Safety Institute are intelligent, talented, and caring professionals, committed to excellence and self improvement. Simulation: An Innovative Learning Strategy Live simulation with high-fidelity simulators Learner-centric environment Experiential, emotionally engaging activity Enhances self-discovery and learning through debriefing and reflection Emphasizes learning outcomes Stresses teamwork and communication 2

3 Debriefing Feedback is the primary opportunity for learning Most learners feel that inadequate feedback is provided during training Without feedback, poor performance is not corrected, appropriate behavior is not reinforced, and learners develop their own system of self validation It s Not About the Simulator The power of individual or team training in a simulation environment lies in the integration of validated educational methods into the real simulation experience (Dunn, 2008) Pre-Work Simulation Debriefing Reflection Advantages of Simulation Deliberate practice of high risk, low incident events Fosters the development of leadership, interpersonal skills and team behaviors Minute by minute video and audio recording for reflective debriefing sessions and immediate feedback Higher level of learning -Teamwork - Communication - Critical Thinking - Technical Skills Interprofessional Education (IPE) Interprofessional education occurs when learners from the health professions and related disciplines learn together about the concepts of health care and the provision of healthcare services toward improving the effectiveness and quality of healthcare Essential Elements: Collaboration Respectful communication Reflection Application of knowledge and skills Experience in interprofessional teams Interprofessional Education (IPE) Why Increased incidence of preventable errors (IOM) How care is delivered is as important as what care is delivered Disruptive Innovation Interprofessional educational models are essential to develop and maintain inderdisciplinary teams thereby advancing teamwork and improving patient safety Effective clinical teams are essential to the delivery of care that is patient-centered, safe and efficient Train in teams those that work in teams 3

4 Course Development Process: A Team Approach How Initial Contact Committing to the Partnership Developing the Program Finalize Program Design and Logistics Deliver Program Post-Program Review and Follow Up Building strong relationships between PSI and clinical leadership Planning meeting Faculty attends Simulation Instructor Course Design program according to established objectives Program agenda Faculty and participants execute the learning experience Post-program surveys completed by participants Establishing trust among the stakeholders with their initial programs Establish program objectives Confirm program timeline Prepare scenario template for each scenario that is part of the program Distribute prework to participants Combine pre- and post-program learning, action learning, teaching methodologies, and delivery principles Debrief with faculty and PSI staff Success breeds success word of mouth Share PSI s approach, experience, capabilities Conduct practice session to ensure scenarios meet learning objectives Take key learning from the delivery process into the redesign process PSI Interprofessional Education The Patient Safety Institute ACLS Provider Online Course and Skills Testing Associate Fellow Course BLS Provider Online Course and Skills Testing Internal Medicine Residency Program Pediatric Clinical Interventions Session Pediatric Fundamental Critical Care Course Pediatric Procedure Course OB Emergency Drills PALS Instructor Course PALS Provider Online Course Pararescue Critical Care Course Pediatric Clinical Scenarios Pediatric Communication Course Southside Family Medicine Trauma Nursing Core Course Hofstra North Shore-LIJ School of Medicine West Campus Basic Obstetrics Behavioral Health Clinical Skills Program Behavioral Health Medical Emergency Simulation Program Cardiothoracic Surgical Team Emergency Medicine Pediatric Emergency Medicine Mock Codes PSI Nurse Fellowships Neonatology Resuscitation Pediatric Acute Care Assessment and Stabilization Perioperative Core Orientation Taming Sepsis Education for Nurses Perinatal Teams Simulation Instructor Course The William Randolph Hearst and Rhonda N. Gilbert Critical Care Nurse Fellowship Program The Emergency Department Nurse Fellowship Program The Pediatric Nurse Fellowship Program The Pediatric Hematology/Oncology Nurse Fellowship Program Establishing a Simulation Center PSI 2012 Number of programs: 743 Number of learners: 8,017 Total learning hours: 72, 724 Facilities Integrated vs. Free-Standing Anticipated Volume & Nature of Programs Storage Room for Expansion Technology AV System for Video Debriefing Internet Access Telephones IT Support Equipment Matched to Program Needs Human Patient Simulators Part-Task Trainers Virtual Reality, Gaming Warranties & Service Contracts 4

5 Establishing a Simulation Center Patient Safety Institute Faculty & Staff Sim Center Team Medical Director Educators Technologists Administrative Support Adjunct Faculty Course Directors Subject Matter Experts Ensuring Competence & Ongoing Development SSH Standards: Road Map for Design 10 Patient Simulation Rooms Cardiac Catheterization/OR Infant Simulators 5

6 Perinatal Delivery-Patient Safety Institute Trauma Simulation Debrief Rooms Lithotripsy Unit-North Shore University Hospital Cardiac Cath Lab-Lenox Hill Hospital 6

7 14 Exam Rooms CSC: Control Room What We Know for Sure No matter how sophisticated the technology, if humans are involved, errors will occur- the brightest and best make errors Culture is directly related to the safety record The safety net is the team, not the individual Teamwork allows larger and more complicated tasks to be accomplished safely and effectively Teamwork is Essential to a Culture of Safety Teams Rule In complex problems, team performance will exceed the expected sum of all single actions Mutual monitoring can help to notice individual errors Shared workload can help to prevent the overstrain of an individual, and make sure that all tasks planned can be executed in a timely manner Mutual support and encouragement can enable team members to master even the most difficult situations Successful team performance results in low-error, high quality patient care and high satisfaction of the healthcare providers Train in Teams Those That Work in Teams 7

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