esimulation in Action Kettering Medical Center Sharing Our Success Story and Strategies Laerdal Simulation Users Network Dianne Ditmer, PhD, RN, CFN, DABFN, FACFE
Improving the quality of life for the people in the communities we serve. Mission Statement Kettering Medical Center
KETTERING HEALTH NETWORK Kettering Memorial Hospital Sycamore Hospital Kettering Behavioral Medicine Center Grandview Medical Center Southview Medical Center Green Memorial Hospital And Growing..
Our Commitment To Excellence Recognition as Top 100 Hospitals Centers of Excellence Stroke Center Chest Pain Center Bariatric Center Joint Replacement Center Cancer Center Premier Q Award JD Powers Distinguished Hospital Service Excellence Best Place to Work Magnet designation 3 campuses
High achievement always takes place in the framework of high expectation. Charles F. Kettering
Objective Evaluate and implement a comprehensive online staff development program Priorities HeartCode BLS HeartCode ACLS Integration of Simulation
Background By The Numbers 2250 staff required to maintain BLS competency 30 BLS course offerings 5 courses per month January June 80 students per course 14 BLS Instructors per course offering
Background Challenges Off campus facility Accommodate large volumes Staff travel Equipment Instructors Volume Availability Scheduling Interpretation of competency Staffing schedule Challenge for CNM Replacement staff Budget variances Long lines Refreshments
Survey The Scene What is the most important issue? Connect everything we do to clinical outcomes Support the staff at the bedside Enhance knowledge and competency Acknowledge learning styles and needs
Survey The Scene What keeps you up at night? New grads on the night shift Keeping core competencies solid Focusing on patient needs while supporting staff needs Clinical excellence, staff excellence while meeting financial target Time management Regulatory compliance
Survey The Scene What do you enjoy most about your profession? Collaborative practice Multi-disciplinary approach Positive, measurable outcomes Nurturing staff growth Self governance
Survey The Scene How do you use the Internet? Shopping Access information, music Educational resources Travel planning Social networks Connections to family and friends News Digital photography Finances
What We Were Searching For Cost effective Evidence-based Inadequate training of nurses is a factor in 58% of serious errors (The Joint Commission in Block, Claffey, Korow User friendly Replacement two times salary (Barton, Goudy & Hawthorne, 2005) Easily accessible Improve clinical outcomes Regulatory compliance Reduce monitoring time by Nursing Leadership and Educators Korow & McCaffrey, 2005)
They just don t t get it! You teach the same thing over and over but they just can t t remember
Sensitivity To Levels Of Expertise What Type Of Support Do They Need? Novice: experienced nurse in a new setting Advanced Beginner: new graduate nurse Competent: 2-33 years clinical experience Proficient: Nurse clinicians, nursing faculty Expert: Advanced practice nurse clinicians and faculty (Benner in Zerwekh & Claborn, 2006, p 14)
Sensitivity to Generational Differences and Learning Styles Traditionalists 5% Written Visual Learners Baby Boomers 45% Love meetings - Auditory Generation X 40% Video game and PC pros Stimuli, multiple strategies Generation Y 10% Grew up on the Internet, e-mail, e Facebook Instant feedback, visual and tactile (Dittman, 2005)
Business Plan Developed and presented a business plan to Nursing Leadership and Administration Identifying needs Listing initial and long-term costs Calculating long-term savings to the healthcare system
Cost Analysis 2007 Traditional BLS 2008 HeartCode BLS Registered Nurse $354.38 Registered Nurse $41.00 Licensed Practical Nurse $322.00 Licensed Practical Nurse $41.00 Nursing Assistant $244.86 Nursing Assistant $41.00 Registered Nurse $556,376.60 Registered Nurse $64,370.00 Licensed Practical Nurse $58,604.00 Licensed Practical Nurse $10,742.00 Nursing Assistant $64,153.32 Nursing Assistant $7,462.00 Total Cost $679,133.92 Total Cost $82, 574.00
HeartCode BLS Cost Effective Savings Savings $596,559.92 Staffing solutions No need to schedule nurses off unit Staff coverage issues Hours not available for all shifts Instructors Facility Equipment
Evidence-based Partnership Laerdal Medical Corporation 2007 HealthStream 2006 Patient American Heart Association Kettering Medical Center
It s s Not Your Grandmas BLS Anymore
Deployment HeartCode BLS Kick-off November 2007 Pilot December 2007 Go live January 2008 Skill Labs 3 campuses 6 mannequin sets 6 dedicated computers Labs accessible 24/7 Professional Development staff available for coaching
Measures of Success Staff Satisfaction - BLS 2008 84.2% rated 5/5 (5 Excellent) Educational needs met (Survey Monkey, 2008) 2009 91.2% rated 5/5 (5 Excellent) Educational needs met (Survey Monkey, 2009)
Measures of Success Staff Satisfaction Loved the computer feedback! Love this. It is more realistic. I I love it this way! I feel I am more prepared should I need to use my skills. This is wonderful. I love the hands on experience and how the computer lets you know how you are doing through the whole procedure. Great and concise. This ROCKS! Much better than class. I received precise feedback from the computer. I I liked taking the test online and then applying it to the skills. s. It made it real.
Measures of Success Clinical Outcomes 2007 14% 14% successful resuscitation rate 2008 27% 27% successful resuscitation rate 2009 34% 34% successful resuscitation rate
Today, I made a difference!
Next Step HeartCode ACLS ACLS available AWESOME You get the best efforts from others not by lighting a fire beneath them, but by building a fire within them.
Deployment HeartCode ACLS Pilot 2008 50 licenses purchased for trial User Group Staff nurses, medical residents and clinical nurse managers All completed with a passing rate Satisfaction rate 96% 5/5 met educational needs
HeartCode ACLS 2009 567 nurses for recertification of ACLS in 2009 Residents and physicians
HeartCode ACLS 2009 Benefits No waiting for available class Assignment for new hires instantly Over 30 days for course completion Textbook on-line and User Guide Participants can practice at own pace CE s s upon completion
Measures of Success Staff Satisfaction - ACLS 2009 Extremely satisfied 82.3% Content Content met objectives Contribution to professional effectiveness
What s s next? High tech, high touch
High Tech High Touch Embracing technology and patient- centered, relationship-based care Nexternship Program Orientation Collaboration Nursing Nursing Assistant Unit Orientation Walking Rounds Unit Focused Focused support New Graduate ECCO Program
The New Graduate Nurse 35% - 61% of new nursing students leave their place of employment within the first year. (Winter-Collins & McDaniel, 2000)
Supporting Problem Solving Skills Safe Environment Assessing the problem Identifying and analyzing alternatives Making sound decisions Taking action
High Tech High Touch Essentials of Critical Care Orientation 64 contact hours Developed by American Association of Critical Care Nurses 25 licenses purchased as trial in 2009 Students have one year to complete Hands on with Susan! Integration of simulation with on-line scenarios
High Tech High Touch ECCO and Beyond HealthStream courses have been bundled with simulation scenarios to target specific patient populations More hands-on practice to promote critical thinking skills Integration of simulation with multidisciplinary approach
High Tech High Touch Susan joins the Air Force
Disaster Preparedness Calamityville
High Tech High Touch Susan goes international
watch us grow
Watch Us Grow Level II NICU Trauma Center Transition to Heart Tower Six story tower 23,500 open heart surgeries 6,000 caths 600 open heart surgeries in 2010
As We Grow Priorities for 2010 Magnet View Transformational Leadership Structural Empowerment Exemplary Professional Practice New Knowledge, Innovations and Improvements Empirical Quality Outcomes Culture of Safety Staff participation SNAC Nurse preparation at hire Certifications Clinical Ladders - Mentors PI Projects Simulation Scenarios Staff Research Level II NICU - PALS Trauma Educators - Research Resuscitation rates
leaving a legacy for the next generation of Nurses
Sarah age 10
Malayna age 3
for the next generation of patients
Improve the quality of life for the people in the communities we serve. Together, with Laerdal, we will save lives.