Mark Shah, MD FACEP Deborah Kim, MSN APRN CHEP Madeline Lassche, MSNEd RN Mark Shah and Deborah Kim are supported through DHHS/ASPR/HPP and DHS/MMRS grant programs. Madeline Lassche, MSNEd RN is a consultant with Elsevier Publishing Co. The Intermountain Center for Disaster Preparedness is supported in part through funding through Intermountain Healthcare. Define the difference between exercise play vs. immersive simulation and how simulation improves disaster response outcomes. Demonstrate how immersive simulation techniques increase learning outcomes and provide better standards of care to disaster victims. Describe how interprofessional education enhances interagency and academic partnerships; keys to successful disaster preparedness. 1
Describe the development and implementation of an interprofessional disaster preparedness course that is part of the University of Utah Health Sciences Interprofessional Education program (IPE). Content includes: steps in development of a collaborative relationship between the University of Utah and the Intermountain Center for Disaster Preparedness (ICDP) the process of course design essential course elements including core disaster preparedness and interprofessional competencies Our Challenge foster learning about disaster preparedness and response in a meaningful and longlasting way Resources A facility within a functional hospital Faculty with years of disaster response experience Experience with the existing disaster medicine educational offerings Knowledge of learning theory Support from Utah Department of Health The Intermountain Center for Disaster Preparedness Courses: ADLS, BDLS, CDLS BLS HazMat Ops Moulage Leadership/ICS BCP/COOP DEHP Partners: Hospitals National Guard UT-DOH UT-DHS/UT-DEM SL County Health UT-DMAT-1 UHA, HHS-ASPR Local NGO/VOAD Exercises Simulation Federal Contractors: CTOS New Mexico Tech/TEEX 2
3
Developed a Disaster module as part of a Population Health and Illness Course Encompassed disaster preparedness and response Emphasized strategies De-emphasized memorization Format Minimized didactic learning Created immersive simulations Collaboration Intermountain Center for Disaster Preparedness University of Utah Utah Department of Health Dr. Vivian Lee announces the University of Utah Health Sciences IPE Initiative: Our interprofessional education initiatives are directly focused on transforming our siloed teaching approaches to team learning at its best Vivian S. Lee, M.B.A., M.D., Ph.D. Dean, School of Medicine Senior Vice President, University Health Sciences CEO, University of Utah Health Care Course Format 8 hour course, combining lecture and simulation methodology Integrates the consensus-derived Core Competencies for all potential health system responders Students experience both the provider and patient/role Students complete FEMA ICS 100 online course as prerequisite 4
Going beyond exercises Goal: to promote higher level learning of teamwork skills while performing in a high stress environment Communication Collaboration Suspend disbelief- realistic environment Contrasted with Exercise Play, which tests operating procedures, plans, and is passfail IMSH2014 - Making Connections January 2014 Utilizes University and ICDP faculty members who have completed Simulation Facilitation training ICDP faculty also used as Subject Matter Expert s to clarify teaching points and answer questions Students assigned groups at the beginning of the day and stay in same groups Facilitation discussion points provided for debriefing Simulations in level of complexity Add concepts taught in previous didactic presentations 5
Focus on key disaster skills: Team training Communication Surge Triage PPE/Respiratory Protection Patient evacuation (Slydes) Performance of life-saving interventions (LSI) Psychological response of providers/patients in a disaster situation Welcome Simulation #1 Didactic Basics of Disaster Response Simulation #2 Lunch Breakout Sessions / Table Top Exercise Simulation #3 Group Discussion Challenges in Disaster Response 6
Shock and Awe Surprise influx of patients with simulated injuries from a motor vehicle crash Patients students from local high schools (Drama, Health Care) Basics of Disaster Response Regional hazards Surge strategies Disaster triage Crisis Resource Management Core Competencies DISASTER TRIAGE STEP 1 Is the Scene Safe? Get Help Global Sort If you can hear me, walk or wave? Individual Assessment Respirations? ne Open Airway and then Respirations? Distress Lifesaving Interventions Control major bleeding Rescue breaths (2) for kids with a pulse Chest decompression Antidotes rmal Pulse? Assess Last DECEASED Adequate resources to help? Mental Status? Follows Commands? MINOR DELAYED EXPECTANT IMMEDIATE MINOR DELAYED 7
Mass Casualty/Mass Fatality Partial structural collapse/degraded work area Smoke filled work area with debris Patient extrication Utilization of hand held radios & HICS structure Organization of triage areas Red, Yellow, Green, Gray, Black IMSH2014 - Making Connections January 2014 PPE / HAZMAT Levels of PPE State and Federal Resources Examples of local events Integration of local, state, and federal response Surge Capacity Small groups assume HICS roles for a critical access hospital Disaster scenario with influx of patients and limited resources 8
Pandemic Urgent Care setting Onset of ILI pandemic Allocation of limited resources Quarantine and isolation Provider absenteeism Challenges in Disaster Response Ethics considerations Legal issues Resiliency I learned more about professional roles and what different healthcare professionals bring to the team and how we can work together. I was also really appreciative of the disaster scenarios and especially liked the message of resiliency and how it applies to professional and personal life. It was fantastic. I learned so much. I hope you guys continue to do this sim each year. I feel it helped me realize how vulnerable we are as a community, and how important it is to be prepared for a disaster even as a family. I feel much more prepared. 9
Divide into two groups Scenario: Pandemic Influenza Providers: Pick a leader Consider resources Consider communication Consider community organization/coalitions Emphasize crisis resource management skills over knowledge acquisition Choose simulation learning over didactic teaching whenever possible Utilize interprofessional education opportunities in all areas of disaster training Mark Shah: markbshah@gmail.com Debbie Kim: debbie.kim@imail.org Madeline Lassche: madeline.lassche@nurs.utah.edu 10