Failure Is an Option: Using Simulation to Improve Practice in a Multispecialty Setting
Handout (225.0 kB)
The purpose of this session is to describe the role of high-fidelity simulation in creating a supportive learning environment and improving quality and communication among multisystem teams.
Relevance/Significance:
Simulation training was largely successful based on details discovered during simulation. Surveys revealed that in-situ simulation improved clinical skills, created communication standards, and provided a no-fault learning environment for the team. Simulation efforts increased confidence in managing new or unfamiliar clinical presentations. Post-simulation surveys revealed a 34% increase in comfort levels with team management of various scenarios.
Strategy and Implementation:
This hospital recently developed an integrated obstetric delivery program to address the needs of high-risk newborns in the delivery room. The hospital uses in-situ simulation training for ongoing program development, quality improvement, and risk avoidance. Team participants include Neonatology, Anesthesia, Obstetrics, Perinatology, Nursing, Respiratory therapy, OR techs and Pharmacy. Simulations are scheduled numerous times per month; scenarios are unannounced and performed in-situ. The training is coordinated with a cognitive, technical and behavioral skills focus. The team uses a videotaped simulation practicum with emphasis on integrated team behavioral performances. Formal debriefing occurs after training sessions to identify additional learning opportunities. Team performance is measured using scales that are objective, measurable, and reproducible.
Evaluation:
Post-simulation surveys revealed a 34% increase in comfort levels with team management of various scenarios. It is determined that overall outcomes, employee satisfaction and general safety are improved through the use of simulation-based training methods.
Implications for Practice:
The Fetal Health Center currently has a 0% obstetric adverse event rate and continues to use simulation to prepare for new procedures, emergencies, and following safety events. Simulation training improves communication, professionalism, and performance.