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Simulation training in medicine and technology management
 

Simulation training in medicine and technology management

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Presentation by the Ukrainian-Swiss Mother and Child Health Programme at 2nd Regional Health Technology Management Worskhop (April 10-11, 2014, Chisinau, Moldova)

Presentation by the Ukrainian-Swiss Mother and Child Health Programme at 2nd Regional Health Technology Management Worskhop (April 10-11, 2014, Chisinau, Moldova)

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    Simulation training in medicine and technology management Simulation training in medicine and technology management Presentation Transcript

    • SIMULATION TRAINING IN MEDICINE AND TECHNOLOGY MANAGEMENT I. Shchaviy, A. Bashkov, D. Konkov Ukrainian-Swiss Mother and Child Health Programme, Ukraine
    • Why simulation? • Simulation is valuable when „on-the-job‟ training is expensive or risky • Simulation has been adopted for training where consequences of error expose many people to risk or the cost of error is high, for example: – Aerospace – Military – Nuclear power plants Medicine: A High-Risk Industry
    • Risk Management Considerations - Hazards in Medicine “Most serious medical errors are committed by competent, caring people doing what other competent, caring people would do.” -Donald M. Berwick, MD, MPP • Not just about the people, it is about the design: • System, medical devices, procedures • Human Factors: safeguard in the design “making it difficult for people to do the wrong thing”
    • Advantages of Simulation • Structured learning • Guaranteed and scheduled opportunities for teaching learning – Uncommon situations can be presented – Teacher can model process, give feedback, repeat process, modify process • Repetition as often as needed
    • Successful strategies for crisis management: • Use of written checklists to help prevent crises Use of established procedures in responding to crises Training in decision making and resource co- ordination • Systematic practise in handling crises including part-task trainers and full-mission realistic simulation
    • Simulation technologies used in medical education • Computer-based simulations (micro-worlds, micro-simulation) • Virtual environments +/- haptics • Part-task trainers • Low-fidelity simulators/manikins • Simulated or standardised patients • Hybrid simulations • High-fidelity (full mission) simulation
    • Technical infrastructure and technology management – key factors • Facility • Manikins • Multimedia equipment • Hardware and software • Human resources • Medical equipment • Good management
    • Facility
    • Debriefing Simulation The Heart of the Matter Frame • Assumptions • Feelings • Mental Model • Knowledge Base • Situation Awareness • Context Actions Results
    • Facilitated debriefing with an expert practitioner. Participants reflect on their own performance and discuss this with the group
    • Hardware & Software
    • Working place of operator
    • Resources • Equipment – Simulators, monitors, defibrillator, trolleys, etc • Disposables – Appropriate for scenario, setting and participants, re-use w/o compromising fidelity • Faculty – Trained, available, practised • Support staff – Bio-medical technician essential! Also clerical.
    • Before and after simulations... • Set-up scenario – eg. make blood, set up OR, X-rays, etc • Load up simulation program • Check everything works – Cameras, VCR, communicators Afterwards... • Check simulator • Clean everything used and put away • Replace/reorder all used items
    • Medical equipment Set of medical equipment for certain scenario
    • Team work is the key to success
    • Why Teamwork? • Reduce clinical errors • Improve patient outcomes • Improve process outcomes • Increase patient satisfaction • Increase staff satisfaction • Reduce malpractice claims
    • TeamSTEPPS • Knowledge – Shared Mental Model • Attitudes – Mutual Trust – Team Orientation • Performance – Adaptability – Accuracy – Productivity – Efficiency – Safety
    • High fidelity simulation • Allow time for familiarisation with the simulator & equipment • Brief participants on: – The scenario – Educational objectives – How to get help
    • High fidelity simulation Always follow the script but... …have alternative outcomes planned and rehearsedSimulation control room
    • High fidelity simulation Using simulation situations can be re-run to explore outcome with different treatments Mission critical tasks can be performed by learners without putting patients at risk
    • The future of simulation... • Skills training tool for all disciplines – Acute care – New techniques and/or equipment – Managing complications – Retraining • Multi-disciplinary training – inter-professional communication – team performance • Training in decision-making/resource co- ordination
    • Conclusions • A large majority of medical errors are related to teamwork, communication and technology management, elements that can be improved though use of simulation. • The adequate simulation technology can be used to reduce different types of errors and their contributing factors.
    • Thank you!