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Alert 2017 wheaton

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The utilization of just-in-time simulation in optimizing the quality of rapid response calls and resident contingency planning

Published in: Health & Medicine
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Alert 2017 wheaton

  1. 1. ALERT Presentation: The utilization of just- in-time simulation in optimizing the quality of rapid response calls and resident contingency planning Taylor Wheaton, MD, Kheyandra Lewis MD, Emmanuelle Topiol MD, Sharon Calaman MD St. Christopher’s Hospital for Children, Philadelphia, PA INSPIRE @ IMSH 2017 – Orlando, FL, USA International Network for Simulation-based Pediatric Innovation, Research and Education
  2. 2. • Training in the era of duty hour restrictions – Increased handoffs • Barriers to activation of rapid response team – Poor self efficacy in recognizing need – Perception of poor interpersonal implications – Hierarchy in medical teams • Curricula currently in the literature does not address just-in-time simulation as it pertains to these patient-centered outcomes International Network for Simulation-based Pediatric Innovation, Research and Education Background
  3. 3. • Population: Pediatric residents at St. Christopher’s • Intervention: Six months of weekly just-in-time simulation • Control/Comparison: Six months immediately preceding the intervention • Outcome(s): – Improved quality of rapid response calls – Improve quality of contingency planning on written handoff document International Network for Simulation-based Pediatric Innovation, Research and Education PICO / Research Question
  4. 4. International Network for Simulation-based Pediatric Innovation, Research and Education Approach / Design Senior resident identifies “watcher” Senior resident and simulation coordinator develop just-in-time simulation
  5. 5. International Network for Simulation-based Pediatric Innovation, Research and Education Approach / Design Inpatient team and nursing convene for simulation 15 minutes of simulation 15 minutes of debriefing
  6. 6. International Network for Simulation-based Pediatric Innovation, Research and Education Approach / Design Rapid Response Quality Contingency plans and Situational Awareness Resident Perception • Delayed calls >4hrs • Disposition of the patient • Treatments initiated on the call • Length of stay and interventions taken in the critical care unit if transferred • Quantity of plans on written handoff document • Quality of data on written handoff using validated I-PASS tools • Pre-intervention survey • Post-intervention survey
  7. 7. • November 2015 – IRB submission – Renewed November 2016 • February 2016 – Intervention initiated with concurrent data collection – August 2016: Post intervention data collection started • Ongoing data analysis for rapid responses and contingency plans • Winter 2016-2017 • Spring 2017 International Network for Simulation-based Pediatric Innovation, Research and Education Timeline
  8. 8. 1. Is there opportunity to expand to a multi-institutional collaboration to increase the power of the study? 2. Are there recommendations on evaluation of trainees and other participants? 3. Are there suggestions for reviewing additional outcomes? International Network for Simulation-based Pediatric Innovation, Research and Education 3 questions to improve study
  9. 9. At INSPIRE @ IMSH 2017: To obtain multi-institutional collaboration in expanding the study In 2 months: To begin final phase of data analysis International Network for Simulation-based Pediatric Innovation, Research and Education Goals to accomplish
  10. 10. Taylor Wheaton, Kheyandra Lewis, Emmanuelle Topiol, and Sharon Calaman St. Christopher’s Hospital for Children International Network for Simulation-based Pediatric Innovation, Research and Education Contact Information Taylor.wheaton@drexelmed.edu 607 425 5331 Kheyandra.lewis@drexelmed.edu 215 427 4132 Emmanuelle.topiol@drexelmed.edu 215 427 5170 Sharon.calaman@drexelmed.edu 215 427 8846

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