Presentation by Stefan Gisin at the International conference on Simulation-based training in medicine (Kyiv, Ukraine, March 19-20, 2015) http://motherandchild.org.ua/eng/SimConf-2015

1. Team training matters
for patient outcome
Stefan Gisin, MD

2. / 1
 Critical Incident Reporting
System (CIRS)
 New culture for Patient Safety
and Error Handling
 Crisis Resource Management
(CRM)
 Guidelines & Algorithms
 Use of Simulation
 TEAM TRAINING
Patient safety

6. Emergency Situation
• 3 important facts:
– Characteristics of crisis situation
• Not influenceable!
– Knowledge and competences
• Can be improved!
– Multidisciplinary teamwork
• Can be improved!

7. Simulation
• Collaboration Swissair / Anesthesiology Basel

8. Aviation US Airways 1549

9. Aviation Training

10. Umbilical Cord Prolapse

11. Umbilical Cord Prolapse

12. Confidential enquiries UK (CEMACH,CESDI)
• Potentially avoidable!
– 50% maternal deaths
– 75% intrapartum related deaths
• Contributing factors
– Communication problems
– Absent or poor teamwork
– Poor interpersonal relationship
• Fire drills“ for better management of obstetrical emergencies
– Multiprofessional
– Teamwork training
– Annual repetition of training for all staff
– CTG-courses every 6 months

13. • 1 day emergency training
interprofessional every 2
months
• Decrease interval decision
delivery :
25 vs 14,5 min p <0.001
• Increase in recommended
actions to alleviate cord
compression
34,7% vs 82,3% p=0.003
Siassakos D et al BJOG 2009
Emergency C-section

14. Simulation

15.  Retrospective analysis 1998 – 1999 (8430 births)
 Intervention 2000: multiprofessional training
Neonatal outcome

16. 86/10.000 births 44/10.000 births
27/10.000 births 13/10.000 births
 Results 2001 – 2003 (11’030 births):
 50% reduction APGAR < 6
 50% reduction hypoxic-ischemic encephalopathy
 70% reduction plexus injuries after shoulder dystocia
Neonatal outcome

17. Neonatal outcome

18. Surgical outcome

19. Surgical outcome
 … 50% greater decline in risk-adjusted mortality …

20. Surgical outcome

21. Teamwork

22. Teamwork

23. Team oriented medical simulation

24. спасибо
stefan.gisin@simulation.ch