Congratulations! You Have Robots, Now What?

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You’ve made the business case for purchasing (including the extended maintenance agreement), celebrated the approval from your supervisor and have been waiting patiently for your new simulator to show up. And then, it finally happened.

You unbox the high fidelity patient simulator and laptop(s), assemble the fluid ports, cables, cords and so on.  You stand back and admire the pristine look of the simulator and perhaps dream of how you’ll impact the world of teaching and learning. Someone calls you and says “let’s do a simulation this afternoon”. Excitedly, you say “YES!”…but here’s why you should say “I love your enthusiasm, but let’s reschedule for a later date.”

New technology is pretty appealing, but without understanding how your simulator functions on-site could mean some unnecessary technological and professional relationship hiccups.

If you’re running a wireless connection, how does it perform? What’s the actual distance that your connection can really perform at? Is the software lagging? What about wireless interference? Do cell phones cause connection issues? If you’re using wireless cameras for recording and debriefing, do they cause any issues? I encourage you to be very curious at this stage and test, test, TEST your simulator and environment before running scenarios!

You’ve read the instructions, filled the fluid ports and feel like you are ready to start running scenarios. Have you considered failure and contingency planning? Discussing this with your teams will definitely help you and your program. Dealing with a massive technological failure mid-scenario can be embarrassing and frustrating to you, learners and instructors. Not knowing how to deal with failures can add even more stress to the situation. Do some risk analysis and draft up a plan of “if XYZ happens, the next steps are…”

It’s always exciting to receive new technology, however, there’s a lot of planning that should be considered from the time that the simulator arrives and when actual simulations are being performed. By planning, testing and refining actual performance and processes, your simulation teams can alleviate many potential headaches.

Cheers,

Matthew

About the Author: Matthew Jubelius wants to change the future of education and training. He has championed the design, implementation, and evaluation of simulation-based education and training programs, including quality improvement measures for post-secondary institutions, private industry, and the federal government. Matthew can be reached through www.amoveotraining.ca

Simulation-Based Education: Experience Matters. Patient Safety Matters.

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It’s been nearly a decade and I can still recall the day that simulation-based education and training made sense to me and witnessed the profound benefits for healthcare practitioners, workers, and patient safety.

I had never observed a simulated training event and was curious what was going to happen. The concept of using patient simulators was intriguing and I was optimistic about how the learner was going to perform.  The cohort had completed their traditional lecture and lab-based education and was “ready” to deliver care.

The simulation experience was based on Advanced Cardiac Life Support (ACLS) guidelines and the learning objectives were:

  1. Recognize a life-threatening ECG rhythm
  2. Activate emergency system and call for assistance
  3. Administer appropriate ACLS medications and perform CPR

Before the experience, I observed the learner’s behavior and they appeared very confident. “Let’s see what happens,” I thought to myself. The lights went out and the simulation began.

The patient simulator was breathing, showing signs of distress and the software performed spectacularly according to the preset programming (shout out to engineers). The learner entered the event area and began to assess the simulated casualty. The ECG was set up and displayed a life-threatening rhythm that needed defibrillation and immediate drug therapy. Something wasn’t right; the learner interpreted the incorrect ECG rhythm and started giving the wrong medication.  The simulator responded in real-time, vital signs became more complicated and the patient simulator condition worsened.  Within a very short time, the situation became unmanageable for one person, yet there was no call for support. There was no call for help. The scenario continued and ultimately the experience had concluded. In this case, things did not end well.

In the debriefing phase, the facilitator went into more detail about what happened; based on the learner’s performance and connected the pieces to a meaningful learning experience. The scenario was repeated and the learner’s performance was dramatically improved, resulting in better outcomes for the simulated patient. Truly remarkable learning.

Why does this matter? The immersive experience in a controlled environment provided an additional layer of safety, where potential errors could be addressed and corrected well out of harm’s way.

Simulation-based experiences have the ability to positively impact patient safety, help people and teams deliver appropriate interventions.  Simulation – the replication of an experience, can also expose system weaknesses and provide opportunities for healthcare quality improvement.

By designing and facilitating experiences based on models of current and best practices, we have the opportunity to address current challenges and impact the future of healthcare delivery.

Even after thousands of simulation experiences, I remain passionately curious about how people interact with complex systems. Failure can be an enormous learning experience, especially in a setting where there is absolutely no risk to patients.

I believe that we can make a difference in creating safer and effective systems.

Matthew
About the Author: Matthew Jubelius wants to change the future of education and training. He has championed the design, implementation, and evaluation of simulation-based education and training programs, including quality improvement measures for post-secondary institutions, private industry, and the federal government. Matthew can be reached through www.amoveotraining.ca

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Big News is Coming

Hi there!

Our team has been working on several awesome projects over the course of 2018 and we’re excited for 2019.

Make sure to follow us on LinkedIn to see more photos and news that’s up to the minute. We’ll be sharing some big news there shortly.

Cheers,

Matthew

Healthcare Simulation: Innovators Wanted

Modelling and Simulation are concerned with exactly that: replicating the model and simulating the conditions as close as possible to the current standard. In some cases, creating that perfect simulated experience takes a lot of innovation and creativity. I applaud and respect the many simulationists that work behind the scenes in modelling to increase the realism of training experiences.
With many healthcare simulation centres that are underfunded and understaffed, it takes innovation and creativity to make things happen. It takes a keen eye to redistribute resources as needed. From experience as a former centre administrator, I noticed that we were going through an insane amount of oxygen in our labs that carried significant cost. What could be done to optimize resources? Several things:
First, we needed to understand how much oxygen was costing us to provide a picture of the financial importance. Next, we needed to collect information from instructors, staff and ask vital questions regarding learner safety such as “do we actually place oxygen on a live person in a simulated experience?”, “does the simulator only receive oxygen?”, “does real oxygen actually change the simulator’s vital signs?”, “what safety labelling do we need to place on a nursing headwall?” and so on. I would also recommend performing a risk assessment with key external stakeholders including occupational health and safety departments. When you have collected the information and identified risks, you can make an evidence-based decision with your team.
In my situation, we made the switch to compressed air. The cost to create a compressed air delivery system was minimal compared to cost savings of traditional oxygen. The decision to switch had additional benefits that included the injection of tens of thousands of budget dollars could be reallocated into program support per year. Yes, per year! It also decreased operational demand as we did not need to have staff call suppliers, request refills, set aside delivery time, pay for cylinder maintenance, etc.
Many healthcare simulation centres are not fully supported and rely on the innovation of team members to maximize operations. Take a look around your department, what do you see that could be optimized? Send me an email, I’d love to hear about it.
Matthew
About the Author: Matthew Jubelius is a subject matter expert in healthcare simulation. He is a consultant, educator and wants to change the future of people development, education, and training. He has championed the design, implementation, and evaluation of simulation-based education and training programs, including quality improvement measures for post-secondary institutions, private industry, and the federal government.
Matthew can be reached through www.amoveotraining.com for simulation consulting, program development, employee training and speaking engagements.
#simulation #safety #education #qualityimprovement

Simulation: Using Quality Improvement to Increase Patient Safety

Simulation-based Education (SBE) is a wonderful teaching and learning application to increase patient safety, but did you know that it can also be used for quality improvement activities as well?
So, what’s the big deal with quality improvement and why does it matter? Quality improvement (QI) is used in many industries to decrease variation and there is a huge focus on standardization. This includes documentation and educational sessions to ensure that everyone is following the same process and approaching situations in the same manner. In previous posts, we mentioned the importance of having certain elements when designing an immersive scenario (feel free to take a look at the post What’s the Plan: The Importance of Design). This is a standardized approach that allows the instructor to design a plan that is consistent.
Being consistent is a key feature in quality improvement activities. If there are several different approaches being used, there is a potential not only for error, but also contributes to waste such as materials, time, etc. Demonstrating a consistent approach to designing a SBE activity helps ensure that clear learning objectives are being met, which helps the learner demonstrate competency and safe patient care. For example, when learning about how to obtain a blood pressure or auscultate heart and lung sounds, there is a clear and distinct order in how to perform the assessments. If healthcare professional #1 decides to talk while listening to heart and lung sounds, it may take longer to obtain clinical findings and they may be inaccurate. If healthcare professional #2 decides to obtain clinical information without the proper equipment, there will be challenges in understanding the competency of professional #2. Of course, these are hypothetical examples of variance to approaching patient care.
So, how do we decrease variance and improve quality improvement? Try using a checklist with your individual and team care. What’s working and what is the team great at? Are there some items that you would like to see improvement on? What are they and how will you measure success?
There are many opportunities to use QI activities to improve patient safety. Whether through implementing them in a SBE experience or in real-time, the benefits to the patient are positive. And, that’s who this is for.
Have an outstanding week,
Matthew
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About the Author: Matthew Jubelius wants to change the future of people development, education, and training. He has championed the design, implementation, and evaluation of simulation-based education and training programs, including quality improvement measures for post-secondary institutions, private industry, and the federal government. Matthew can be reached through www.amoveotraining.ca