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Simulation to Assess the Safety of New Healthcare Teams and New Facilities.
MedLine Citation:
PMID:  21383646     Owner:  NLM     Status:  Publisher    
INTRODUCTION:: Our institution recently opened a satellite hospital including a pediatric emergency department. The staffing model at this facility does not include residents or subspecialists, a substantial difference from our main hospital. Our previous work and published reports demonstrate that simulation can identify latent safety threats (LSTs) in both new and established settings. Using simulation, our objective was to define optimal staff roles, refine scope of practice, and identify LSTs before facility opening. METHODS:: Laboratory simulations were used to define roles and scope of practice. After each simulation, teams were debriefed using video recordings. The National Aeronautics and Space Administration-Task Load Index was completed by each participant to measure perceived workload. Simulations were scored for team behaviors by video reviewers using the Mayo High Performance Team Scale. Subsequent in situ simulations focused on identifying LSTs and monitoring for unintended consequences from changes made. RESULTS:: Twenty-four simulations were performed over 3 months before the hospital opening. Laboratory debriefing identified the need to modify provider responsibilities. National Aeronautics and Space Administration-Task Load Index scores and debriefings demonstrated that the medication nurse had the greatest workload during resuscitations. Modifying medication delivery was deemed critical. Lower Mayo High Performance Team Scale scores, implying less teamwork, were noted during in situ simulations. In situ sessions identified 37 LSTs involving equipment, personnel, and resources. CONCLUSIONS:: Simulation can help determine provider workload, refine team responsibilities, and identify LSTs. This pilot project provides a template for evaluation of new teams and clinical settings before patient exposure.
Gary L Geis; Brian Pio; Tiffany L Pendergrass; Michael R Moyer; Mary D Patterson
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-4
Journal Detail:
Title:  Simulation in healthcare : journal of the Society for Simulation in Healthcare     Volume:  -     ISSN:  1559-713X     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264408     Medline TA:  Simul Healthc     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
From the Division of Emergency Medicine (G.L.G., M.D.P.), Center for Simulation and Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; and Center for Simulation and Research (B.P., T.L.P., M.R.M.), Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
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