Polling Question. Polling Question. Taking Education to the Healthcare Team In-situ Simulation in Acute MI Care as a Model for Team-focused CME

Transcription

1 Polling Question How many people are participating in this webinar at your location today? Just me! More than 10 6 Polling Question What member section do you belong to? Health Care Education Association Federal/Government Health Care Educator Hospital/Health System Medical Education and Communication Company Medical School Medical Specialty Society State Medical Society Pharmaceutical Other Taking Education to the Healthcare Team In-situ Simulation in Acute MI Care as a Model for Team-focused CME Tuesday, June 15, :00-3:00 PM ET Alliance for CME

2 Presenters Laura Lee Hall, PhD Associate Director, Strategic Educational Initiatives American College of Cardiology Elizabeth Yarboro Associate Vice President American College of Cardiology 4 Let s Get On the Same Page Introduction and Disclosures Laura Lee Hall, Ph.D. Associate Director, Strategic Educational Initiatives, American College of Cardiology Does not have an interest in selling a service to CME professionals Elizabeth Yarboro Associate Vice President, Professional Development & Education Division Does not have an interest in selling a service to CME professionals

3 Objectives To answer the following questions: What is in-situ simulation? What is its educational significance? When and how can you apply simulation? First, some acknowledgments Simulation Team ACC Team Laura Lee Hall, PhD Project Director Associate Director of Strategic Educational Initiatives Amanda Pauley Associate Director, Educational Grants Obsie Debela Specialist Elizabeth Yarboro Associate Vice-President Professional Development & Education Western Michigan University Center for Simulation Research Team William R. Hamman, MD, PhD Principal Investigator John Niehaus, BS Technician Mentice Inc. Team Cynthia DeMeyer RN Clinical Application Specialist Graham Bostrom, BS Technician Beth Seiler, MS Research Associate Vice-President PSOne, Inc., Ben Speich, BS Customer Service Engineer Melissa Ketchum Senior Specialist Chester Dalski, AAS, BS, RN-P, EMS I/C, MA Technical Director Jennifer Smith Assistant 9

4 Commercial Support This project is supported by an educational grant from Pfizer and St. Jude Medical, general educational support for ACCF s educational programs from Medtronic Foundation, and by the ACC 11 Single Most Challenging Problem Reported by Responding Hospitals (n-522) 25.0% Percentage of hospitals 20.0% 15.0% 10.0% 5.0% 0.0% ED physician Single call Cath lab team Prompt data Senior Team-based Other activation activation available 20- feedback management approach challenging of cath lab of cath lab 30 commitment problem minutes after page

5 What is In-situ Simulation? Simulation exercises conducted on actual patient care units involving actual healthcare team members employing actual organizational processes psychologically engaging learning experience more than training and performance assessment methodology: part of larger organizational culture change initiative 13 DOOR TO BALLOON IN SIMULATION 14 In-situ Simulation: Project Design -30 of 81 volunteers selected from CathPCI Registry and ACTION Registry GWTG -Participants selected and matched based on D2B time, caseload, + surgical back-up, geographical diversity, and commitment of hospital leadership Control group I (n=15) - Matched controls; no intervention Control group II (n = 5) - Informed consent/pre-sim assessment - One simulation - EMS - Brief, general debrief - Post-assessment - Receipt of post-simulation report Experiment group (n=10) - Informed consent/pre-sim assessment - EMS simulation - Deep debrief - First post-assessment - Walk-in simulation - Post-assessment - Receipt of comprehensive post-simulation report

6 Project Milestones Beta-test Conducted 10/7 Henry Ford Hospital 1 st advisory Group meeting Second betatest 15-hospital implementation November 12 th New Orleans Conducted 2/21 Mercy Hospital May-October 2009 Data analysis End of 2009/Mid-2010 Dissemination of results June-December Information Sources on STEMI System Pre-selection survey STEMI treatment algorithm from EMS/ED/Cath lab Lab orders Pre-simulation survey Pre-selection Survey Contact information for leadership in EMS/ED/Cath lab Questions concerning: EMS-ECG capabilities and use; cath lab activation methods (who activates the lab, preactivation diagnostic tests); time for cath lab readiness; transport from ED (or EMS) to cath lab; walk-in registration approach

7 Sample Rating Form Effective transfer of information during transition and care Complete clear communication (closed loop) NA Announces changes in patient condition NA Assign and reassign tasks NA Defining Roles Care Leader clearly defined NA Care Coordinator clearly defined NA Care Givers clearly defined NA 19 Teamwork Skills Correlating with Outcomes Announce plans, seek confirmation/consultation Communicate clearly what is needed from outside depts. Follow-up until need has been met Assign and re-assign tasks to personnel Update patient on changing conditions Announce significant changes in patient status Verbalize potential threats and risks Brief team on situation and goals State directions clearly, in commonly understood language Ask for patient and family information/input Request clarification of ambiguous answers 20 Common System Barriers Transporting the patient in healthcare system Difficult interdepartmental communication Undefined team member roles as the catheterization team came together in the room 21

8 Transfer of clinical information between departments Communication with patient Common System Barriers!

9 At Last! Where Do You Keep Your Notes? CME/CE Evaluation Data

10 Hospital Post-simulation Interview Results Concerning Action Taken to Improve Acute STEMI Care Number of Hospitals Action Taken 4 Reconvened participants to review simulation videotape and discuss implications for care processes 2 Planning to use video-recording for future education 3 Developed patient information forms to assure transfer of vital patient information in real time between departments 4 Working to better specify health care staff functional roles in ED and/or catheterization laboratory 3 Developed methods for better communicating care plan to all staff in the catheterization laboratory 1 Used in Chest Pain Center certification process Relevant Lessons Learned Can implement in situ simulation in complex healthcare environment BUT requires lots of teamwork! Educational model appears to improve teamwork, communication, and systems Model of combining education and research 29 For the CME Professional Work in collaboration with clinical content experts and core competencies Partner with experts in simulation/technology Bring QI into the mix 30

11 FOR MORE INFORMATION CONTACT: 31 QUESTIONS? We welcome your questions and comments. Please use the chat box on the left side of your screen to submit a question. 32 Thank You! Please take a moment to complete the brief evaluation. We appreciate your feedback!

12 Thank You! Join us for the Alliance s next Takeout Tuesday webinar! Translating What You Do into What You Write in Your Self-Study for ACCME Accreditation Tuesday, July 20, :00 3:00 PM ET