Archive March 2018

Simulation and Safety

Simulation and Safety

Absolutely. It’s very clear that simulation and safety go together and in previous articles, we’ve discussed how quality improvement fits in as well. But how do simulation and safety go together? More research is being conducted in Medical and healthcare simulation and this is a good thing. Here’s some literature about simulation and why it’s needed in healthcare training and education.

The hallmark To Err is Human was released in 1999 and healthcare has made progress. In 2015, the National Patient Safety Foundation released a report entitled Free from Harm: Accelerating Patient Safety Improvement Fifteen Years after To Err is Human and outlined eight key recommendations:

  1. Ensure that leaders establish and sustain a safety culture
  2. Create centralized and coordinated oversight of patient safety
  3. Create a common set of safety metrics that reflect meaningful outcomes
  4. Increase funding for research in patient safety and implementation science
  5. Address safety across the entire care continuum
  6. Support the healthcare workforce
  7. Partner with patients and families for the safest care
  8. Ensure that technology is safe and optimized to improve patient safety

So, how are we doing? There’s room for improvement. Another alarming statistic that medical error is the third leading cause of death in the United States. Let that sink in for a moment. Third. In the United States. Further, Makary and Daniel (2016) suggest that there may be over 251,000 deaths annually as a medical error is not recorded on US death certificates.

There are many factors that can lead to a medical error including working conditions, patient load, distractions at work, resource shortages, personal stress, employee disengagement, unanticipated conditions such as natural or man-made disaster and the list goes on. Healthcare is a very complex system that has many moving parts at any given moment.

However, what if we had the opportunity to make a difference? What does that look like? Some might say “Yeah, but what can you do about it? The system is just too big to make a change”. Rather than give in, what if you reframed the conversation?

What if today, you observed a potential error and said something to someone about it (in a nice way, of course)? Maybe you noticed some unsupervised medications on a hospital unit. Perhaps, you noticed how an IV paralytic medication and a blood pressure medication have similar packaging. Maybe your simulation program relies on the good graces of expired medications that were donated and the school uses them for demonstration purposes.

What would it look like if you brought the potential of error forward to your supervisor or a senior management team? It takes courage to speak up, it really does. I implore you to say something if you see something that needs changing. The safety of people depends on your courage. We talk about patient safety a lot; but consider your personal safety, the safety of your colleagues, the safety of students. Critics may say “Sounds like too much work” or “That’s above my pay grade” and other complaints. Don’t be afraid to step up and speak up.

Safety is about doing what is right. At the end of the day, the most important thing is to go back home to our loved ones, our friends, our pets, our lives.

Be safe. Be awesome.

Matthew

I want to help raise awareness for simulation-based education, patient safety, and quality improvement and I need your help. Please share the link with people that you feel would enjoy what we’re about. If you really enjoy the content, subscribe for free at the bottom of the page to get the good news delivered straight to your inbox.

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.ca for simulation consulting, program development, employee training and speaking engagements.

Referenced Material:

Institute of Medicine (1999). To Err is Human: Building a Safer Health System. Courtesy of the National Academy of Sciences (2000). Accessed through www.nap.edu/catalog/…/to-err-is-human-building-a-safer-health-system

James, J. (2013). A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care. Journal of Patient Safety, Vol 9(3). P122-128 Accessed through http://journals.lww.com/journalpatientsafety/Fulltext/2013/09000/A_New,_Evidence_based_Estimate_of_Patient_Harms.2.aspx

Makary, M.A., Daniel, M. (2016). Medical Error – The Third Leading Cause of Death in the US. BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i2139

National Patient Safety Foundation (2016). Free from Harm: Accelerating Patient Safety Improvement Fifteen Years after To Err is Human. Accessed through http://www.npsf.org/?page=freefromharm

 

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Developing People

Developing People

Have you ever started a new job? Of course! We all have. Depending on your surroundings, it can be pretty intimidating. While learning your new role in addition to (but not limited to) break schedules, Human Resources info, Occupational Health and Safety policies, organizational processes, getting to know your supervisor, names of the administrative staff, colleagues and so on… how do you develop in the role?
There are many approaches to people development and perhaps the one that we are most familiar with is the “sink or swim” mentality. Personally, I believe that this approach is antiquated and does not set people up for success. Work cultures are changing and we can take an approach from simulation training and apply it to employee development.
Simulation can be defined as the replication of a system. An immersive scenario or event is designed and modeled according to objectives and expectations and an accurate simulation reflects the fidelity or reality of the system. With this in mind, how do we use simulation to develop new hires? Modeling. No, not the runway and catwalk in New York or Milan type; model the behaviors and reality of the job. Here’s why modeling is important – it sets the nature or tone of the working relationship and the first 90 days are critical to employee development.
The most important development tool during the modeling phase is the mentor, buddy, senior staff or whatever the common term is in your workplace. This mentor should be someone who is great at their job and who demonstrates or models the key characteristics that you want to see in the new employee. Consider the example of someone who is happy at work, who lends a helping hand to colleagues and does a good job. Alternatively, think about the mentor who was “told” that they are mentoring a new staff member 15 minutes before a shift begins. There can be two very different experiences and outcomes for the new employee and mentor. Either way, the result reflects the working culture and expectations of the new hire.
Bringing new employees on board can be an exhilarating experience and is a critical piece in employee development. The use of modeling key behaviors and expectations through mentors that we see in a simulation can help alleviate stress for new employees, help build positive relationships, impact work culture and most importantly, set the person up for success.
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Create an outstanding week,
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.ca for simulation consulting, program and people development opportunities.

Simulation Operations: Building a Winning Team

Simulation Operations: Building a Winning Team

Operations. The Daily Flow. The Day-to-Day. The Grind. The Work Week. Whatever you call your schedule, operations are vital to the success of your simulation (and any) program and when things are not flowing according to plan, equipment gets (and stays) broken, faculty, instructors, and students are not happy. Simulation is a team sport and assembling an awesome operations team will make or break your program. So, what are the key elements?

The number one element and characteristic that a simulation team must share is a service leadership mentality. Without a shared vision of being of service and helping others, things can fall apart quickly. Ultimately, there will be times where people become frustrated for whatever reason; equipment will break, politics happen and so on. If your team is consistently willing to help solve problems and assist others, this will move your program forward. It’s very important that the operations team (including management) needs to be on the same page when it comes to being of service to others.

Another key element is having a strong administrative and detailed focused person. This individual will obtain numerous product and supplies quotes, draft schedules, demonstrate outstanding customer service and resolve conflicts with strong personalities (but there are no strong personalities in healthcare, right? *wink wink). The administrative component of your program needs to possess the ability to remain patient and calm, follow up and be highly effective communicators. Depending on the size of your operations, you may want to consider web-based scheduling to free up some administrative and logistics time.

What about the technical element? Is a healthcare background necessary to be a simulation technologist? Perhaps we can discuss this topic in a future post, however, does it take a Master’s degree to operate and fix a patient simulator? No. What is important is to demonstrate service leadership and help solve problems. Of course, the technical person should be keen on how the equipment works, including some general knowledge of information technology.

The most important aspect of the operations team is attitude and the shared vision of being of service. Technology changes, people win the lottery and quit jobs and the list goes on. Clearly demonstrating that the team is there to help will take your simulation program to the next level. After all, people want to be around those who are positive and helping others develop is what simulation is all about.

Cheers,

Matthew

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