Tag #education #leadership #reflection #excellence

Simulation: Using Quality Improvement to Increase Patient Safety

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

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Simulation-based Education Matters

Simulation-based Education Matters

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 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.

Building on Strengths

Building on Strengths

People are awesome! Think about it. I really believe that individuals and teams are capable of accomplishing great things. Flight, capturing and storing electricity, the creation of the internet, advances in modern medicine… Yes, people can do great things.

We often hear about these successes from a distance through media and can list numerous famous individuals because we see their name in the highlights. Have you ever wondered what made them successful and strong? Although I will never know the true answer, this causes me to reflect on several questions a little closer to home: What are my strengths? What makes me successful? What am I most proud of?

There are many things that contribute to our strengths and we all have varying degrees. Some people are physically gifted with an abundance of muscle mass or athletic talent, some have outstanding intellect, while others carry enough empathy to completely understand and calm one’s soul. Whatever our strengths are, how much time do we devote to building on them?

There are different theories of how long it takes to become excellent or master a subject; for example, Malcolm Gladwell and the 10,000 hours concept. However, what about the personality traits that make us amazing, is there a time requirement? Does the learning stop after 10,000 hours?

I believe that we continually evolve as we grow from our experiences. One of my strengths is that I love to educate and inspire others. Another is that I’m very passionate about creating safer communities and know that we can do more to train effective healthcare and safety personnel. I truly believe that we can make a difference. For me, there is no time requirement. This is me, every single day and I know that I’m not alone. My passion doesn’t have an off switch.

We all have the capacity for greatness. We’re also given 24 hours in a day and we know that it takes time to work on our strengths. This week, think about what you’re amazing at. What are your strengths and passions? How will you build on them?

Have a great 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 development, employee training and speaking engagements.

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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