G202(P) Identifying latent risks through in situ simulation training to improve patient safety

Abstract Background Simulation training may improve patient safety, decrease trainer and trainee anxiety, and reduce the number of cases needed for competency. Complications associated with dilation and evacuation (D&E) have been directly related to provider skill level, yet no low-fidelity model has been formally described or evaluated in the literature for second-trimester D&E training. Objective We report physicians' assessments of the realism of 3 D&E models to establish a composite training model. Methods We surveyed experienced providers at 2 national conferences to evaluate 3 D&E models and rate each model's components on a Likert scale. Results Fifty-five obstetrics-gynecology and family medicine physicians completed the survey. Most respondents rated 4 components of 1 model as somewhat realistic or very realistic. The components rated highest were the fetal parts (82% [45 of 55]) and placenta (60% [30 of 50]). This model was rated as more likely to be used in training by 80% (43 of 54) of participants than the 2 other models, as rated by 28% (15 of 54) and 9% (5 of 54) of participants. Conclusions A model made from a plastic bottle containing a stuffed fabric form with detachable parts has tactile similarity to a D&E procedure and should be further developed for testing and training.

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Simulation training to improve patient safety

Operating Room Leadership and Management ◽

10.1017/cbo9781139084277.029 ◽

2012 ◽

pp. 274-278 ◽

Cited By ~ 1

Author(s):

Valeriy Kozmenko ◽

Judy G. Johnson ◽

Melville Wyche ◽

Alan D. Kaye

Keyword(s):

Patient Safety ◽

Simulation Training ◽

Improve Patient Safety ◽

Improve Patient

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The effect of in situ simulation training on the performance of tasks related to patient safety during sedation

Journal of Anesthesia ◽

10.1007/s00540-018-2460-5 ◽

2018 ◽

Vol 32 (2) ◽

pp. 300-304 ◽

Cited By ~ 7

Author(s):

Meital Ben-Ari ◽

Gilad Chayen ◽

Ivan P. Steiner ◽

Dana Aronson Schinasi ◽

Oren Feldman ◽

...

Keyword(s):

Patient Safety ◽

Simulation Training ◽

In Situ Simulation

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Implementation of an in Situ Simulation-based Training Adapted from Morbidity and Mortality Conference Cases: Effect on the Occurrence of Aevents – Study Protocol of a Cluster Randomized Controlled Trial

10.21203/rs.3.rs-479645/v1 ◽

2021 ◽

Author(s):

Nicolas Michel ◽

Bernard Bui-xuan ◽

Lionel Bapteste ◽

Thomas Rimmele ◽

Marc Lilot ◽

...

Keyword(s):

Patient Safety ◽

Adverse Events ◽

Simulation Training ◽

Training Programme ◽

Morbidity And Mortality ◽

In Situ Simulation ◽

Active Feedback ◽

Morbidity And Mortality Conference ◽

Mortality Conference

Abstract Background: Morbidity and Mortality Conferences provides the necessary improvement measures required for patient safety. However, it is an underused resource mainly because the conclusions to be drawn from the discussion and their implications for practice are not always well integrated by inpatient care teams. We therefore propose in this study two interventions to optimise their efficacy; a passive feedback with wide dissemination by e-mail and/or on paper of the results of the Morbidity and Mortality Conference to inpatient care teams, and an active feedback with in situ inter-professional simulation-training programme in which scenarios will be based on cases studied in Morbidity and Mortality Conference. In the present study we hypothesise that the greatest reduction the occurrence of adverse event will be in the active feedback arm.Methods: A cluster randomized controlled study will be performed at four study sites. Passive feedback and active feedback arms will be compared to standard arm in terms of occurrence of adverse events. The trigger tool methodology used to identify adverse events is a retrospective review of inpatient records using “triggers” to isolate potential adverse events. Discussion: The in situ simulation training based on cases processed in Morbidity and Mortality Conference is built according to the main topics identified for the successful implementation of healthcare simulation in patient safety programmes: technical skills, nontechnical skills, assessment, effectiveness, and system probing. The in situ simulation-training programme conducted as part of the study has the potential to improve patient safety during hospitalisation. We therefore expect the greatest reduction in the occurrence of adverse events in patients hospitalised in the active feedback arm. This expected result would have a direct impact on patient safety and would place in situ simulation at the highest level of the Kirkpatrick model. Trial registration: T he study has been registered in Clinicaltrials.gov (NCT02771613). Registered on May 12, 2016.

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P103: A human factors-based framework analysis for patient safety: the trauma resuscitation using in situ simulation team training (TRUST) experience

CJEM ◽

10.1017/cem.2017.305 ◽

2017 ◽

Vol 19 (S1) ◽

pp. S113

Author(s):

A. Petrosoniak ◽

M. Fan ◽

P. Trbovich ◽

K. White ◽

S. Pinkney ◽

...

Keyword(s):

Patient Safety ◽

Human Factors ◽

Improve Patient Safety ◽

Significant Risk ◽

Individual Responsibility ◽

Team Approach ◽

Framework Analysis ◽

Trauma Resuscitation ◽

In Situ Simulation

Introduction: Effective trauma resuscitation requires a coordinated team approach, yet there is a significant risk for error. These errors can manifest from sequential system-, team- and knowledge based failures, defined as latent safety threats (LSTs). In situ simulation (ISS), a point-of-care training strategy, provides a novel prospective approach to identify factors that impact patient safety. This study quantified and formulated a hierarchy of LSTs during risk-informed ISS trauma resuscitations. Methods: At a Level 1 trauma centre, we conducted 12 multi-disciplinary, unannounced ISSs to prospectively identify trauma-related LSTs. Four, risk-informed scenarios were developed based on 5 recurring themes found within the trauma program’s morbidity and mortality process. The actual, on-call trauma team participated in the study. Simulations were video recorded with 4 cameras, each positioned at a different angle. Using a framework analysis methodology, human factors experts transcribed and coded the videos. Thematic structure was established deductively based on existing literature and inductively based on observed ISS events. All LSTs were prioritized for future patient safety, systems and ergonomic interventions using the Healthcare Failure Mode and Effect Analysis (HFMEA) matrix. Results: We identified 893 LSTs from 12 simulations. LST analysis resulted in 8 themes subcategorized into 43 codes. Themes were associated with team-, knowledge- or system-related issues. The following themes emerged: situational awareness, provider safety, mental model alignment, team/individual responsibility, team resources, equipment considerations, workplace environment and clinical protocols. The HFMEA hazard scoring process identified 13 high priority codes that required urgent attention and intervention to mitigate negative patient outcomes. Conclusion: A prospective, video-based framework analysis represents a novel and robust approach to LST identification within trauma care. Patterns of LSTs within and between simulations provide a high degree of transparency and traceability for an inter-professional trauma program review. Hazard matrix scoring facilitates the classification and prioritization of human factors interventions intended to improve patient safety.

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