Vail Health Magazine 2013 - page 37

Photos by Dominique Taylor
VVMC’s manikin family, the
Jetsims, are found in an RV converted
into a high-tech mobile training lab.
Opposite page, clockwise from top:
Emergency medical technicians, nurses and
paramedics practice transferring a manikin
from emergency medical services care to
Emergency Department care. Handoffs
are practiced to ensure a high quality of
continuum of care. The team simulates
management of a patient’s airway through
placement of a breathing tube.
And so began the effort to
implement a simulation education
program at VVMC. It started with
a vision that has become a reality
in the form of a 40-foot bus and a
family of manikins — the Jetsims:
George and Jane and their children
Elroy, Ollie and Judy.
For VVMC, simulation training
will close a gap so often experi-
enced by health care institutions
located outside of a metropolitan
area: the ability to prepare for
low-volume, high-risk medical
occurrences and to develop and
refine skills that may save a life.
Prior to the implementation of
VVMC’s mobile simulation learn-
ing program, participation in clini-
cal educational events typically re-
quired a trip to Denver or beyond.
Over the past decade, simulation
training has rapidly gained ground
as a preferred tool for health care
professionals to acquire and hone
skill sets that may not get much
use in day-to-day operations or
are emerging best practices. In
this world, everyone is an outlier
capable of achieving 10,000 hours
of practice. And, as we all know,
practice makes perfect.
“Historically, health care edu-
cation in the hospital has been
based on situations you happened
to encounter in your training
or orientation,” says Mary Hinz,
VVMC’s Clinical Simulation Edu-
cator. “Through simulation, we can
conduct identical and repeatable
learning events, ensuring that
health care providers within all
of our facilities practice the same
high level of expertise.”
Added Alice Weydt, VP of
Patient Care: “The ability to perfect
our skills in a learning environ-
ment builds our confidence to care
for patients that we see routinely
or only occasionally.”
The manikins are startlingly
lifelike — one reason they’ve been
given names. Their chests rise and
fall as they breathe. They blink, cry
and talk, all via the technicians at
the computer controls. VVMC’s
two simulation technicians devel-
op scenarios that are designed to
elicit responses from the manikin
based on interventions conducted
by the staff. Simulation techni-
cians sit out of sight and manip-
ulate the sequence of actions and
reactions for the practicing team
via video feed. The manikin’s skin
is capable of absorbing various
injections or cuts and blood and
other bodily fluids are produced
accordingly. One could almost
expect the patient to sit up and
reach for the TV remote.
As important as it is to know
the sequence of events to treat
and stabilize a patient when a
medical situation presents itself,
it’s equally important to hone
communication skills between
team members. “Past research
by The Joint Commission (the
independent entity that accredits
and certifies hospitals across the
United States) has indicated that
a majority of medical mistakes
are caused by errors in commu-
nication and teamwork,” says
Hinz. “Team-based simulation
supports perfecting clinical skills
and critical thinking while we
integrate both behavioral and
communication competencies
into every scenario.”
In a typical VVMC simulation
scenario, a team of six to eight
medical professionals is gathered
around a stretcher inside the mo-
bile training center. There may be
some live acting in the form of a
distraught loved one who will give
an initial set of circumstances or
sequence of events that led to the
patient’s current condition. That
same person, typically part of the
team that conducts the sessions,
will also respond to questions, but
will keep to an undisclosed script.
The medical team’s assessment
and treatment of the patient are
video recorded for playback in a
debriefing session — what went
well, what could be improved,
what was learned.
“With the capacity to create
specific scenarios, we can
adapt education to specific
learning needs,” says Hinz. “For
example, all caregivers will
experience learning events
focusing on the care of a pregnant
woman; however, the needs of
the ICU staff will differ from our
obstetric caregivers. This scenario
design concept continues our
focus on a safe learning environ-
ment as we alter the complexity
of care to match the learner’s
level of expertise.”
By having a mobile training
center, VVMC can bring simulation
to its five campuses along a 36-mile
stretch of I-70, as well as to other
groups such as ski patrol, paramed-
ics and rescue organizations. This
way anyone involved in the contin-
uum of care can achieve a level of
training that will enhance patient
outcomes. In time, the program will
be shared with other health care
institutions outside of Eagle County
on Colorado’s Western Slope.
“We now have an enormous
opportunity to elevate the level
of care and collaboration among
groups that share the same goal:
providing the best possible care to
anyone in need, no matter where
that care occurs,” says Hinz.
For Kirchner, the reality of an
idea borne out of a happenstance
moment is a milestone for Vail
Valley Medical Center. “We are a
unique health care institution,” says
Kirchner. “I like to say we’re a big
little hospital. For a 58-bed facility,
we are expected to provide a vast
array of services. And we want to be
able to give our patients exemplary
care, which means we need to be
prepared to handle virtually any-
thing on a moment’s notice.”
by having a mobile
training center,
vvmc can bring
simulation to its
five campuses
along a 36-mile
stretch of i-70.
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