Global Healthcare Simulation Update from SimGHOSTS President

08/22/2016

Blog post by SimGHOSTS President Scott Crawford

Global Healthcare Simulation Update from SimGHOSTS President

 

I was recently given the opportunity to represent SimGHOSTS and the voice of simulation operators at the Global Network for Simulation in Healthcare (GNSH), a summit of leaders from simulation organizations and corporations around the world, in Oxford, England. This is the second year I have been awarded this opportunity, and this piece will give some insight into the state of healthcare simulation globally.

We have heard perpetually that simulation is the answer to patient safety concerns and that it was born out of a similar system used by the aviation industry during the last half century. While a great deal of pioneering work in this industry has crossover, the ability to accurately reproduce human physiology is much more difficult than the ability to mimic the function of an airplane. Still, improving communication and addressing human factors – ways people can work better in the healthcare system to deliver quality patient care – are likely to bring about the greatest change in patient safety.

Some of the greatest challenges in healthcare delivery are related to interpersonal communication breakdown. Often a member of the healthcare team has information to prevent errors but does not share it due to fear of hierarchy or concerns of demonstrating inadequate knowledge. While the aviation industry has been able to adopt a culture of change that supports and encourages any member of the flight crew to mention concerns, this is still in early adoption throughout the healthcare industry. A push toward in-situ simulation and interprofessional simulation is expected to facilitate this culture change in the world of healthcare.

Laerdal CEO Clive Patrickson said, “Do good, save money” during the GNSH summit. While few would argue that simulation does anything but good, the debate about saving money is not universally accepted. Equipment, personnel, warranties and training are all expensive, and some still argue that they don’t know the value of simulation. That is likely because the conversation for many years has revolved around the notion that we must still translate simulation training into a direct improvement in patient outcomes. While this is an admirable goal, the truth is that too many other educational and training activities, as well as too many individual system variables, exist to allow this type of direct translation. Instead, should we not also focus on other aspects of the healthcare system?

Does simulation also improve the efficiency of care provided, by allowing more efficient and appropriate treatment and transitions of care? Are nurses who are trained in a simulation environment more capable of entering directly into the workforce without requiring on-the-job training? Are care providers who are better prepared to care for and monitor critically ill patients less likely to experience burnout and have a connection to the healthcare team that will decrease staffing turnover and save the system money? I think the answer to many of these questions is undoubtedly “yes.” But the push to look at direct patient care outcomes has clouded a larger and more system oriented view of simulation-based training.

Michael Seropian, past president of IMSH and current Chair of GNSH, suggested simulation is in the “early adopter” phase of the Rodgers-adoption curve globally. While anyone reading this article is likely immersed in simulation and lives in an environment that fosters and supports simulation-based education, delivery of healthcare simulation-based education still has poor penetration into the overall market of healthcare providers in actual practice. Most simulation-based training is focused on new students and trainees, while those already in practice are less likely to receive refresher training with simulation as a component. As those who have been trained in simulation advance in their careers and become educators, I believe that a continued push for healthcare simulation at all levels of training is likely to occur.

So if you are reading this and wondering if you should just wait another 20 years for simulation to come around, the answer is no. You are an expert in the world of healthcare simulation; your insight is valuable. You can suggest how the tools and techniques at your center or institution can be utilized to provide better training and suggest reaching out to new markets and care providers. Suggest measuring outcomes in a different manner to highlight not just patient care, but other metrics that affect healthcare system finances, including staff training time, retention, patient throughput, and communication improvement with systems like TeamSTEPPS, now in version 2.0, that supports all members of the healthcare team to use their voice for safe patient care delivery.

There will be more updates in the year following with specific ideas about how to identify areas to support and improve healthcare education and patient safety using simulation from the work done at GNSH. Remember that every person in healthcare has a role to achieve better patient care, and you are an integral part of that healthcare delivery process even if you are not in a clinical care environment.