SIMULATING EMERGENCIES
Up to 100,000 Americans die each year because of medical errors. Researchers say about three out of every four errors are caused because of miscommunication. Now, a new training program aims to help.
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A seven-year-old boy is thrown in a car wreck and rushed to a nearby ER.
The child's mother is a distraction. Everyone's talking at once. What if someone makes a mistake?
Mary Patterson, MD
Emergency Medicine
Cincinnati Children's Hospital
Cincinnati, OH
"Some of the cases are actual cases where we know something wasn't right, or we could have done better."
Actually, Doctor Mary Patterson is just playing the role of a distraught, distracting mother. And, the patient is an interactive simulator. It's all part of a unique training exercise to reduce errors at Cincinnati Children's Hospital.
Mary Patterson, MD
"It seemed that the simulator was an incredible tool for adult education but also a really intuitively a really good way to teach safety, to teach teamwork."
Technicians control the scenarios, and sessions are taped for debriefing. The training stresses using key communication skills, overcoming intimidation and working as a team.
Mary Patterson, MD
"Many will tell you -- many of the nurses in particular -- will tell you this is the first time they've ever done any kind of training with a physician."
Knowing that the wrong medicine or decision could be deadly makes it authentic.
Jennifer Ross, RN
ER Nurse
"Oh yeah, it makes you think. It makes you learn, remember things."
Ultimately, Doctor Patterson believes safety will increase for patients real or not.
During the next year, all emergency room health care providers at Cincinnati Children's Hospital will rotate through the training, and an infant simulator will be added. Researchers are currently conducting a study to find out if the program really reduces errors.
EMERGENCY ROOM ERRORS: Emergency Rooms at hospitals all over the country are one of the most stressful worksites in the health care profession. The standard of care in United States hospitals is high quality. Doctors, nurses, surgeons and all other health care professionals take pride in this. However, the fact remains that malpractice occurs in the medical profession. Today's hospitals may need improvement to meet the demands of tomorrow. More than 225,000 people die from medical malpractice-related injuries each year. Nearly half of these are from emergency room errors.
HUMAN PATIENT SIMULATORS: Cincinnati Children's Hospital Medical Center is training health care providers using human patient simulators with the hopes of reducing medical errors in the emergency department -- an area of hospitals that the Institute of Medicine has identified as being at high-risk for adverse events. "We set-up the kinds of chaotic situations that we see in real life," Mary Patterson, M.D., an emergency physician at Cincinnati Children's says. "This forces medical providers to practice behaviors that will be safer when they encounter these situations in reality. As many as three of every four adverse events that occur in emergency departments are due to communication issues among providers." The training emphasizes team behaviors -- not only to decrease errors but also to quickly identify those that do occur and to mitigate their effects, according to Dr. Patterson. For example, instructors introduce deliberate errors; create situations in which appropriate care is ambiguous, making conflict among caregivers likely; and bring in people posing as parents to distract the team while it is providing simulated care. Cincinnati Children's has two patient simulators. One is a child and one is an adult. The medical center is adding a newly-designed infant simulator and a second adult simulator, which will be equipped for bioterrorism simulation. In the next 18 months, physicians, nurses, residents, patient care assistants and emergency medical squads will each spend a day and a half together in training. The multidisciplinary nature of the training is unique in that every emergency provider who touches a patient will go through the curriculum, according to Dr. Patterson.
DOES IT HELP: Whether the training actually reduces medical errors will be difficult to measure. But the evaluation of the program will include examining behaviors during real traumas to ensure that what's learned in training is transferred to the real world. If it's successful, it could change the way educators approach patient-safety training, according to Dr. Patterson. I think we have an opportunity to make training more realistic; based more on the way adults actually learn," she says. "Instead of sitting in a classroom, we're having people actually practice behaviors. I think that's a quantum leap in the way we approach patient safety. I think it's the wave of the future."
Jim Feuer
Cincinnati Children's Hospital Medical Center
3333 Burnet Ave. ML 9012
Cincinnati, OH 45229
(513) 636-4656
Jim.feuer@cchmc.org
www.cincinnatichildrens.org
Copyright © 2006 Ivanhoe Broadcast News, Inc.
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