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Gretchen Matika, MSBaltimore SUNMay 20, 2009
Penn Medicine Clinical Simulation Center
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Overview
Overview and Structure Timeline for Sim Center “Secrets of our Success”Budget BasicsOverview of Center Layout & ProgramsUtilization Operational Considerations
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Simulation at PENN
Health System Simulation Efforts – SOM, 3 hospitals and rehab facility, all disciplines
Main geographic sites :• PENN Medicine at Rittenhouse– centrally
located between 3 hospitals. Also houses rehab facility.– All simulations except cadavers and live animal
• Measey Simulation Center (SOM)– ~800 sq feet - 2 Sim Rooms and a Skills lab
• Glenolden Research & Education Facility - – Robotic Training Center & Animal Research Facility
• Brunner Center (SON)
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Penn Medicine Clinical Simulation CenterJim Mullen, MD
Chair, Steering Committee
Andrew Resnick, MD, MBAExecutive Director
Steering Committee=Bellini, Black, Brennan, Corrigan, Driscoll, Jost, Kennedy, Kinslow,
Morrison, Resnick, Volpe
Operations Committee=Luba, Matika, Palmieri, Jones,
Lipschik
Steering Committee Exec=Corrigan, Morrison, Mullen,
Resnick
Tech Advis Committee=Kochman, Kofke, Nadkarni,
Patel, Williams, Kuchenbecker
Research Committee Operations Director=Matika
Sim Tech=Luba Sim Admin Assist=
Jones
Specialty Directors Sim Educator=
Palmieri
Dir. Life Support Programs=
Lipschik
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Timeline (Concept to Current Day)
Spring 2006
1st Steering Committee MtgBudget (v.1) & Narrative
Fall 2006
Sub-Committees FormedRequest “Needs
Assessment”
Space & Capital Requested
Spring 2009Move into Center- 7/08Basic AV
B-line/AV Install Complete- 5/09
Summer 2008Staff Identified and Hired- 4/08-6/08Construction Begins- April 2008
Spring 2008
CONCEPT- WINTER 2006
Winter 2006
Sub-Committees Meet Vendor Quotes and Demos, Grant SubmissionsID Specialty Directors & Core Equipment Needs
Spring 2007
“Graduate Hosp” Space Identified/ApprovedArchitect Retained, Development & Industry Involved
FY08/09 Capital Funds ApprovedSurgery Obtains Grant- Initial Simulators Purchase
Summer 2007
Fall/ Winter 2008FY08 Ops Budget (v.4) Approved
Architectural Drawings Finalized/PricedMeet/Select AV hardware/software vendors
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Secrets of Our Success
Strike a Nerve• What are your peers/competitors up to?–Regionally–Nationally
• Public Scrutiny
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Secrets of Our Success
Discover Broad Institutional Needs• Unmet Educational Need• Regulatory accreditation• Reducing Medical Liability• Increasing Patient Safety• 80 Hour Work Week• Reducing Cost
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Secrets of Our Success
Identify Your Champions• Internal
–Departments–Physicians–Administrators
• External–Vendors–Other organizations
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Secrets of Our Success
Form Partnerships• Affiliated Medical & Nursing School, other Graduate Program and Hospitals
• External Groups
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Secrets of Our Success
Consider Alternative Funding Options• Grants – research, government, industry, charitable
• Development/Alumni Offices• Corporate Partnerships• Course Tuition• Rental Space
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Utilize the Existing Resources• Personnel• Equipment
–Medical and Simulation• Programs• Vacant Clinical/Other Space
Secrets of Our Success
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LUCK & GOOD TIMING!
Secrets of Our Success
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Initial Capital and Operational Budget
CAPITAL ~3 million to:
• Construction• Simulators• AV hardware/software
OPERATIONS~1.2 million annually
GRANTS/COMMERCIAL SUPPORT/GIFTSTotal to date: $1.7M
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Penn Simulation Facility 22,000 sq ft complex at Penn Medicine at Rittenhouse Includes:
• Administration/Reception• Standardized Patient Exam Rooms
– (12) exam rooms• Simulation Training Rooms (6)
– IR/OR– ED/ICU– LDR– In-Patient– Endovascular– FLS Trainers
• Skills Lab• Large Group Instruction and Debriefing Space
FLS EndoVasc ICU/ED
InPatientORLDR
CORE
SP EXAM ROOMS
Brk Out RmsMultiSkills LabLarge Conf Rm
ADMIN SUITE
Task
Trainer
Rms
Comp Rm
ENTRANCE
Sm Conf Rm
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ADMINISTRATIVE OFFICES
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Standardized Patient Area•SOM H & P/Board Exams•Patient Disclosure Pilot•OB/GYN Resident Training•Staff handoffs•Staff/Faculty remediation
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Simulation Core and Control Center
•Team training with remote manikin control and advanced AV capabilities
•OB-GYN•Surgical Critical Care•ED•NICU
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Simulation Core and Control Center
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Control Center
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MultiSkills Lab•Skill Sim Certification•Interns/new to practice nurses/staff/SOM •External courses
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Skill CertificationVideo/Checklist
DevelopedXXXXXX
XXXX
X
X- video/refX- video/ref
XX
IV Insertion/PhlebFoley Catheter
Normal Vaginal Delivery
Instrumentation
Skill
Cricothyrotomy
Thoracentesis
Central Line FemoralIntubation
Paracentesis
Arterial Line
Central Line Neck
Chest TubeABG
Sign-offs/HandoffsMRX Defibrillator Use
NG Tube
Lumbar PunctureScope Handling
Emergency Childbirth
Suturing/Knot Tying
Gowning/Scrubing
NEJM For Video and Article: http://content.nejm.org/cgi/content/short/358/26/e30
Competency Checklist:
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Small and Large Conference SpacesAlternative site for Skills LabsPost-session
DebriefingBreakout sessions
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Faculty Training & Credentialing•Fundamentals in Laparoscopic Surgery•Patient Disclosure/Communication Sessions•Remediation•ACLS/PALS/ATLS•Acquisition of new skills
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Simulation courses July ’08 thru April ‘09
• Students trained: >4350• ACLS = 993 (June thru April 2009)• BLS = 619 (since Jan 2009)
• Student hours: ~39,950
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User of PMCSC (excluding ACLS and BLS)
Number by % Total by Group
Number by % Total by Residency Program
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Sim Center April 2009 by Room
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Sim Center Utilization FY09
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Operational Considerations
Users charged for timeSelf supporting via external revenueFully supported by entityCombination
• Internal vs external ratesSimulator Purchases/WarranteesStaff TimeDepartmental Instructor ContributionsDisposables
