TradelinePPT DRAFT€¦ · 16/10/2013 · – Team training – Specialty team ... net square feet Virtual/Computer Common Clinical Skills Simulation Simulation Center Space Benchmarks

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presents

The Inter-professional Simulation Center: Opportunities, Challenges, Solutions

Presented by:Colleen O’Connor Grochowski, Ph.D

Mary Jo Olenick, AIASidney Ward, AIA, LEED AP

Colleen O’Connor Grochowski, Ph.D

Associate Dean, Curricular Affairs

Duke University School of Medicine

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Mary Jo Olenick, AIA

Principal

The S/L/A/M Collaborative

Sidney Ward, AIA, LEED AP

Principal

The S/L/A/M Collaborative

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Agenda

• Current State of Simulation

• Planning Considerations

• Case Studies – Emory University

– Western Michigan University

– Duke University

• Inter Professional Education

• Strategic Integration of Simulation into the Duke Curriculum

Learning Objectives

• Program and Planning benchmarks

• Planning a Simulation Center for Maximum Efficiency

• Cost Benefit Analysis

• Future Impacts

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Current State of Simulation

Impacts on Medical Education

• Halstedian approach

• Increased emphasis on patient safety

• Changes in health care delivery

• Simulation– Opportunities

– Outcomes

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Expanding Role in Health Prof. Training & Certification

• Regulatory Drivers– JCAHO documentation of

improvement

• Patient Safety Drivers– Continuum of care logistics and

handoff

• Education Drivers– Procedure rehearsal

– Team training

– Specialty team training

– Identification of knowledge into actions

– Competency-Based Education & Assessment

Accreditations

• Undergraduate Medical Education– Liaison Committee for Medical

Education

– United States Medical Licensing Exam Step 2CS

• Graduate Medical Education– American Council for Graduate

Medical Education

– Educational Commission for Foreign Medical Graduates

• Continuing Medical Education– American Council for Continuing

Medical Education

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Organic Evolution in Simulation Programs

• Simulation Program vs. Center

• Renovation & Opportunity

• Strategic Mission & Business Plan

• Rightsizing: Aligning Program, Mission, Budget & Facilities

• Emerging Trends

SIM

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Aggarwal R et al. Qual Saf Health Care 2010;19:i34-i43

Medical Simulation Time Line

Strategic Mission & Business Plan

• Know the utilization by experience – Plan for learner thru-put in order to plan for FTE support

– Number of Hours Per Learner Per Year

• Critical to know FTE operational support before design

• Too many have large sites unused due to lack of $$$ planning before design

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Strategic Mission & Business Plan

Emerging Trends

• Synthetic cadavers instead of manikins

• Virtual Simulation

• Expanding standardized patient use for Nursing

• All striving to be a “Center of Excellence” in order to differentiate and be able to charge for sharing space / equipment / personnel

• Intra and Inter Professional Training

Duke Immersive Virtual Environment

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Technology

• Flex use

• Integrated data collection

• Mobility

• 3D visualization

• SimCUBE virtual reality room

• Haptics

Renovation & Opportunity

• all rooms flex

• continuum of rooms

• centralized shared control & storage & work areas to minimize duplication & increase efficiencies

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Tomorrow’s Physician

Tomorrow’s Physician

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Planning Considerations

Simulation Program vs. Simulation Center

• Medical errors constitute the fifth leading cause of death, being more common than victims of breast cancer, AIDS and road accidents.

ProceduralBasic Skills Development

• Decision Making• Group Dynamics• Patient Interaction• General Procedures

• Surgical Procedures• Research• Clinical Trials

Nursing

Research Staff

PhD

Residents

Medical StudentsM 1, 2, 3,4

Undergraduate MedicalEducation

Inter-professional Education

Co

st –

Co

mp

lexi

ty –

Fle

xib

ilit

y

Square Footage Requirements

Regional

Immersive

• Virtual Reality• Continuum of Care• Disaster Response

$

Physicians Assistant

Pharmacy

Emergency Medical Service

Industry

Clinics

UM

EG

ME

All

ied

Hea

lth

P

rofe

ssio

nal

sS

trat

egic

P

artn

ers

Hospitals

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class size 100 100 120 200 125 150 150 150 50completion 2014 2013 2011 2014 2010 2008 2006 2005 1999

10,886

4,995 4,775

7,043 6,5785,811

1,375

4,7983,720

3,772

3,7342,907

6,412

3,830 4,685

3,510

4,147

1,838

3,991

1,4412,768

449

846

2,200

571

1,194

3,401

0

4,000

8,000

12,000

16,000

20,000

WMU Duke CMC VCU Stanford Emory JHU Wash U Mayo

ne

t

sq

ua

re

f

ee

t

Virtual/Computer Common Clinical Skills SimulationSimulation Center Space Benchmarks

18,6

50 N

SF

10,5

00 N

SF

7,08

0 N

SF

8,95

0 N

SF

6,75

0 N

SF

14,6

50 N

SF

13,4

50 N

SF

8,23

0 N

SF

10,1

70 N

SF

Simulation Center Benchmarking

186

10287

56

117

70

4763

135

1,695

925

2,612

993

1,628

2,624

1,417

793965

-3,000

-2,400

-1,800

-1,200

-600

0

600

1,200

1,800

2,400

3,000

0

40

80

120

160

200

240

280

320

360

400


NSF / MS1 NSF / staff

100 100 120 200 125 150 150 150 50 class size

11 11 4 14 9 4 5 12 7 pers cap

average benchmark range : 70-100 NSF/MS1

800-1,000 NSF/staff group

1,500-1,600 NSF/staff group

2,600 NSF/staff group

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43

2

44

9

30

7

43

9

76

5

61

4

31

7

31

4

36

7

15

0

12

3

13

0

12

3

15

8

14

0

13

0

95

13

4

10

3

6 6

2

3 3

4 4

12 12 12

16

12

16

12

13

6

0

2

4

6

8

10

12

14

16

18

0

100

200

300

400

500

600

700

800

900


nu

mb

er

o

f

ro

om

s

ro

om

a

re

a

(N

SF

) avg sim rm size avg exam rm size # of sim rms # of exam rms

Task Trainers Fundamental Skills Case Simulation Clinical Skills

Experiential Learning Environments: Spectrum

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PROCEDUREROOM

RECEPTION

CONTROL ROOM

PROCEDUREROOM

OPERATING ROOM

SIMULATION

MAN.

OFFICES

PROCEDUREROOM

SP TRAINING & FACULTY VIEWING

CONF ROOM

SL

SUR. SIM. BOXES

STORAGE

DEBRIEFING ROOM

PROCEDURAL SIMULATION SUITE4,250 NSF

CLINICAL SKILLS SUITE2,975 NSF

SHARED810 NSF

CLASSROOM

EX

EX

EX

EX

EX

EX

PR

PR

CR

SUPPORT WRITE‐UP CORE

OFFICES

EX

EX

EX

EX

Critical Adjacencies

Case Studies

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Emory University (UME)

• User Profile

• Utilization

• Design & Layout

• First Cost

• FTE’s

• Operational Cost

Emory University Building Section SID

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Emory University Simulation Center

GROUND FLOOR

Emory University Simulation - Labs

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Emory University Beneficial Adjacencies

Emory University Simulation Center

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Emory University Standard Patient - Clinical Skills Lab

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Emory University Computer Classrooms

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Atlanta, GAEST. 1854NEW BUILDING 2007CLASS SIZE 138-150

11,520 SIM LEARNER HOURS / YEAR15,360 SP LEARNER HOURS / YEAR19,200 TASK LEARNER HOURS / YEAR

FIRST COST

3.41M$ 320 / SF $$

ANNUAL BUDGET

800KFULL TIME EMPLOYEES

7.6

1 2 1 3 .6

10,256SFSF

2.05MEQUIPMENT COST

+$+$REVENUE

5K

73K

TUITION

SFSF5,571K

SIMULATION

SFSF4,865K

STANDARD PATIENT

46855811

Clinical Skills

SimulationSFSF

SFSF

AV EQUIPMENT COST

1.07M

Western Michigan University (Regional)

• User Profile

• Utilization

• Design & Layout

• First Cost

• FTE’s


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Western Michigan University Building Section

Western Michigan University Simulation Center

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Western Michigan University Simulation

Kalamazoo, MIEST. 2014NEW BUILDING 2014CLASS SIZE 50 – 80

FIRST COST

4.48M$ 240 / SF $$

ANNUAL BUDGET

tbdFULL TIME EMPLOYEES

5.75

1 2 1 3 1 .75

2.51MEQUIPMENT COST

+$+$REVENUE

tbd

50K

TUITION

18,650SFSF

SFSF10,866K

SIMULATIONSFSF3,772K

STANDARD PATIENT

3,991COMMONSPACE

SFSF

3991

377210886

Common

Clinical Skills

SimulationSFSF SFSF

SFSF

AV EQUIPMENT COST

1.94M


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Duke University (Inter-Professional)

• User Profile

• Utilization

• Design & Layout

• First Cost

• FTE’s


Duke University (Existing Facilities)

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Duke University Building Section

Duke University Simulation Center

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Duke University Student Write-upUniversity – Case Study

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Duke University Standard Patient - Exam Rooms

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Duke University Debriefing

Duke University – Case Study

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Duke University Simulation - Labs

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Duke University Support Space

EST. 1930

Durham, NC

NEW BUILDING 2012CLASS SIZE 100

FIRST COST

3.41M$ 309 / SF $$

ANNUAL BUDGET

tbdFULL TIME EMPLOYEES

8.7

2.5 0.2 2.0 1.0 2.0 1.0

1.07MEQUIPMENT COST

+$+$REVENUE

tbd

80K

TUITION

10,170 SFSF

SFSF4,995K

SIMULATIONSFSF3,734K

STANDARD PATIENT

1,441COMMONSPACE

SFSF

1441

3734

4995

Common

Clinical Skills

Simulation

SFSF

SFSF

SFSF

AV EQUIPMENT COST

1.17M


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Strategic Integration of Simulation Into the Duke Curriculum

Identifying Target User Group(s)

• School of Medicine Faculty and Students

• School of Nursing Faculty and Students

• Residents –Anesthesiology, Surgery

• Durham VA Faculty

• Duke Hospital Employees

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INITIAL WORKINITIAL WORK

Current Simulation Activity

Inventory of Equipment

Articulated Cost

Delineated Funding

Competitor Analysis

SWOT Analysis

POTENTIAL OUTCOMESPOTENTIAL OUTCOMES

Savings

Improved Operational Resilience

Increased Course Capacity

Improved Educational Curricula

Expansion in Scope

Innovation

Inter-Professional Education

• Organized Implementation of Inter-Professional & System Wide Ventures

– Code Team Training

– Trauma Management

– Obstetric Hemorrhage Response

– Disaster Planning

• 3DiTeams

• ILE@D

• Inter-professional student clinic

“there is a need for stakeholders to function as a unified team to achieve common vision and goals.”

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Competency Based Assessment

• Movement by GME

• Assess Milestones and Competencies

• Formative and Summative Assessments in UME

Research

• Quality

• Patient Safety

• Applied Informatics

• Human Factors

• Teamwork

• Communication

• Education

• Leadership

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Documents

TradelinePPT DRAFT€¦ · 16/10/2013 · – Team training – Specialty team ... net square feet Virtual/Computer Common Clinical Skills Simulation Simulation Center Space Benchmarks