2011 SUN eLearning
eSimulation in Action
eSimulation in Action
Goal of this Interaction:Discuss implementation and deployment of a successful
eSimulation program leading to improvement in efficiency, skills
retention and employee satisfaction at MU Health Care.
eSimulation in Action
Outcomes of this interaction…We will discuss how eLearning and eSimulation at MUHC :
Improved skills and teamwork
Increased training efficiency
Reduced costs
Trained more people in less time with fewer instructors
Improved employee satisfaction, confidence and competence
Saved lives!
In the Heart of
the Midwest
eSimulation in ActionMU Health Care…
Level 1 Trauma Center for large area of Missouri-rural
Schools of Medicine, Nursing, Health Professions
Shelden Clinical Simulation Center, CED Skills Lab, SON Simulation Lab
Chest Pain Center
JC Primary Stroke Center
AHA Training Center
Missouri University Health System 475 beds MUHC
>500 medical staff members MUHC
1600 nurses MUHC
Includes MU Health Care, Missouri Rehabilitation Center, Women’s and Children’s Hospital, Missouri Orthopedic Center. Missouri University Psychiatric Center, Ellis Fischel Cancer Hospital, Internal and Outside Clinics
eSimulation in ActionTraining at MU Health Care
>2100 participants trained annually for BLS (live classes, BLS Online, BLS HC)
>900 participants trained annually for ACLS (live classes, ACLS HC)
>450 participants trained annually for PALS (live classes, PALS HC)
>750-1000 participants annually- Mock Code Training
>2500 participants annually Simulation Classes
eSimulation in ActionTraining at MU Health Care
>80-100 participants trained annually for AACN ECCO
>500 participants trained annually for Stroke Education
>50,000 In house WBT annual training
>80,000 EMR annual training
>275 NRP training annually- online after 2011
eSimulation in Action
Training at MU Health Care
Goal is to implement and provide a diverse number of training options for all learning styles and work schedules, to improve efficiency in skills training, to
improve skill retention and staff satisfaction and to save lives.
eSimulation in Action
Approach To Training
1.Live training/traditional classroom2.eLearning with HeartCode, BLS Online,
other self directed online learning 3.Simulation4.Blending eLearning and eSimulation
approaches
eSimulation in Action
Live training/traditional classroom
Familiar environment, more comfortable for some
Training costs can be higher
May improve knowledge but not necessarily practice
Need space, instructors, time
eSimulation in Action
eLearning & eSimulation
Focus today on:
Heartcode eLearning Mock Code eSimulation
Other simulation at MU Health Care
eSimulation in Action
eLearning with HeartCodeSelf-Directed Learning
eLearning lets the participant learn at their own pace and convenience-independently
No certified instructor needed (except PALS HC)
This is the age of technology and computers!MU Health Care has used some form of eLearning since the mid to late 80’s. It wasn’t called eLearning back then, but it was the beginning of eLearning.
eSimulation in Action
eSimulation
Reduce errors
Improve skills
Practice in safe environment
Right patient at the right time
Learn and practice teamwork! MU Health Care purchased Sim Man in 2005.
eSimulation in Action
“Having knowledgeable
instructors, computer programs and thousands of dollars worth of simulation equipment doesn’t guarantee successful program outcomes nor improve patient
outcome.”Author Unknown
eSimulation in Action
It takes cooperation and a blended approach to learning, using all of
the training options available.
Learn-Practice-Apply
eSimulation in Action
Top Ten Things eLearning and eSimulation Can Do:
10. decrease stress in an inherently stressful environment.
9. improve confidence.
8. improve critical thinking in a safe and controlled environment.
7. allow participants to learn from their mistakes without impacting patients negatively.
6. provides standard learning situations for everyone.
eSimulation in Action
5. allow learning from peers. (model behavior)
4. work on time management and priority setting.
3. allows updating of new information and technology quickly and seamlessly.
2. bridge the student nurse, medical student, new resident, returning to practice employee transition to the workplace.
eSimulation in Action
And the #1 thing
eLearning and eSimulation can do
eSimulation in Action
1. improve resuscitation, patient care and patient outcomes!
eSimulation in Action
eLearning with HeartCode
Self-Directed LearningHeartCode: (all AHA approved)
ACLSBLS
PALS!
UMHC used the Actronics system until 2004 and upgraded to Heartcode ACLS. Due to popularity, ACLS use grew and BLS was added in 2008 and PALS added this year.
eSimulation in Action
HeartCode: Link between “book learning” and simulation. Helps efficiently maintain compliance and competence for otherwise experienced employees that don’t necessarily need live training to maintain a certification.
eSimulation in Action
2 Part Process >>> course completion
Cognitive-BLS, ACLS, PALSSkills Test with VAM- BLS, ACLS
(PALS-Live skill check with AHA PALS Instructor)
Receive Course Completion Card (Laerdal is AHA TC and will issue BLS and ACLS Provider cards)
eSimulation in Action
Benefits to Learner:
Self directed learningShorter than live classPotential availability 24/7Instant, objective feedback
eSimulation in Action
Benefits to Organization
Reduced costsClear cost structureConsistent and standardized trainingDiversifies training options
eSimulation in Action
BLS Live BLS BLS Online = Skill check
BLS HC
Hours to complete
3.5-4* 2.5 total* (1.5 hr for online part, 1 hr skill check)
<1.5 hr average**
# Instructors needed
6-8 3 + 1 non-instructor for check in/check out
NONE
# Participants trained/session
24/4 hr(48/month)
36/4 hr(72/month)
9/day (180/month potential)
*set up and take down/clean up time-
45min- 1 hr
*set up and take down/clean up time-45min- 1 hr
**<10 minute clean up of computer room
eSimulation in Action
eSimulation in Action
eSimulation in Action
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eSimulation in Action
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eSimulation in Action
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eSimulation in Action
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eSimulation in Action
ACLS Live ACLS ACLS HC
Hours to complete 14-16 hrs Initial*8-9 hrs Renewal*
6-7 hr avg
# Instructors needed
8-16 /2 day Initial class8 Renewal class
NONE
# Participants trained/session
24 Initial/month24 Renewal/month
4/day (208/month potential)
*set up and take down/clean up time-2 hr
**<10 minute clean up of computer room
eSimulation in Action
pictures
eSimulation in Action
PALS Live PALS PALS HC
Hours to complete 14-16 hrs Initial*8-9 hrs Renewal*
6-7 hr avg (online portion )3 hours (live skill check)
9-10 hours total
# Instructors needed 8-16 /2 day Initial class8 Renewal class
NONE -online portion2-3 skill check
# Participants trained/session
24 Initial/month24 Renewal/month
12/month(12 participants/
1 skill check/month)
*set up and take down/clean up time 2 hr
*set up and take down/clean up time-45min- 1 hr
eSimulation in ActionHEARTCODE THROUGH THE YEARS
2007 2008 2009 2010
BLS HC NA Start Nov 2008
94/yr136
Jan-Sept
ACLS HC 252/yr 273/ yr 328/yr310
Jan-Sept
PALS HC NA NA NA12
May-Sept
eSimulation in Action
Barriers to using HeartCode …
(student)
Fear of technology Lack of team support found in live classes Frustration
eSimulation in Action
Barriers to using HeartCode …
(institution)
Concern about quality of training Equipment and software costs Administration costs
eSimulation in Action
COSTS Live Classes HeartCode Online + Skill Check
BLS $90/studentno instructor costs
Cost of licenseno instructor costs
Cost of access codeno instructor costs$35/student/skill check
ACLS $342/student/Initial*$210/student/Renewal
Cost of licenseno instructor costs
NA
PALS $342/student/Initial*$210/student/Renewal
Cost of license$25/hour/instructor
NA
*includes instructor costs at $25/hour/instructor
No charge to staff at MUHC-outside participants pay student cost as calculated
eSimulation in Action
Additional benefits noticed at Missouri University Health Care:
Offering multiple opportunities outside the structured classroom staff satisfaction!Address all learning stylesLast minute recerts!Critical thinking in a safe environment-teaching environmentCan use over and over to review-”practice makes perfect”
eSimulation in Action
SIMULATION AT
MISSOURI UNIVERSITY HEALTH CARE
eSimulation in Action
At MUHC simulation is collaborative effort to help provide safe and
effective patient care. Students
New Staff Current Staff
eSimulation in Action
Missouri University Health CareThere are multiple simulation opportunities for our students and staff.
Center for Education and Development Skills LabShelden Clinical Simulation CenterSinclair School of Nursing Simulation Lab
Missouri University Health Care’s Journey…
One paw print at a time
The beginning was rough…
When Sim Man was first purchased, he sat in Linda's shared office for months until they got tired tripping over the boxes.No space had been designated to “keep” Sim Man so the boxes were moved to storage.When finally opened he was already due for an upgrade!The search for a home commenced.
eSimulation in Action
eSimulation in Action
eSimulation in Action
The first simulation course with CEDrick was an interdisciplinary effort
to improve resuscitation.
Mock Code Monday
eSimulation in Action
Mock Code Monday0730-0900 (46)
Interdisciplinary Mock Code practice Internal Medicine Residents Nursing (New and Current Staff) Respiratory Therapists and Respiratory Therapy Students Nursing Students Anesthesia Residents
ACLS instructors using ACLS Scenarios Uses simulation manikin in simulated setting Includes debriefing
eSimulation in ActionUsing Simulation for Interdisciplinary Code Blue Training: 2
Year Experience
178 ACLS Professionals -1 ½ hour of Simulated COde Team training (SCOT)
Moderately ConfidentInterpreting rhythms-35%Follow ACLS Protocols-30%Drug Selection-28%
eSimulation in ActionConclusions:Lack of confidence among certified ACLS providers.
Simulation can be used to foster interdisciplinary teamwork and focus on common educational objectives, thereby reducing duplication of cost and time associated with training.
85% agreed that the simulated code training was useful or extremely useful and would return for more training.
Poster Session Presented at IMSH 2010
eSimulation in Action
Trauma Nursing Update
Unit Based Mock Code Classes
Introduction of Simulation
Trauma Update 2009
Building the Program
Introduction of Simulation
Partnering Sim Center and SON
eSimulation in Action
eSimulation in Action
Just as a code team needs both skills and teamwork to work effectively, the
different simulation centers and groups are working together collaboratively to
meet student and staff needs.
eSimulation in Action
Purchased Mobile Unit with recording and data collection capabilities
eSimulation in Action
Pre and Post Evaluation Data Collection
Metrics
eSimulation in Action
eSimulation in Action
2010
Mock Code Training for Women's and Children’s Hospital (Formerly CRH)
Training for Pediatric Transport team
Training for the Helicopter Flight team
Missouri Psychiatric Center Emergency Response training
eSimulation in Action2010
Missouri Orthopedic Institute training for staff and evaluation of emergency protocols
Added Simulation to New Staff Orientation
Mock Code Stroke Insitu training for evaluation of ER and Inpatient Stroke protocols
Patient and Family Centered Care Model Videos
eSimulation in Action
Future Plans
Increasing Insitu Simulations
Increasing Simulation in New Staff Orientation
And about a MILLION other requests….
eSimulation in Action
To sum it up…
eSimulation in Action
Healthcare providers need to
respond to the changes in training requirements, address different
learning styles, consider challenging schedules and
workloads.
Missouri University Health Care’s Journey…
One paw print at a time
QUESTIONS?