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Impact of multidisciplinary simulation-based training on patient safety in a paediatric emergency department
Mary D Patterson1, Gary L Geis, Thomas LeMaster
1Akron Children's Simulation Center for Safety and Reliability Akron Children's Hospital, Akron, OH 44308, USA. mpatterson@chmca.org
Insights
Simulation-based training improved patient safety in a pediatric emergency department by enhancing teamwork and communication. This approach led to sustained improvements in knowledge, attitudes, and over 1000 days without safety events.
Area of Science:
- Medical Education
- Patient Safety
- Emergency Medicine
Background:
- Pediatric emergency departments (EDs) face high patient volumes and frequent interruptions, increasing the risk of medical errors.
- Cincinnati Children's Hospital's ED is a high-acuity, high-volume setting with inherent risks to patient safety.
Purpose of the Study:
- To enhance patient safety within a busy pediatric emergency department.
- Implement a multidisciplinary, simulation-based curriculum focused on improving teamwork and communication skills.
Main Methods:
- All healthcare providers in the ED participated in simulation-based training sessions.
- Training focused on teamwork and communication behaviors in critical clinical scenarios.
- Knowledge tests, the Safety Attitudes Questionnaire (SAQ), and performance evaluations were used to assess outcomes.
Main Results:
- Knowledge scores improved from 86% at baseline to 96% post-intervention and 93% at re-evaluation.
- Significant positive changes in safety attitudes were observed based on SAQ scores.
- The ED sustained over 1000 days without a patient safety event, a significant improvement from the baseline of 2-3 events per year.
Conclusions:
- Simulation training effectively modifies safety attitudes and teamwork behaviors in emergency departments.
- Sustained improvements in patient safety culture require ongoing practice and reinforcement through simulation.
Background:
Cincinnati Children's Hospital is one of the busiest paediatric emergency departments (ED) in the USA; high volume, high acuity and frequent interruptions contribute to an increased risk for error.
Objective:
To improve patient safety in a paediatric ED by implementing a multidisciplinary, simulation-based curriculum emphasising teamwork and communication.
Methods:
Subjects included all healthcare providers in the ED. Multidisciplinary teams participated in simulation-based training focused on teamwork and communication behaviours in critical clinical scenarios. The Safety Attitudes Questionnaire, tests of knowledge and evaluations of critical simulations and actual performance in the ED resuscitation bay were assessed. Methods to sustain improvements included mandatory participation of all new staff in simulation-based training and the introduction of routine in situ simulations.
Results:
289 participants attended the initial training. 151 participants attended the re-evaluation at a mean of 10.2 months later. Sustained improvements in knowledge and attitudes were demonstrated. Knowledge tests at baseline, postintervention and re-evaluation had scores of 86%, 96% and 93%, respectively. Friedman's test analysis of SAQ scores at baseline, postintervention and re-evaluation indicated significant attitude changes. The ED with a preintervention baseline of 2-3 patient safety events per year has now sustained more than 1000 days without a patient safety event. This improvement occurred even though the time required in initial simulation training has been condensed from 12 to 4 h.
Conclusions:
Simulation training is an effective tool to modify safety attitudes and teamwork behaviours in an ED. Sustaining cultural and behavioural changes requires repeated practice opportunities.
