Using simulation to prepare multidisciplinary teams and clinical environments for complex fetal interventions and...

Area of Science:

• Medical Simulation
• Surgical Planning
• Fetal Surgery

Background:

• Severe congenital diaphragmatic hernia (CDH) necessitates innovative fetal interventions.
• Fetoscopic Endoluminal Tracheal Occlusion (FETO) is a promising treatment for severe CDH.
• Successful FETO program implementation requires meticulous planning and risk mitigation.

Purpose of the Study:

• To identify potential weaknesses in the initial planning stages of a FETO program.
• To evaluate the effectiveness of simulation in preparing for complex fetal procedures.

Main Methods:

• Simulated clinical scenarios involving FETO device placement and removal in a realistic hospital setting.
• Video recording and subsequent analysis of simulated sessions to identify issues.
• Utilized patient simulators and task trainers for realistic training.

Main Results:

• Generated plausible clinical scenarios and required equipment lists.
• Developed diagrams for room setup and personnel positioning.
• Created decision trees and identified situation awareness and workflow issues.
• Highlighted areas needing further planning and remediation.

Conclusions:

• Simulation effectively facilitated the development of essential planning documents (equipment lists, room diagrams).
• Simulation-based training enabled teams to devise tactics for identified weaknesses.
• Simulation is a valuable strategy for preparing for the launch of high-risk clinical programs like FETO.