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CONCLUSIONS

MISSIONandVISION

Using Quality Improvement Methods to Improve Neonatal Resuscitation Simulation Based Education

Defining improvement opportunity phase Anne Ades1,2, Shela Siddiqi1, Crystal White1, Jean Marie Carroll1, John Chuo1, 2

1. Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA 2. Perelman School of Medicine at the University of Pennyslvania

CONTEXT

QUALITYIMPROVEMENTFRAMEWORKUSEDINPROJECTDEVELOPMENT

9th International Pediatric Simulation Symposium and Workshops 2017

1-3 June, Boston, MA, USA

Mission:TouserigorousqualityimprovementmethodologytoimproveNRPcoursesintheCNBCNSites

Defineanddiagnosephases:1. Iden2fiedleaders2. Developedprimaryoutcome3. BrainstormeditemsforFishbone(Figure1)andDriverDiagram(Figure2)4. Usingitemsiden2fiedintheFishboneandDriverDiagramsdevelopedsurveyforbaselinedatacollec2onandpoten2alspecificopportuni2esforimprovementSurveyfocusareas:1. Educa2onofNRPInstructorsinsimula2onanddebriefing2. AdherenceofNRPInstructorstoNRPsuggestedformat3. ResourcesavailableforNRPcourses4. Ra2ngofthequalityofNRPcoursesandInstructorsfrompar2cipant’sfeedback

Figure1 Figure2

Children’sHospitalofPhiladelphia(CHOP)NewbornCareNetwork(CNBCN)encompasses13siteswithapproximately30,000birthsannually.

SeveralclinicallyfocusedqualityimprovementprojectshavebeensuccessfullyaccomplishedthroughouttheCNBCN.

NeonatalResuscita2onProgram(NRP)recommendssimula2on(forbothforma2veandsumma2veuses)dependingonexis2ngskilllevelofpar2cipant.

TeachingNRPInstructorsinsimula2onanddebriefingbyNRPwashistoricallydoneinasta2cnon-mentoredon-lineformat.

New2015NRPGuidelinesrequirementoringofInstructorcandidatesintheirsimula2onanddebriefingskillsaZertheon-linematerialsarecompleted.

SURVEYRESULTS

Objec2ves:1.  Toiden2fygapsinNRPeduca2onintheCNBCN2.  Todevelopinterven2onstoresolvethegaps3.  Todemonstratethattheuseofqualityimprovementmethodologycanimproveeduca2onalprocessesandoutcomes

Vision:ImprovingNRPcourseswillimprovedeliveryofcareinthedeliveryrooms

Severalques2onswereraisedbythischangeandbyself-reportofNRPProvidercoursepar2cipants:

1. ArecurrentInstructorsaswell-trainedintheirsimula2onanddebriefingskillsastheyshouldbe?2. WilltheybeabletoadequatelymentorInstructorcandidatestoensuretheInstructorcandidate’sskillareadequate?

3. Doweknowifcurrentprac2ceregardingCNBCNNRPcoursedeliveryisop2mal?

Survey:• 494Inter-professionalandmul2-disciplinaryrespondentsOverall:• 24%ofNRPInstructorshavenothadtraininginsimula2onanddebriefingoutsideoftheon-lineeduca2on• 17%ofInstructorshave“passed”alearnerthatperformedsub-op2mally• Increasingfrequencyofsimula2onswasthemostfrequentsugges2ontoimproveNRPeduca2on

Selected NRP Instructor Survey Responses Selected NRP Provider Survey Responses

Basedonsurveyresponses,thefollowingareaswereiden2fiedaspoten2alopportuni2esforimprovement:1. Increasinginterprofessionalpar2cipa2oninNRPcourses.2. Providinghands-ontraininginsimula2onanddebriefingskillsforInstructors.3. EnsuringInstructorshaveresourcesandskillstohelpthepoorlyperforminglearner.4. Discussingwithnetworkadministra2onstheneedfordedicatedequipmentandInstructorsupportsoCNBCNsitescanop2mizetheirNRPcourses.Basedonthesurvey,wehaveiden2fiedhighperformingsiteswherewecanfurtherinves2gatetheirprac2cesforincorpora2oninanimprovementstrategy.

Basedonfeedbackofpar2cipantsintheKick-Offmee2ng,wedistributedindividualSiteresultsforlocalreviewandevalua2onwithaplantomeetagaininJune,2017.Thismee2ngwillfocusonprocessmappingthestepsnecessarytoimplementspecificimprovementmeasuresandinterven2onsacrosstheCNBCN.