using simulation to test iemr clinical workflows and clinician ......subheading using simulation to...
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Subheading
Using simulation to test ieMR clinical workflows and clinician change readiness in preparation for rollout
Centre of Excellence
Dr Clare Thomas and Meegan Palmer
Declaration and contact details
No conflict of interest.
Dr Clare Thomas Meegan Palmer
Paediatrician Physiotherapist
ieMR Simulation Lead ieMR Clinical Change Lead
Sunshine Coast HHS Centre of Excellence, eHealth QLD
[email protected] [email protected]
@MeegsMP@DrClareTPaed
Review the impact of the ieMR roll out on:
• Complex patient workflows as they cross departments
• Detect latent patient safety threats
• Confirm patient centred care remains the priority
• Gauge staff readiness
Simulation: A strategy for better outcomes
FOURTEEN IEMR ADVANCED SITES
“The secret to leading successful
change is rooted in something much
simpler: how to facilitate change in one
person” – Prosci®
ADKAR Model
Change: organisational or individual?
• Clinical education - adult learning principles
• Practical
• Goal orientated
• Self - directed
• Life experience and prior knowledge
• Adults learn by doing
Dress rehearsal
15 multimodal simulations:
• Category 1 caesarean section and neonatal code blue
• Adult code blue
• “Code stroke”
• Paediatric code blue
• Red blanket
• Mental health deteriorating patient
• Trauma of an unknown patient
Simulation
Simulation Expert
• Ensure safety to staff and patients
• Effectiveness of system testing
• Provide pre and debrief
In-situ simulations
Scenario Development
Desktop simulations
• Critical and complex patient journeys
• Stakeholder input
• National Safety and Quality Health
Service Standards
ieMR support
Rapid cycle deliberate practice - Little Path-Athletics
How much work?
Adult code blue / MET
call
CAT 1 Caesarian Section and neonatal
Red blanket
Trauma of unknown patient
Mental Health deteriorating patient
Paediatric Code Blue
15+ simulations
10-50 people per scenario
180+ people hours
40+ hours simulation
Issues identified
• Patient centred care remains
a priority - consumer
engagement representative
• Latent safety threats:
• updated business rules
• created QRGs, lanyard
cards, education packs
• Specific team practice
• Gauge staff readiness
Solutions
Was it worth it?
• + 450 staff involved
• 99% of clinicians felt that simulation was
extremely relevant or relevant to their
workplace
• Consumer representatives reinforce patient
centred care
• Simulation activities were recognised by the
executive leadership team
• Dedicated ieMR simulation team for the
second hospital go-live.
Lessons Learnt
• Engage ALL stakeholders from the beginning
of the patient journey to the end
• Sims don’t have to be perfect
• Consumer representatives reinforce patient
centred care
• Pre-brief and debrief time are vital
• Support your participants
• It takes time to prepare but it get’s easier