Traditional Poster Round
Context: : Medical Simulation Programs provide a safe environment that allows healthcare professionals to detect errors and improve the quality of care provided. Although it represents a great educational tool, some usual characteristics may limit its accessibility and effectiveness: different location and time from where the daily healthcare activity occurs, the reproduction of standardized clinical situations instead of real previous cases and associated high costs assumed both by institutions and professionals.
Description: : With the aim of establishing the feasibility and effectiveness of a low-cost simulation program "just in place, just in time", the 1-year-long Quick-SIM project was designed at the Department of Pediatrics of the University Hospital of Santiago de Compostela. The program is based on 25-minute-long simulations that take place at the Pediatric Intensive Care Unit or the Emergency Department, every 2 weeks. Simulated cases are real previous cases from the unit, selected either because mistakes were made or significant difficulties were encountered during their management. Professionals involved in the simulations are attending physicians, residents and nurses that are at their current place of work and shift. Low fidelity manikins, Resusci Baby, Resusci Baby QCPR, Resusci Junior and Little Anne QCPR, and a free version of the Patient Monitor software from Laerdal are used, along with the usual equipment from the unit. These characteristics ensure accessibility to the program, render simulation conditions more similar to the real ones, and reduce associated costs. A common standardized checklist was designed for simulations in order to analyze and evaluate attitudes and procedures. Observers complete these checklists, which guide 25-minute debriefings where results are analyzed.
Observation/Evaluation: : 20 simulations have been completed since the beginning of the Quick-SIM project on January 2018 (8 at the PICU and 12 at the Emergency Department). High acceptance, positive evaluation as an educational tool, and no significant interference with the unit function and activity have been reported by PICU and Emergency Department staff at the time. Also, intermediate results show, after analyzing checklists and debriefings of the cases, improvement in teamwork, communication, decision making under critical conditions, and technique performance. On the other hand, evaluation and treatment of pain, adequate sedation, high quality bag-mask ventilation, and leadership management represent key-points where more difficulties were encountered and further and specific training may be required.
Discussion: : Medical simulation programs represent an effective and safe training tool for healthcare professionals, but universal access and impact may be limited.
The Quick-SIM model, as a low-cost "just in place, just in time" simulation program, focuses on the characteristics, idiosyncratic difficulties and usual pathologies from each unit, providing a realistic, efficient and accessible educational tool that may be taken into account as a feasible alternative.