How do you improve your management of critical medical emergencies, if you don’t face them often? This challenge faces most medical departments. Many have pointed to the value of simulation to enable staff and clinicians to practice their skills in a non-critical context. However, logistical and administrative barriers can present challenges, including finding time during busy clinical duties, creating new and relevant cases, ensuring adequate attendance and participant buy in, and having appropriate equipment and funding.
The Department of Pediatrics at Victoria General Hospital aimed to address these barriers and improve their management of pediatric emergencies by piloting a 6-month Pediatric Simulation In Situ Program, drawing on support from the South Island Medical Staff Association. This was a collaborative effort between South Island pediatricians (Dr. Marie-Noelle Trottier-Boucher, Dr. Katherine MacCulloch, Dr. Amanda Barclay, Dr. Jeff Bishop), pediatric intensive care nurses (Melissa Holland, Jennifer Morgan) and Island Health administrative team members (Trapper Edison, Kim Johnson). From October 2019 to March 2020, they ran simulations on the ward every 2 weeks, involving pediatricians, pediatric nurses, pediatric intensive care nurses, respiratory therapists and unit clerks. Each simulation lasted 15 minutes, followed by a 15 minute debrief.
Over this time, they averaged 75% attendance from staff and clinicians, as well as gathered useful feedback about the value of the process. One participant noted “It was very helpful to do Sims on the floor where we work together to really figure out logistics, timing, etc.”. Another remarked, “I think it would make me less nervous if it happens for real”.
Just prior to the final simulation of the pilot project in March 2020, the coronavirus pandemic became an urgent issue for all medical staff. The pediatric team took the opportunity to adapt one of their cases to a coronavirus simulation, to ensure staff were well supported and more confident in developing safe protocols for managing these patients.
In addition to preparing 28 simulation case scenarios, the project leads also created and employed a scheduling system to improve attendance and prioritize this team building and learning opportunity. The team hopes to continue to run regular simulation cases and continue this valuable work in the long term.
We congratulate the Pediatric Simulation Team and thank them for their hard work!