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Using Simulation for Resuscitation Innovation During the COVID-19 Pandemic

Despite the healthcare work challenges that have arisen due to the covid-19 pandemic, innovation is still a focus at many healthcare institutions. When healthcare outcomes can be improved, staff are determined to find a way to make a difference. For example, there’s still significant room for progress when it comes to resuscitation outcomes. The success rate for cardiac arrest continues to be too low, which drives many efforts to improve the quality of resuscitation care.

Simulating Resuscitation Procedures During COVID-19

During a recent Webinar, Enhancing Resuscitation Education During a Crisis Through Innovation, Dr. Pooja Nawathe, Medical Director of Simulation and the Associate Director of the Cardiac ICU at Cedars-Sinai Medical Center in Los Angeles, discussed her team’s efforts to innovate ICU resuscitation procedures to match the demands of the Covid-19 pandemic. Cedars-Sinai is a non-profit institution in urban Los Angeles with around 850 beds and 500,000 admissions annually. The focused use of state-of-the-art technology in their Simulation Center plays an important role in their efforts to enhance patient outcomes. The COVID-19 pandemic has led to significant challenges in the need to “come up with methodologies to educate and make process improvements in our workflow without people physically being there.”

Exploring and Learning What Needed to Change to Diminish Risk

For Dr. Nawathe, the pandemic has driven innovation for improving existing processes, specifically because no one knew how to best respond to cardiac arrest under pandemic conditions. Her team used simulation to power a healthcare design sprint to explore resuscitation in the ICU; they designed a solution, conducted a prototype procedure, then proceeded to validate it. This was simulation that involved more than just training a single person. Instead, the whole team was included, and a component of the exercise included solving problems as they arose. The pandemic meant that certain roles and functions had additional risk, like intubation. That meant the team also had to investigate systems changes, including ergonomic issues and the addition of personal protective equipment (PPE).

Specific Changes to Protect Clinical Staff

Other risk-related components of the exercise included determining the number of people who needed to be in the room to minimize thechance of spreading infection, as well as the staff needing more extensive PPE. Rather than the typical task-oriented simulation, this was truly systems improvement for a specific critical situation. The process even received appreciable “buy-in from attending physicians who had practiced critical care for the last 20 years who could now participate in simulations as learners.” The simulation occurred in situ, with appropriate staff, including a pharmacist and anesthesiologist, as well as video for home-based participants’ learning.

Immediate and cold debriefings were important for helping staff think about adapting to COVID-19 situations. Ultimately, simulation allowed the team to re-envision processes in a way that would involve minimal exposure to staff. In addition, it helped the organization preserve supplies at a time when equipment shortages were common and continue to train everyone when they could not physically be on campus. Simulation was also used to examine other invasive procedures that needed to be adapted to the reality of pandemic conditions, as well as changed staffing models, new communication processes, an even greater focus on sterile fields, as well as helping multidisciplinary teams work better together. For education and simulation, Dr. Wathe suggests that healthcare organizations “keep on assessing and improvising and should be prepared for the post-pandemic catch-up when learners come back to the physical environment.”

CPR Training That Protects Healthcare Providers

COVID-19 is affecting all aspects of life, even CPR training. As more and more Instructor-led classes and training centers are being canceled or indefinitely postponed, the training demands are increasing for frontline care givers as we manage the risk of unnecessary viral exposure. HealthStream has heard from multiple clients how the American Red Cross Resuscitation Suite™ is the perfect way to be safe and remove unnecessary risk for providers without compromising competency and quality. Our CPR training solution facilitates social distancing with self-paced, self-directed training, while meeting all regulatory requirements.

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