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Simulations help team design most efficient ER

A 15-month-old lies in an ER trauma room after being transported by EMS from an adult hospital. Lab results indicate possible kidney failure.

A 6-month-old suffering seizures is being treated in an ER patient room.

A baby has been found not breathing in a bassinette by a babysitter and has been brought to the ER by EMS.

A normal day in Akron Children’s Hospital’s ER?  Not today.

These are 30-minute simulations being played out at the warehouse in Green Township. They’re helping the ER team in its continuing effort to design the most efficient ER, which will be part of the hospital’s new Critical Care Tower.

In previous sessions, the ER team defined equipment needs, room sizes, basic layouts, and the location of support services.

Dr. Mary Patterson

This week, ER team members are enacting simulation scenarios created by Dr. Mary Patterson and her staff in the simulation center, to refine the details of the space and determine how it actually works in practice with a patient.

This means fine tuning what’s in the rooms and where everything is placed. Is equipment easily accessed or in the way of staff providing patient care?

ER staff members are assigned roles to play – residents, attending physicians, medical nurses, procedure nurses, recording nurses, respiratory therapists, x-ray techs, anesthesia assistants, observing students, child life specialists, even distraught parents – to evaluate how well the space and equipment work for each member of the team.

The team surrounds the “patients” – mannequins with pulses, eyes that react to light, and breathing and heart sounds – to test the placement and functionality of equipment.

These simulations are videotaped, and with Dr. Patterson leading the debriefing sessions that immediately follow the simulations, team members watch the videos and talk about their own experiences to identify what’s working and what needs to be changed.

As the week progresses and equipment and cart placements are decided, slow-motion simulations will be used to confirm that medications and critical equipment are within the reach of all members of the team, from the tallest to the shortest.  Simulations will also capture patient care at and from ambulance bays.

All of these workshops taking place at the warehouse are part of what’s called a Kaizen, a rapid process improvement event. This will be the last Kaizen meeting for the ER team. Refinements made in this session will be reflected in the completed architectural drawings due by March 8.