What is ImPACTS?
ImPACTS starts with a day of in-situ simulations to measure the quality of pediatric acute care in your hospital. Our multidisciplinary team of Pediatric Emergency Medicine- trained physicians and nurses will bring high-fidelity simulation equipment to your hospital in order to assess pediatric emergency performance in the workplace. After each simulation we will provide real time feedback to participants through debriefings. These simulations are the first phase of an ongoing relationship between your ED and the ImPACTS team. Approximately two weeks after this session we will provide explicit performance metrics in a report out that compares your hospital to other similar hospitals. We will work with you to update pediatric policies, provide guidance on equipment, invite your providers to educational events and facilitate debriefings after difficult cases.
To date we have completed ImPACTS evaluations in over 40 US Emergency Departments! Our team will provide you with a detailed report that compares and contrasts your performance to other departments (de-identifying all departments).
Specific details on the simulation component are below.
The cost of this program is supported in part by CT EMSC and Yale New Haven Children’s Hospital.
Feel free to contact me with any specific questions: Marc Auerbach, MD MSci firstname.lastname@example.org
The care of an acutely ill child can be one of the most stressful moments health care providers. This stress is highlighted in community emergency departments where pediatric patients make up a minority of the total annual census. Additionally, many systems of care are not optimized to care for the sickest of pediatric patients.
Details of -situ simulation day
In Situ Simulations will conducted on actual patient care units using equipment and resources from that unit and involving actual members of the healthcare team. High- fidelity simulators will present clinical findings (pulses, breath sounds, heart sounds), be connected to a monitor displaying vital signs and a computer displaying the electronic medical record (labs, imaging). Actors will portray family members. Scenarios will be programmed into a computer and the simulator’s status will change over time and in response to interventions. Simulations mimic clinical care and facilitate training and assessment in ways that cannot be accomplished in real patient care safety efforts.
On the day of the simulation we will need you to arrange for two teams of providers to participate for approximately 2 hours in your departments’ resuscitation bay. Each team will be composed of two medical providers (MD, PA, &/or APRN), three nurses, and two medical support staff members (medic, tech, &/or Respiratory Therapist). In many hospitals we have conducted these simulations in the mornings in the resuscitation bay. Team members sign up to attend this session outside of their normal workday (either before/after a shift or on a day off). Some hospitals have paid staff for their time and others have made this voluntary.
Sims will provide a platform for valid and reliable measurement of the quality of care and identify the impact of both human and systems-based safety threats. For the duration of the simulations we will need one room in your department to hold simulations and debrief afterwards.
Participants will reflect on their experiences immediately following each simulation. Trained experts will facilitate debriefings using the Army’s after action review format to identify failure modes in the work environment and the systems of care. Debriefings will provide perspectives not readily apparent during clinical care and that would not be uncovered using traditional retrospective risk reduction techniques.
Teams will care for a variety of simulated pediatric patients in a series of four scenarios. The structure, processes and outcomes of care will be evaluated for four identical infant patients with common life-threatening conditions: Pneumonia/sepsis, hypoglycemic seizure, airway foreign body, and cardiac arrest/drowning. We will collect valid and reliable data through novel data capture from the simulator and videotape reviews (securely stored).
We will work with a designated "Pediatric Champion" at your hospital to provide specific feedback on performance and to develop “action plans” to improve the quality of care. Ex: refining pediatric sepsis algorithms, identification of latent safety threats, new pediatric medication dosing systems. We have a variety of resources and interventions that have been created through this program that your department will have access.