AHRQ: Building a Safety Program Across a Vast Healthcare Network

UPMC’s Medical Director of Patient Safety and Director of the WISER Simulation Center, Dr. Paul E. Phrampus MD, recently shared his AHRQ article “Building a Safety Program in a Vast Health Care Network”, which highlights the unique needs of patient safety, workforce training, and medical simulation utilization when considering vast institutional healthcare networks. Below we share an excerpt of the article along with the upcoming simulation courses you can register for with Dr. Phrampus and WISER, which is celebrating its 25th year of service in 2019! *Update: Check out their live-streamed event this April 23rd, below!

As hospital-based health care in the United States has consolidated, large health care systems have proliferated across the country in the last decade. Health care networks involving a variety of care facilities (such as hospitals and physician practices) functioning as a single coordinated entity present unique opportunities and challenges for building patient safety programs.

Large systems often have access to more resources in terms of funding, personnel, and information technology (IT) infrastructure. Many have amassed internal aggregate data that can be used to inform the needs of a patient safety program. Several systems have become fully integrated health delivery networks and have developed their own insurance payers, which further increases access to information on costs and outcomes. Health care networks can communicate across their systems with relative ease, hopefully sharing best practices and lessons learned from within the system itself.


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However, large health care systems also present challenges to the building and maintenance of safety programs. Haas and colleagues recently framed some of the risks potentially associated with such systems. Things become even more complex when systems span across state borders. Differing rules, regulations, and state legislation complicate the development of all kinds of programs, including ones focused on patient safety.

While there are advantages to scaling and sharing practices and data across a large network, safety remains a uniquely local phenomenon. The fact that a given practice—whether it’s a change in workflow or a computerized reminder—worked in a clinic or hospital that is part of a large integrated system may offer surprisingly little advantage if adopted in a new site, even one that is part of the same system. Trying to legislate or drive safety as a top-down initiative from the corporate towers is a nonstarter.

Beneath the surface of most large health care systems lies a heterogenous set of local entities (often hospitals) of varying size, capacity, and specialization, each having their own culture. Creating a central program that has the flexibility to serve each of the member organizations at a level that they require is crucial for success. Relationships must be actively developed that allow the system-level safety initiatives to interact with the local care–providing entities of the system. This work is challenging but essential.

Measuring the culture of safety across a vast health care network can help guide system initiatives, particularly when these measurements are effectively communicated and used to guide the development of action plans. Such efforts also help to encourage collaboration between the member institutions. The net results are more shared learning and institutional growth of a successful safety program.


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In summary, while the development of large, integrated health care networks offer major opportunities to improve patient safety, such improvements require careful attention to the respective roles of the central leadership and the local sites. It also requires tremendous attention to information flow in both directions—from the center to the local hospitals and clinics, and from the local entities back to the center. The fact that most safety is local is an important truth to appreciate, but it is no excuse for the central leadership of a large entity to avoid articulating a vision for safety and creating programs and information flow that helps the local entities in their improvement work.

Read Dr. Phrampus’s Full Article on the AHRQ Website Here!

WISER Live-Stream “Experts in Simulation” Event – April 23, 2019

WISER in collaboration with the SAFAR Center at the University of Pittsburgh are pleased to provide you with this great opportunity as part of the Annual Safar Symposium featuring topics on “scholarship in sim”, “facilitation and debriefing“, and “research in simulation”! They would love for you to spend the full day with us, enjoying engaging lectures in the morning and interactive workshops in the afternoon. Morning Session: 8:30 – 12:00 Lectures and Q&A speaker panel Afternoon Workshops: Facilitation & Debriefing OR Simulation Research Project Development

Registration:

1. See full flyer here. email [email protected]
2. Indicate attendance of morning lectures and/or afternoon workshop choice

WISER Hosts iSIM Facilitation & Debriefing Courses in 2019

Those looking to improve their healthcare simulation instructional skills should strongly consider in-person training activities, as the nuances of debriefing and instructional design in the field are extremely unique. Designed and facilitated by internationally renowned experts in simulation and faculty development, the training courses available from WISER at the University of Pittsburgh and The Gordon Center for Research in Medical Education at the University of Miami called iSIM, or Improving Simulation Instructional Methods, will prepare healthcare educators to enhance their skills using best practices in simulation-based education methods. Hurry, these courses fill up fas with dates at WISER in Pittsburgh, Pennsylvania, three times next year (July 29th – 31st, October 9th – 11th). Read more about the iSim Courses here.

The iSIM program is intended for healthcare professionals and educators who are interested in improving their instructional skills. An intense focus on scenario design, debriefing skills, and assessment tool design and implementation set the stage for success.

WISER Hosts Additional 2019 Courses on Key Topics to Simulation Operations

  • Designing or Enhancing Your Simulation Center: This one day course is designed to assist those individuals or centers who are interested in designing new or updating existing simulation centers. This is an 8 topic course that will guide the participants, step by step, through the process of identifying their training needs and designing a world class simulation center to meet those needs. Course Fee: $695 (Dates April 4, August 13, November 14).
    • Introduction to WISER and Course Overview
    • Identifying Your Center’s Training Missions
    • Blueprints to Build Out, Designing Your Center
    • Identifying your Center’s Audio and Video Needs
    • Administrative Considerations
    • Job Descriptions
    • Creating Environments
    • Additional Tips for Success
  • Simulation Operations Specialist Training Program, Onsite: This 1.5 day interactive training program is designed to educate simulation operations specialists (SOS) on the key tasks associated with the daily operations and maintenance of a simulation center. This course builds upon asynchronous online content to provide a more detailed and in depth exploration of the many roles of the SOS. Some of the covered topics include: Roles and Responsibilities of Simulation Operations Specialist, Supply and Inventory Management, AV and IT Considerations and Troubleshooting, Course Preparation, Scenario Creation, and much, much more! Cost: $495 (Dates June 11/12, September 26/27, December 10/11)
  • How to Run a Successful Simulation Center: Participants of this two day program will learn best practices associated with the operations of a simulation center. Key operational, administrative, and technological elements of a successful simulation center will be reviewed. Topics such as creating budgets, staff considerations, daily operations, course development, and simulator programming will be discussed. Interactive exercises will allow participants to practice what they learned during course sessions. (Dates: March 27/28, August 22/23, November 6/7)
  • Find More Courses are Available on the website!

Visit the WISER Website to Learn More Today!


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