October 29, 2019By Lance Baily

Swedish Medical Center’s “InSytu” Team Improves Professional Healthcare Outcomes with Clinical Simulation

“Don’t practice until you get it right, practice until you can’t get it wrong” quotes the new Swedish Medical Center’s “InSytu” website. Although based out of Seattle, the InSytu group has already worked with leaders and caregivers across the United Staes in large systems and critical access hospitals to help improve performance outcomes through the design of clinical simulation experiences. Working with multidisciplinary teams in their real workplace, InSytu leverages their simulation expertise to drive real systems-level change. In this article we explore the use of healthcare simulation in the InSytu team’s process and consider how it can help professional healthcare systems. If your healthcare institution is looking to jump start its medical simulation program or improve team performance outcomes this is a must read article!

“At insytu we help professional care institutions perform clinical simulation experiences to improve outcomes”, says executive director Theresa Demeter MHA. “We bring our expertise to clinical facilities across the country, practicing exactly where your healthcare team performs so that we can best evaluate, develop, train and assess needed care outcomes”. Practicing together with simulated exercises in actual patient care environments grows an institution’s strength in leadership, communication and teamwork and those non-technical skills whose absence can derail even the most technically proficient team.

InSytu was born in 2008 as the donor funded Gossman Center for Pediatric Simulation at Swedish Medical Center in Seattle, Washington. A state of the art simulation lab led to expansion of scope beyond pediatrics to obstetrics, emergency medicine and other high risk areas. The team soon learned that simulation outside of the lab in areas where patient care actually takes place led to mitigation of latent safety hazards and that using realistic multidisciplinary teams practicing high risk, low frequency events together allowed the caregivers to improve their practice while learning with and from each other.


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Moving outside the lab setting allowed them to grow their simulation in healthcare practice to support the entire Swedish system and eventually working outside their home, as InSytu. In 2015 they began a pioneering system wide set of OB emergency simulations across the greater Providence system (30 sites) to facilitate a standardized evidence based approach to managing high risk emergencies, the largest program of its type. They have since partnered with dozens of hospitals and health systems across the United States, helping engage their bedside caregivers in improving outcomes, decreasing risk and cost improving their work caring for patients.

Since 2007 they have worked with over 60 hospitals and healthcare systems providing training for over 10,000 multidisciplinary participants. Their client list already includes Providence, Swedish, HPI, Bozeman Health Deaconess Hospital, Sarah Bush Lincoln, Physicians Insurance, Olympic Medical Center, Kalispell Regional Healthcare and many more.

Joyce Dombrouski MHA, RN, CENP CNO of Providence Health and Services shared about InSytu that “I find myself being unable to adequately express the level of support and expertise that the simulation team brought here to St. Pat’s to prepare us for our OB opening on Monday August 3. The expertise, professionalism, depth etc. was so remarkable to me, but more importantly critical to our team. We certainly would not have been able to be prepared to provide safe care so confidently without all of their time and assistance. My thanks and gratitude.”


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The Insytu Approach

  • Multidisciplinary: The onsite InSytu team include physicians, registered nurses and other industry experts, for a comprehensive experience.
  • Team-Focused: An inclusive and collaborative environment provides the opportunity for everyone to work together toward improved patient outcomes and experience.
  • Uniquely Tailored: Each program is tailored to your team goals and resources, and is conducted in your patient care areas for the most realistic experience.
  • Results Driven: They start with your desired goals and data, so we can quantify real improvements and ROI.

The InSytu team are experts in simulation facilitation and have decades of experience in their clinical disciplines, including emergency medicine, critical care, cardiac care, OB/GYN, pediatrics, NICU, anesthesia and other specialty areas. InSytu’s goal is to engage and empower caregivers to improve quality, safety and cost of care. The team has even helped to publish research related to their mission entitled “Multidisciplinary, In Situ Simulation Improves Experienced Caregiver Confidence With High-Risk Pediatric Emergencies” by Tara Cristallo, BS et al. which found that “Multidisciplinary, in situ simulation improves experienced ED caregivers’ confidence with pediatric emergencies in an ED setting. These findings suggest that investment in simulation-based education may improve clinical care and quality and safety improvement plans for the treatment of pediatric emergencies in general EDs.”

Theresa was specific to mention that “This isn’t in a lab, this isn’t one size fits all. This isn’t a drill. This is a program we design with you to get you the results you identify as being needed”. Participation in an InSytu simulation program kick starts process improvement, demonstrating measurable change in meeting your individual goals. The team has done thousands of medical simulation sessions in dozens of facilities, and they work to ensure each program is tailored to get the best results for teams, and patients.

Learn more on the InSytu Website Today!


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