IMSH 2021: Dr. Paul Phrampus Presents “Bringing Sim to Life”
The second week of the International Meeting on Simulation in Healthcare (IMSH) virtual conference showcased a variety of presentations in a variety of formats and on a wide range of topics. The first of a series of lectures entitled “Bringing Sim to Life” was given by Paul Phrampus, MD, FACEP, FSSH, the director of the Peter M. Winter Institute for Simulation, Education and Research (WISER) in Pittsburgh, Pennsylvania. During this presentation, entitled, “Simulation: A Critical Infrastructure for Patient Well-Being, Quality and Safety” he focused on the role of healthcare simulation in providing patient-centric healthcare.
The presentation also emphasized the goal of improving patient safety. Phrampus noted that in the 1998 Institute of Medicine’s landmark study “To Err is Human,” an estimated 98,000 patients were injured or killed by preventable medical errors every year. Since then, clinical simulation has been touted as a method to improve patient outcomes and increase patient safety. However, today healthcare education (including medical simulation) and healthcare practice most often exist in two different silos that rarely connect.
With his different roles — as professor in the Departments of Emergency Medicine and Anesthesiology of the University Of Pittsburgh School Of Medicine, medical director for patient safety of the UPMC Health System, and director of WISER — Phrampus is in a unique position to bring together the various branches of healthcare that affect patient safety. During his presentation, Phrampus offers some suggestions on how to bring the practice and education sides of healthcare together.
The C-suite executives (CEO, CFO and COO) and their committees hold the purse strings for institutional spending, but they may view simulation as merely an expense item on an educational budget. Communication between education departments and these committees is vital. Education must identify a return in investment for the institutions. Reducing law suits or loss of Medicare reimbursements seriously affects hospital budgets.
If healthcare simulation can be used to prevent medical errors, the institution will reduce the costs. Clinical simulation program representatives need to sit on patient safety, risk management, finance and operating committees, and must routinely communicate with these committees. For example, healthcare simulation has been shown to reduce central-line infections, thus reducing patient harm and at the same time saving money for the institution. Identifying when clinical simulation is not effective or cost effective is as important as identifying when the method of training is.
Often healthcare simulation programs have a limited outlook, being focused solely on education without seeing a bigger picture of their role in patient safety and saving money. Departments that receive money must “create value” for those that provide the funds. Clinical simulation centers should not focus on what they can do with the equipment that is in the center, but rather on the patient issues in the parent facility and how simulation can be used to identify and mitigate them.
When a link can be made between data of improved patient safety and financial studies that show healthcare simulation can save the institution money, the C-suite will listen. This in no way undervalues the important role of simulation in healthcare education, but rather expands the use of simulation in preventing patient harm. In academia, the focus should also be patient centric, focusing on new graduate competencies needed for safe patient care.
All departments should focus on patient safety, which Pharmpus defines as “reducing unexpected patient harm that occurs during the delivery of healthcare,” whether harm is caused by omission or commission. The ultimate goal is no harm. Clinical simulation should not be solely considered as a subset of training but through assessment, research and systems integration a method to improve patient safety. Phrampus noted that “using simulation to improve safety will require full integration of its applications into the routine structure and practices of healthcare.”
In other words, healthcare simulation should be “hard wired” into the healthcare system so that use is fully integrated throughout. Clinical simulation programs should have access to data, including errors, quality problems and lawsuits, and should be used to identify latent safety threats and to review external agency mandates. Any identified latent safety threats should immediately be reported to the appropriate safety and risk management committee and to institutional leadership.
The insightful presentation provided by Phrampus recognizes that healthcare simulation has a key role in patient-centric healthcare. Clinical simulation offers both the rationale and methodology for moving the field into a much expanded role in preventing patient harm. During the remaining weeks of IMSH, other healthcare simulation leaders from across the world will give additional presentations demonstrating the importance of clinical simulation, and the trajectory of the industry’s future.
Check out several recorded presentations from Dr. Phrampus on HealthySimulation.com’s new webinar platform!
More About WISER
The Peter M. Winter Institute for Simulation Education and Research (also known as WISER) is a world class multidisciplinary healthcare simulation training and research facility out of UPMC. Through the University of Pittsburgh and a partnership with the University of Pittsburgh Medical Center (UPMC), the WISER institute serves 29 acute-care hospitals caring for a population of 3.8 million people through over 382,000 patient contacts per year. The WISER institute operates from a 91,000 sq. ft. simulation center and 8 satellite centers located in hospitals within the UPMC system.
In addition to improving patient safety, the facility is dedicated to the advancement of healthcare simulation and education to promote education, mentorship, systems design and research to enhance the high quality delivery of healthcare. To achieve this outcome, WISER works to enhance patient safety through state of the art educational and assessment methodologies and techniques. The facility also creates innovative education programs for healthcare providers ranging from students through practicing professionals.
Dr. Kim Baily, MSN, PhD, RN, CNE has had a passion for healthcare simulation since she pulled her first sim man out of the closet and into the light in 2002. She has been a full-time educator and director of nursing and was responsible for building and implementing two nursing simulation programs at El Camino College and Pasadena City College in Southern California. Dr. Baily is a member of both INACSL and SSH. She serves as a consultant for emerging clinical simulation programs and has previously chaired Southern California Simulation Collaborative, which supports healthcare professionals working in healthcare simulation in both hospitals and academic institutions throughout Southern California. Dr. Baily has taught a variety of nursing and medical simulation-related courses in a variety of forums, such as on-site simulation in healthcare debriefing workshops and online courses. Since retiring from full time teaching, she has written over 100 healthcare simulation educational articles for HealthySimulation.com while traveling around the country via her RV out of California.