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Medical staff in an operating room.

The U's "in-situ" training aims to improve group communication and dynamics in emergency and operating rooms.

Partnering with hospitals on safety training

From eNews, Oct. 26, 2006

The University of Minnesota's School of Public Health is partnering with hospitals in the Twin Cities on a first-of-its-kind simulation training to improve patient safety. While past efforts have focused on the technical skills of doctors, nurses and technicians, this new training aims to improve critical elements of safety that are much more difficult to measure, namely communication and group dynamics.

"Experts are finding that threats to patient safety are not because hospital staff lack technical skills or a commitment to safety," says University associate professor William Riley. "Rather, most often, the cause is a breakdown in communication among hospital staff."

Riley is working with Fairview Health Services to launch "In Situ" simulation training. Unlike most hospital safety training that occurs in classrooms or simulation laboratories, the In Situ training happens in real-world emergency and operating rooms. (The dictionary definition of "in situ" is "in its original place" or "on site.")

The simulation scenarios are fast-paced and involve emergency "stressors"-- something that suddenly goes wrong with a patient or procedure--to replicate key parts of the clinical environment. High-tech audio and video equipment catch the action so medical teams can review their performance in a post-simulation debriefing.

Riley is working with leaders from Fairview as well as other University faculty, including Helen Hansen from the School of Nursing and Karyn Baum from the Medical School. That interdisciplinary team, in turn, is collaborating with Federal Aviation Administration pilots to develop the training. Like in the airline industry, the medical trainers track the "near-misses" of each simulation to, as Riley says, "prospectively look at potential errors."

With 14 simulations behind them and 30 scheduled for the coming year, Riley says the impact on the hospital staff has been tremendous.

"When the teams see the playback of their simulation on screen, they realize immediately where communication can be improved, processes are failed, and mistakes are made," he says. "In 25 years of training, this is the most powerful teaching method I've ever seen."

Republished from Advances, summer 2006, a publication from the School of Public Health.