Seriously ill children presenting to small district general hospitals face increased risk unless cared for by a team trained to recognise, stabilise and manage them prior to retrieval by a specialist transport team.¹ Simulation is a teaching technique that enhances the clinical skills of inter-professional teams, identifying learning needs whilst not exposing patients to harm.² A real time simulation was instigated as part of a quality improvement program. This unannounced single site, multi departmental, inter-professional simulation was designed and implemented to offer staff training opportunities to enhance their skills when faced with acute life threatening illness in the paediatric patient. Support was received from stakeholders and the regional simulation team.

Method The simulation followed the real life patient journey of a child with serious illness; from arrival in the resuscitation room of the Emergency Department, transfer to the acute paediatric ward for further stabilisation before being moved to the operating department recovery area, for intubation and ventilation. Staff from all areas participated in this simulated real life event caring for the high fidelity wireless simulated patient, who was accompanied by actor parents to add authenticity to the situation. Contingency plans were established to manage any emergency during simulation.

Results The simulation exercise was fully observed by stakeholders from all departments. Immediate verbal feedback was provided to departments after transition of the patient to the next care team. This process identified latent risks and raised human factors awareness and an action plan was produced. Many of the recommendations were implemented the same day to address key areas of patient safety and clinical care.

Conclusion This simulated patient journey demonstrated the feasibility and value of real time outreach training in small district general hospitals helping to improve availability of safe healthcare irrespective of location. It helped strengthen multidisciplinary working relationships and improve patient safety. Stakeholder feedback was positive and has identified a strong desire for further simulated training opportunities.

References

1. Rollin AM. Working together for the sick or injured child: the Tanner Report. Anaesthesia 2006; 61(12):1135–7. PMID: 17090231

2. Lateef F. Simulation-based learning: just the real thing. J Emerg Trauma Shock 2010;3:348–352. PMCID: PMC 2966567