156 Practice Made Perfect: The Evolution of an LVAD Algorithm Through Clinical Simulation

Abstract

In total, 70% of patients implanted with a left ventricular assist device (LVAD) will experience a life-threatening emergency within the first year of implantation Develop and introduce an emergency algorithm that provides a standardized approach to LVAD patient emergencies.Increase staff confidence, competence and clinical decision-making.Use simulation to facilitate and enable staff to solve complex problems using standardized assessment and management while ensuring transparency and equitable treatment in situations of rapid clinical deterioration.The LVAD Simulation and Algorithm project commenced through the trial of an out-of-hospital algorithm developed by Bowles that was adapted for in-hospital use. Direct feedback from staff attending low-fidelity ward-based simulations was used to consistently develop and adjust the algorithm from a three-page flowchart to a single page (Practice made perfectSimulation has proved to be essential in developing this innovative, unique, patient safety tool that has increased staff confidence and competence throughout the organization while providing a safe place for clarifying questions. The single-page algorithm continues to be practised via simulation weekly with an ever-increasing multi-disciplinary presence. Staff report increased confidence not only in dealing with LVAD emergencies but also in their ILS and ALS skills, all of which increase safety, quality care for patients. This one of a kind algorithm is now finalized and awaiting organizational review, following which a complete evaluation of its effectiveness will be conducted.