G314(P) Can multidisciplinary simulation in a paediatric department improve clinical governance?

Abstract

Background Simulation is increasingly becoming an integral part in paediatric teaching. It offers an excellent opportunity to practice medical emergencies in a safe environment and allows addressing human factors that are pivotal in safely managing the critically ill child. However, multidisciplinary simulation in our paediatric unit has also facilitated discussion about clinical governance issues within the wider institution. Aims Does multidisciplinary simulation program in paediatrics address clinical governance issues? Methods Over a four month period ad hoc in house multidisciplinary simulation sessions involving medical and nursing staff of all levels from the paediatric, anaesthetic, radiology and emergency medicine department were conducted. The simulation sessions were held on paediatric wards and in the emergency department. Faculty members were resuscitation officers, paediatricians, anaesthetists and nurses with experience in conducting simulation. The sessions lasted 20–25 min; followed by debrief for another 20 min. Immediate feedback on the simulation sessions and learning points was obtained. The quality, the usefulness and the conduct of the simulation were evaluated in a feedback form. Results In total, thirteen simulation sessions were held over a four month period and there were an average of 11 attendees per session. During immediate discussions areas of concern were identified. These included clinicians’ performance, human factors and clinical governance issues. Governance risks included inadequate resuscitation equipment and emergency protocol folder, access to emergency lifts, and the quality of emergency activation system. Conclusions Multidisciplinary simulation sessions are an important tool in addressing human factors that are crucial to successfully managing the critically ill patient. Multidisciplinary paediatric simulation has been vital in identifying and addressing clinical governance issues such as above. Subsequently, these areas of improvement were escalated to the divisional management team and appropriate steps were taken to address them and minimise the risk to sick children.