crm symposium bringing the concept into practice ... · crm symposium bringing the concept into...
TRANSCRIPT
![Page 1: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/1.jpg)
CRM Symposium
Bringing the Concept into Practice:
Simulation as a Tool to Simulate, Stimulate and Assimilate
Dr HO Lap-yin Director, Multi-disciplinary Simulation and Skills Center,
Queen Elizabeth Hospital, Hong Kong
![Page 5: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/5.jpg)
Personal skills
• Decision making
• Leadership
• Assertiveness
• Communication
![Page 6: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/6.jpg)
Hospital system
- Team briefing /debriefing
- Standardized communication
- Teamwork and leadership
- Speak up culture
![Page 7: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/7.jpg)
Aviation CRM
• 28th December, 1978
• United Airlines Flight 173
HA Convention 2014
![Page 8: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/8.jpg)
Healthcare vs Aviation
• Multiple teams
• Members in and out
• Simultaneous commitment
• Ill-defined membership
• Highly complex
![Page 9: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/9.jpg)
Critical Area Survey
• Feb, 2013
• 4 areas ( A&E, ICU, Operation Theatre & Delivery Suite)
• 319 responses
![Page 10: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/10.jpg)
Factors that prevent you from having excellent communication and teamwork?
Factors
Too many things to attend at the same time
27%
Different personality of colleagues 24%
Dare not challenge seniors 12%
![Page 11: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/11.jpg)
Major obstacles to patient safety?
Time pressure 24%
Inadequate manpower 27%
Insufficient equipment/ drugs 3%
Poor team collaboration/communication 6%
Workload too heavy 25%
Patient too ill 5%
No clear instructions from senior/leader 5%
Junior colleagues do not follow instructions 5%
![Page 14: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/14.jpg)
Simulation
1. Learning mode
2. Scenario experience
3. Guided reflection
4. Individualized learning
HA Convention 2014
![Page 15: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/15.jpg)
Learning mode
HA Convention 2014
1. Come to learn
2. Interruption free
3. Suspension of disbelief
![Page 17: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/17.jpg)
Scenario experience
• Tailor made
• Relevance
HA Convention 2014
![Page 18: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/18.jpg)
Guided Reflection
HA Convention 2014
1. Debriefing
– “what went well?”
– “why it went well?”
2. Observation
3. Group dynamics
![Page 19: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/19.jpg)
Individualized learning
• Tell me one thing:
– “you have learnt today?”
– “you’ll do differently tomorrow?”
HA Convention 2014
![Page 20: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/20.jpg)
Power of Simulation
• Experiential learning
• Reflective
• Individualized
• Behavioral change
HA Convention 2014
![Page 22: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/22.jpg)
Simulation based CRM
Advantages:
• Relevant context
• Awakening
• Know each other
HA Convention 2014
![Page 23: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/23.jpg)
Simulation based CRM
Disadvantages
• Resources
– Instructor
– Learner
– Simulation Units
HA Convention 2014
![Page 24: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/24.jpg)
Alternatives
• Different disciplines
– Doctors, nurses
• Cross specialties
– OT & OG
– Surgery & AED
• Play different roles
• Generic scenarios
HA Convention 2014
![Page 25: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/25.jpg)
Simulation-based CRM training in HA
HA Convention 2014
Facilities
Training materials
Trainers
Program
![Page 26: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/26.jpg)
Facilities
• Simulation Units
– Environment
– Equipment
– Administration
– Technical support
HA Convention 2014
![Page 27: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/27.jpg)
Trainers
• CRM simulation instructors
– Expertise
– Skills
– Certification
– Trainer database
HA Convention 2014
![Page 28: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/28.jpg)
Program
• Pilot 2013
• Corporate Program
HA Convention 2014
![Page 30: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/30.jpg)
Senior Staff Training Programs 1) Overview training
Senior Ranking Staff
To take on CRM concepts
![Page 31: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/31.jpg)
Train-the-Trainer Program
2) Intensive train-the-trainer workshop
92 frontline clinical staff from 4 clinical areas:
a) the operating theatre; b) intensive care unit; c) obstetrics and gynecology; and d) accident and emergency unit
![Page 32: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/32.jpg)
Frontline Staff Training Program
• Front-line team training
• Coaching
• Development of training materials
![Page 33: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/33.jpg)
Training materials
• CRM videos
• Trainer manual
– CRM
– Clinical Scenarios
HA Convention 2014
![Page 35: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/35.jpg)
Examples of Scenario Practice
• Anaphylaxis • Civil Disaster • STEMI • Deteriorated patient in the ICU • Difficult Intubation in ICU • Eclamptic fit in PACU • Pathological CTG • Hypokalemia • Difficult airway • Blood transfusion • Eclamptic fit
HA Convention 2014
![Page 46: CRM Symposium Bringing the Concept into Practice ... · CRM Symposium Bringing the Concept into Practice: Simulation as a Tool to Simulate, Stimulate and Assimilate Dr HO Lap-yin](https://reader030.vdocuments.site/reader030/viewer/2022040523/5e861f90234820121941ffe0/html5/thumbnails/46.jpg)
Acknowledgement
• CCEs (HKEC, KCC, NTWC)
• HAHO (MG)
• Simulation Training Committee
• CRM Steering Committee
• Team-based Simulation QA Group
• CRM Working Group
• CRM Training Materials Editorial board
HA Convention 2014