The Challenge: Cited as the third leading cause of death in the U.S., it is estimated that up to 400,000 patients die annually from avoidable hospital-related errors. It is generally accepted that breakdowns in the healthcare system, especially communication failures, are major contributing factors. There is powerful evidence that for High Reliability Organizations (HROs), such as aviation, nuclear power, and oil and gas, engaging in realistic simulation training greatly reduces undesirable outcomes.
Safety First: To improve patient safety, an emphasis on team functioning and communication should be taught early and continued throughout healthcare education. Therefore, the University of Nebraska Medical Center (UNMC) has developed a bold and transformative program called iEXCEL (Interprofessional Experiential Center for Enduring Learning.) The overarching vision is to improve human performance and effectiveness in healthcare. This is being accomplished through accelerating the adoption of clinical simulation by using advanced technologies, including human patient and surgical simulators, 3D, augmented and virtual reality, and holographic imagery. To support this new model of learning, the program is an interdisciplinary endeavor involving close collaboration between the health professions colleges and a newly formed team of talented content creators –including clinical simulation experts, artists, graphic designers, web developers and 3D animators. This team works closely with faculty and students to create realistic simulation scenarios involving visually compelling and interactive medical content for the virtual worlds.
iEXCEL presents a model that better prepares future and current practitioners to perform effectively in the modern, technologically advanced and fast-paced healthcare setting
An Interprofessional Endeavor: Purposefully designed to ensure current and future healthcare practitioners focus on patient-centered care, iEXCEL creates simulation experiences for all disciplines at different levels of training. Doctors, nurses, pharmacists and allied healthcare professionals can learn and rehearse important procedural and professional skills in a wide variety of simulated healthcare settings. Soon to be headquartered on the UNMC campus in Omaha, Nebraska in the Dr. Edwin G. & Dorothy Balbach Davis Global Center (Davis Global Center), this state-of-the-art interprofessional simulation center will ensure ongoing team training throughout a lifetime of practice. By adopting a combination of modeling, simulation and gaming modalities, all healthcare professionals can practice the skills of their respective professions, learn how to deal with unexpected and rarely seen scenarios, and participate in interprofessional team training exercises through immersive real-world and virtual simulation environments.
Replicated Healthcare System: The unique design of The Davis Global Center incorporates an entire healthcare system. In these simulated home, community care, emergency and intensive care settings – each outfitted with real furniture, hospital equipment and human patient simulators– interprofessional teams can safely practice procedural and professional skills, including “hand-offs” between units when most errors occur. Therefore, a simulated patient can be transferred throughout all levels of care before being returned to their home, all within the Davis Global Center. Clinical simulation exercises with audio-visual recordings and feedback systems are incorporated into debriefing techniques to facilitate opportunities to learn “softer” and interactive skills, such as critical thinking, diagnostic acumen and clinical judgement.
Keeping Up: During a lifetime of modern medical practice, many new procedures and complex technologies are introduced. Rapid advances in technology require retraining and continuous learning by healthcare professionals to gain familiarity with new diagnostic, interventional and surgical technologies. A comprehensive simulation facility on the scale of the Davis Global Center can ensure healthcare professionals are trained to the desired levels of competence prior to deployment of new equipment in real patient care settings.
Measurement and Assessment: To ensure the maximum impact of simulation training, improved individual and team performance must be demonstrated. Thus, data capture and analysis technology and software related to performance enhancement should be central to such an undertaking. These technological advancements not only afford greater fidelity within simulations for added realism, but also allow for immediate and extensive performance assessment to provide much needed feedback for learners, teachers and content creators.
Summary: Safer healthcare can be provided by creating a relevant and innovative training approach to health professions education. iEXCEL presents a model that better prepares future and current practitioners to perform effectively in the modern, technologically advanced and fast-paced healthcare setting. The creation of the Davis Global Center has been achieved through unique public-private partnerships involving the state of Nebraska, local community leadership, and collaborative industry and military relationships, along with generous philanthropic gifts. iEXCEL is considering lessons learned from fields such as aviation, nuclear power and the military as they relate to improving safety and quality outcomes through simulation to ensure that patients receive the best quality care from highly trained professionals who function effectively as cohesive healthcare teams.