HTE correspondent Marty Kauchak previews the quickly evolving pace of events leading to the July 2018 projected date for substantial completion and opening of the University of Nebraska Medical Center Global Center.   

While the first shovel of dirt for the University of Nebraska Medical Center (UNMC) Global Center foundation is not expected to be moved until this February, concepts for this learning organization’s center of excellence are quickly evolving into programs.

The Global Center design is a multi-level, 134,000-square foot, highly advanced inter-professional clinical simulation facility on the UNMC campus in Omaha. To ensure ease of access for health care providers, faculty and students, the Global Center is purposefully sited proximal to the hospital, colleges and clinics. The facility will be physically connected to other campus facilities by two skywalks.

The center’s project design team focused on meeting the July 2018 opening milestone consists of The Clark Enersen Partners and RDG Planning and Design in collaboration with Energy Studio, C&C Consultants and the technology integration company, AVI-SPL.

The genesis of the center was embodied in the iEXCEL (Interprofessional Experiential Center for Enduring Learning) concept originated at UNMC in 2014 as a result of a series of retreats with faculty and students. This effort, led by the Vice Chancellor for Academic Affairs, H. Dele Davies, MD, was to ensure that the training of health care professionals would be truly relevant for the times.

According to Pamela J. Boyers, PhD, Associate Vice Chancellor for Clinical Simulation, iEXCEL at UNMC, implementing iEXCEL was largely dependent on accelerating the adoption of simulation to foster interprofessional education and collaboration and improving the performance of health care professionals. “The deans of the Health Science Colleges: Medicine, Nursing, Dentistry, Allied Health and Pharmacy worked closely as a team to define the details of the iEXCEL vision. The overall goal was to improve the training of health care professionals, thereby improving the outcomes of patient care,” the university official added.

And while the Global Center for Advanced Inteprofessional Learning (Global Center) will serve as headquarters to the UNMC iEXCEL program, the program today is further cited by Boyers “as a transformative program designed to distinguish Nebraska by creating a new model for education, training and research for health care professionals. This model will be built around, and incorporate, a wide range of simulation technology so health care professionals can learn and become proficient in taking care of patients in safe and simulated health care settings.”

The evolving UNMC program’s overarching goal hits a “sweet spot” in terms of addressing three critical issues faced by the U.S. health care system: medical errors and avoidable deaths; an outmoded educational model and a new generation of learners; and health care professional shortages.

The iEXCEL concept remains a work in progress. Indeed, this October 6, iEXCEL will host its second annual iEXCEL Expo, an event to engage students, faculty and the public with the technologies available to them, and to encourage them to incorporate these technologies into their curricula.

Learning technologies will help take faculty, staff and students to a higher plateau of instruction – with early attention focused on the iEXCEL Visualization Hub. “This hub is intended to familiarize faculty and staff with ground breaking technologies such as 3-D/Virtual Immersive Reality (VIR), augmented and mixed reality. These highly visual technologies provide immersive environments for the students to learn in new ways,” Boyers explained and added, “Additionally, the creation of the iEXCEL Visualization Hub facilitates ‘ramp-up’ time and prepares faculty, staff and learners for when the Global Center opens in 2018.”

Beyond the hub, the facility will reportedly house the widest range of simulation technologies available, set in realistic simulated health care environments as well as surgical simulation suites and debriefing rooms. “These environments range from a realistic home care unit to intensive care settings that feature human patient simulator,” Boyers remarked.

The community subject matter expert further pointed out “The Global Center will include a Virtual Immersive Reality Center, an Advanced Clinical Simulation Center, and a Surgical Skills Center – each of which provides unique training opportunities in and of itself. However, learners have access to all three centers, and faculty and staff have the opportunity to truly make learning sessions memorable and effective with the incorporation of technologies from each synergistic center.”

Boyers also commented on the center’s “carefully thought out equipment strategy.” There will, for example, be procedure training rooms that house a large selection of task trainers, such as airway models, ear and eye exam models, and pelvic trainers as well as procedure trainers such as laparoscopy simulators and endoscopic trainers.

Boyers continued, “In addition to the manikins and task trainers, the Global Center incorporates 3-D/VIR technology for training and research purposes. This technology includes total immersive environments, 3-D CADwalls, interactive visualization walls and head-mounted display sets.”

The center will bring to bear statewide training strategies highlighted on HTE in South Carolina and other states. In this instance, the Global Center will also form the hub for a statewide network of interconnected simulation centers for the development of health care professionals. These conjoined centers will provide state-of-the-art education, incorporating hands-on training opportunities as well as unique research opportunities that are made possible by the advanced modeling and simulation technologies.

Given the steady pace of simulation center openings and renovations around the globe highlighted on HTE, the UNMC Global Center team was asked to share its early lessons learned with the community.

Boyers enthusiastically responded there are many lessons to be learned from this experience as well as previous involvement with the design, planning and operation of other interprofessional simulation centers. “We started with learning how other high-risk organizations - including oil and gas, aviation, and the automobile industry – improve performance outcomes by addressing safety, quality and cost through the adoption of simulation for design, planning and training,” Boyers, began.

The UNMC senior leader continued, “We learned, for example, that while the selection of highly advanced technology is clearly critical, the integration of that technology is of even greater importance. This includes the connectivity of the technology within the center as well as the connectivity to the outside world. Additionally, we learned it is essential to hire a technology integrator at the very start of the project so that these experts can work closely with the architects to ensure the necessary connectivity is built into the simulation center.”

The center also learned that content – especially in the 3-D/VIR arena – is not readily available, and that the staff must create it themselves. “This has implications for staffing and for support from subject matter experts,” Boyers said and continued, “However, these technologies, when combined with content (curriculum) can indeed help reduce the costs of training as well as improve safety and quality for the public. Modeling and simulation can be utilized by turning data into visual images to gain a better understanding, for example, the oil and gas industry has applied this to pinpoint drilling exercises. We expect the application of modeling and simulation to create significant opportunities in the medical field.”

Other lessons learned from direct experience in health care simulation include the importance and effectiveness of interprofessional simulation centers in contrast to “uni-disciplinary” simulation centers. Boyers concluded, “This involves the purposeful design of the center in order to foster interdisciplinary collaboration, including the ability to learn to work and function effectively in health care teams.”

From the financial sustainability perspective, a business strategy that addresses the ongoing replenishment of technology is an important consideration, and simulation centers that are designed to conduct research and development open up many opportunities for revenue generation.