Medical Training Magazine Interviews Clive Patrickson, CEO of Laerdal Medical

MTM: Give us three ways that utilizing simulation can improve outcomes.

Clive Patrickson: Practice is the key. Simulate patients with real problems, low dose/high frequency learning, simple and effective with good debriefing. Debriefing is key, needs to be thorough and specific to the case. Make sure building simulations address real problems so you can measure and improve the goal is quality improvement over time.

Reduce or eliminate need for instructors focus on peer learning, so that you are not constrained by expertise.

MTM: How can healthcare better express its needs in requirements so they get products as they want?

CP: Get rid of traditional barriers between academia and industry. Develop and resource organizations that help break down barriers by working together. Solve for profit versus not for pro t barriers, for example the American Heart Association formed a whole department to work with industry. Its mission is to align business coalitions between their organizations. Even the United Nations in its Sustainable Development Goals are now advocating for “public and private partnerships”. Barriers to these partnerships are much lower in America and the UK but the rest of Europe appears to be much further behind. Collaboration is a key to success and the way ahead.

MTM: A new trend in the US is combining medical schools and engineering schools. How do you think this will affect/effect the healthcare industry?

CP: I do not believe this will help at all. Academics think it will be the way ahead but the real breakthrough will be in the way healthcare is delivered, not in tools. The better alignment would be between business schools and medical schools, to understand and develop processes and standards around simulation, and how the blend of mission and economic value can be generated.

MTM: How does industry ensure that new protocols, procedures and training are delivered more uniformly?

CP: We need to change the way healthcare is delivered. We need to be sure that there are standard processes. Even though we provide educational materials there is no way we can insure how they are delivered effectively. There is really no way industry can do this without collaboration with medical education providers and hospitals, the two must work in harmony.

MTM: Currently much is expected of individuals and their dedication to CME’s gained via peer reviewed journals and conferences. Do you feel that is sufficient, and what more could be done?

CP: Ditch CME’s through these sort of activities they are a waste of time. These one way isolated and uncoordinated activities cannot verify that anyone has learned anything. Standardized practice every year is a much better way; rather than a large meeting, you would have a series of virtual streaming meetings or smaller meetings, more frequently in many locations that have built in assessment and then give credit.

MTM: At a conference last week the participants were allowed to ask industry experts questions about simulation. Susan Snoddy was there for Laerdal and one of the suggestions from the audience was that industry develops open architecture much as defense did by instituting COTS (Commercial Off The Shelf). Do you see that happening with healthcare? Your thoughts.

CP: Some would suggest sharing COTS as the answer but a better way would be not opening and sharing code but building Application Program Interfaces (APIs) to be used with other devices. That way you would build eco systems around businesses for connectivity. Apple is a prime example; for instance you can’t change their hardware but you can connect other devices to theirs. So in healthcare, you may have manikin systems that connect to peripheral devices that emulate other equipment found in the emergency or operating room departments. Or enable AV systems to easily connect to other equipment.

MTM: How do you think healthcare practitioners and industry could more effectively work together to achieve patient safety and do no harm?

CP: Stop artificial barriers and rewalls between pro t and not for pro t. I am afraid that the idea that universities innovate is a myth. They often produce a product in search of a problem. In addition, when good concepts are developed, there is a feeling that the product is almost ready for release industrialization takes much longer and is more complex. We are in this together not as rivals and it takes collaboration.

MTM: Can industry help to establish standards across the healthcare sector? If so, how?

CP: Yes, by striving for connectivity. For instance, you can buy a lot of different light bulbs from different manufacturers and they all t the same socket. For example, USB proprietary standards will help to build open connectivity systems. However, do not kill innovation by trying to standardize everything.

MTM: What do you see as the ‘ultimate pay-off’ from being a part of GNSH?

CP: GNSH is a ‘crack in the door’ to break down artificial barriers among medical organizations and commercial for pro t and non-pro t organizations. To my knowledge, it is the only forum where we are all working together to achieve a common goal. The discussions at the meetings are non-commercial, they deal with how we build a better healthcare environment. As I stated earlier it is not as dif cult in the United States and England but working with other international organizations appears to be harder. This gives us an opportunity to share ideas and develop products together that enhance medical simulation. MTM: If medical error is the third leading cause of death what could and should be done to correct this?

CP: This is an advocacy problem. Take for example a parallel problem in Tanzania. In a project called Helping Babies Breathe, with the American Academy of Pediatrics, the mortality rate of newborns went down 40%. The world nally began to wake up and developed a program to deal with the problem because of awareness. This was achieved by providing a simple educational program for those who deliver babies, not with fancy technology, but by building something designed for their application.

There is a lack of awareness by the public on the seriousness of the problem of medical errors. When there are fifty deaths per year per hospital that doesn’t seem such a problem. When it is spread over hospitals per year there is no recognition that it is epidemic. In fact the recent study in the British Medical Journal suggested that in the USA alone 250,000 deaths per annum are caused by medical errors.

Add to that the fact that doctors, nurses and paramedics are some of the most trusted professions. In discussion with a colleague at the New York City Fire Department, he said that if something happened to him, a heart attack for example, he would rather be treated by first responders because they are trained specifically in the use of defibrillators and CPR and he would have a better survival chance, rather than in general practice. Training must be specific to the task to be the most effective.

MTM: What do you see as industry’s ultimate role in patient safety?

CP: Patient safety is the catalyst for change. Academia and healthcare are slow to change but hospitals are incentivized by financial rewards, so industry’s job must be to act to help that ‘catalyst’ by helping drive changes not just building more devices. Ours is a global environment that is growing yearly, but what we need to do is see that changes take place in the way education is delivered by collaborating to save more lives. No person is “an island” and good healthcare depends on educational establishments teaching best practices, with educational experiences that emulate good practice, and ongoing learning that supports safety and lifesaving. These are best achieved by everyone playing their part by understanding each other and working together.

MTM: How do you see healthcare changing in the next five years? Ten years?

CP: There will be a shift from acute care to home health care. Health care will provide in hospital education to patients as well as providers and educate to provide real care in the home. Many visits will be provided through technology based systems, iPad, television, phone. This will fundamentally change the way healthcare is delivered, and those involved in simulation must be able to not only adopt this change, but enable it to occur.