Patient Safety Advocate Elizabeth Benson

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Elizabeth Benson is an engineer, nurse, and educator. As CEO of B & G Educational Innovations, LLC, and subsidiary ReaLifeSim, LLC, she’s also an inventor and entrepreneur on a mission to improve health and wellness worldwide by improving clinical skills education. Regardless of the environment, Ms. Benson has one goal – improved patient safety and care in our ever-changing healthcare environment.

Ms. Benson blends aspects of nearly 40years’ experience as a RN and education specialist into designing/developingdisruptively innovative products that focus on human factor realism to improvepatient outcomes. Her clinical experience includes EMS, Emergency, CriticalCare, and Faith Community Nursing.


Elizabeth Benson

She was recently recognized with theNightingale Innovative Nurses Award and was featured in MedTech Boston and“Babes Who Hustle,” for innovations in healthcare and encouraging girls toenter STEM programs.

The RealLifeSim nomination: “They havedeveloped a unique and beneficial training product that helps to aid intraining while working on live patients. Their product is beneficial to manyfields, such as training nurses, doctors, vets, vet tech, firemen and manymore.”

Trainthe Way You Treat = Improved Patient Safety

Doctors. Nurses. Medics. All ordinarypeople - called to do extraordinary things. One moment we’re in the market orat the movies – and the next we could be delivering a baby, stopping a bleed orperforming CPR. On a busy day, we might be doing all those tasks - multipletimes.

We all see and feel these eventsdifferently and none of us were prepared for this experience during ourtraining.

Problem- The Disconnect

There’s a disconnect between what weprepare emergency responders, nurses, and doctors to do - and what they willexperience. We need to provide more realism in their training, so theyrecognize the influence human factors have on patient safety.

Medical errors cause thousands of deathseach year. Clinicians are caring people, committed to providing their bestcare, but they’re human and humans make mistakes. Learners and providers needmore realistic experiences in clinical skills practice to improve patientsafety. Improving the realism of clinical simulation education is an effective wayto improve patient safety - now and for the future.

Solution– Reconnect

BGEI’s unique solution is the wearableReaLifeSim hybrid simulation product. It is a hybrid IV trainer designed bynurses to provide realistic, risk-free, immersive learning experiences workingunder the pressure of practicing on real people. Learners experience theinfluence of human factors on hands-on and interactive communication skills,while developing situational awareness.

Books, lectures and lab time provideessential knowledge and good practice. But, practicing in a realisticenvironment is different. After working with ReaLifeSim, learners and providersreported improved competency, better communication, confidence, and deeperempathy - which contribute to fewer preventable errors, reduced time totreatment, and fewer human factor mishaps.

Ten key human factors topics for patient safety identified as most relevant for patient safety:



HumanFactor Mishaps

Human factors analysis is an essential step to designing equipment, procedures, tasks, and work environments. Research shows that human failures cause 80% to 90% of errors. The most common root causes of sentinel events are the human factors of leadership and communication as referenced in “Human Factors Analysis in Patient Safety Systems”.

In healthcare, training, related to theinfluence of human factors, is not routinely provided, unlike othersafety-critical industries like aviation. In 2007, an airline pilot whose wifedied due to an anesthetic accident with human factor causes established thefirst Clinical Human Factors Group in the UK, comprised of clinical and humanfactors specialists. As a pilot, coming from an industry that incorporated ahuman-factors approach into all aspects of safety management, he was surprisedto find there was little awareness of the role of human factors in patientsafety. (www.chfg.org)

The World Health Organization, in their report “Human Factors in Patient Safety - Review of Topics and Tools” defined situation awareness (SA) as the continuous monitoring of the task environment to understand what is going on and what might happen next. Clinical simulation task training and scenarios can be used to measure situation awareness, since activities can be stopped without risk. They defined decision making as a critical component of workplace safety in relation to minimizing errors. Increasing use is being made of clinical simulators to train individuals and teams in decision making, especially under high pressure conditions.

Communication& Patient Safety

As clinicians, we’re committed to promote arevitalized focus on the human element of patient-centric care and clinical training.

Effective provider/patient communication isessential to empower patients to see themselves as part of the process,building a sense of trust with patient and provider and improving patientoutcomes. A look, a tone of voice, a touch - all can communicate competence andcaring.

Patient safety experts agree communication and teamwork skills are essential for providing quality care. “When all clinical and non-clinical staff collaborate effectively, health care teams can improve patient outcomes, prevent medical errors, improve efficiency and increase patient satisfaction. Health care teams that communicate effectively and work collaboratively reduce the potential for error, resulting in enhanced patient safety and improved clinical performance.”

Yet, studies continue to show technical and communication errors are the root cause of most of the morbidity and mortality statistics reported annually. An analysis of 2455 sentinel events reported to the Joint Commission for Hospital Accreditation in the USA (JCAHO, 2008) revealed that the primary root cause in over 70% was communication failure.

The wearable design of ReaLifeSim productsreplicate real-life clinical skills training. Learners safely practice hands-onclinical skills working with a live person, relating to them as in real life,promoting a heightened sense of “presence” and emotional connection. Theimproved communication skills also improve clinical team communication.

“The closer we can get the students to a‘real call’, the better we can transition them from students to practitioners.ReaLifeSim IV trainer added another level of realism to our scenarios. Thistool really helps achieve that goal.” – Hector Martinez, EMS Faculty


Clinical team communicates with patient, shares assessment and monitoring responsibilities, and maintains situational awareness. Image credit: Emergency Nurse Association (ENA).

Clinical team communicates with patient, shares assessment and monitoring responsibilities, and maintains situational awareness.
Image credit: Emergency Nurse Association (ENA).

WhyReaLifeSim?

We designed ReaLifeSim because it wasneeded in our clinical education environments. We needed a better way to"train the way you treat".

For my colleague and business partner,Linda Goodman, RN, and me the tipping point came in 2015. One day in thesimulation lab, a communications professor was participating as a “patient.” Astudent nurse was starting an IV using a fake arm next to the patient when thepatient yelled ‘ouch’! Startled, the student stepped back saying, “It was justa fake arm, I didn’t touch you.” In that moment, we realized we needed to helpour students become as competent in communication skills and situationalawareness as they were in hands-on clinical skills. That’s when we decided - wecan make the clinical simulation experience better.

Our ReaLifeSim products permit repeated,safe skills practice on real people for learning proper hand positioning, IVcatheter manipulation, patient interaction, and situational awareness.

Many schools are substituting 25-50% of clinical experiences with simulation. Nursing educators can use simulation to provide exposure to challenging patient scenarios while optimizing a safe environment.

With up to 50% of clinical training onmanikins and computer scenarios, extra emphasis needs to be placed on effectiveinterpersonal communication as an equal partner with the latest technologies toprovide the best treatment and care.

Experts in these national and internationalvenues choose ReaLifeSim because their clinically challenging scenarios requireadded realism:

  • US&R Task Force Medical Specialistand Medical Team Managers Training with Disaster Medical Solutions (ongoing)
  • EMSWorld Clinical Challenge (10.2017,10.2018) and Patient Safety Bootcamp (10.2018)
  • National EMS ClinicalCompetition (10.2018)
  • Emergency Nurses AssociationAdvanced Skills Practice and SimWar (9.2018)
  • NAEMSE Scenario Challenge(8.2018)
  • JEMS EMS Today Hands-onClinical Competition (2.2018)

“Real world training with Real patientswearing ReaLifeSim in Night Training - the best, high fidelity out-of-hospitaltraining I’ve had!” - Dr. Ryan Jacobson, Johnson County, KS, EMS MedicalDirector

Our clients include healthcare traininginstitutions, acute & long-term healthcare facilities, clinics, diagnosticcenters, and home health agencies.

Those using our IV training products todevelop and maintain skills, and demonstrate clinical competency include:

  • Emergency services(Firefighters, Paramedics/Corpsmen, Search & Rescue).
  • Nursing (RN, LPN, medicalassistants, CNA, Home aides).
  • Medical (MD and Physician Assistants).
  • Phlebotomist.
  • Radiology (technicians andtechnologists).
  • Respiratory therapists.
  • Multiple levels of physicaltherapy professionals.

Reviewing plan of care with 'patient' and members of the interprofessional team promotes clear communication, helping to improve patient safety and outcomes. Image credit: Emergency Nurse Association (ENA).

ProductSpecifics

As educators, we’re committed to providecompetency-based training and assessment.

ReaLifeSim products provide high physicalfidelity wearables with authentic haptic, visual, and interactive feedback toprovide more realistic immersive "train the way you treat" learningopportunities.

  • Realistic - Haptic feedback: palpate rolling vessels, feel skin and vessel “pop”, auditory feedback: tone with deep IV catheter insertion, and visual feedback with flashback.
  • Quick & Easy Set-up - 5 minutes or less, from storage bag to IV catheter insertions.
  • Patient-focused – Combines human communication/interaction with hands-on skills practice.
  • Portable - Wearable, lightweight IV trainers used in classrooms, laboratories, scenarios, IPEs, and in the field exercises and drills, and close-space and austere environments.
  • Affordable - The cost is within the range of most clinical textbooks.
  • Durable - The adult size IV trainer maintains skin integrity for more than 250 insertion attempts
  • (w/20g). Simulated blood vessels (filled/refillable) in a variety of sizes, plus 2 types of continuous flow vessels.
  • Adaptable – Sizes for adults, pediatric and children. Use on a person or placed on a manikin or simulated arm to improve/expand existing resources and technologies.
  • Safe skills practice - Repeated safe practices learning to start an IV or draw blood while interacting with the patient and team.
  • RLSimApp - Goal Evaluation - The ReaLifeSim application (optional) provides secure access on mobile devices to record performance of hands-on IV training and communication skills. RLSimApp software runs on mobile devices for easy updates. Embedded sensors track skill performance with BLE technology and provide multiple sources of objective data. Working with RLSimApp, skills and communication (individual or team) performance are recoded, saved, and stored with remote access for review and feedback.

Conclusions

One of the best ways to positively effectpatient experience is to decrease time to treatment. Instructors andfacilitators report students show increased clinical competency, clearcommunication skills, confidence, empathy, and improved situational awareness -which contribute to reduced preventable medical errors, reduced time totreatment, and minimized human factor mishaps.

Wearable ReaLifeSim products bring together IoT, bleeding edge technology, and the equally important human element of patient-centric care for instructors to leverage the combined benefits in a coherent learner-centered approach.

Originally published in  Issue 1, 2019 of MT Magazine.

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