Written by Andy Smith, MTM publisher
Most discussions within the healthcare training community today revolve around a consensus that to significantly improve healthcare training, patient outcomes and usefully contribute to healthcare cost reduction, we will need standards and mandated behaviors.
The fact that we are talking today about hospitals and not almost solely educational establishments as the beneficiaries of our ever-improving technologies and curricula is noteworthy in itself. Just three years ago I was told it was too early to address hospitals (we did it anyway).
There is no doubt that the ever-effective specter of loss of revenue and reduced margins has focused hospital minds in the U.S. Government-run systems to be more susceptible to press reporting of errors and deaths. In most countries, that reporting pressure is increasing and politicians really do not like failures in their local hospitals!
In a recent telephone conference, a colleague commented on the need to look at the airline experience, to which I could not agree more, but I added that the healthcare model would need to be looked at from two perspectives. Those ‘Standards’ and ‘SOPS’ that could apply to all healthcare operations e.g. OR’s, and those looked at from the needs of the individual specialties each of which might require specific measures.
The response was to the effect that whilst that was correct, we are way behind in healthcare and ‘haven’t even got a black box yet’. Except that we have or very soon could have, the Black Box for Surgery, which we reported on in a recent newsletter.
That idea, of being able to study behaviors in the OR and focus on the critical soft skills that are inadequately taught in med school etc. is a huge step forward. It is the failure in soft skills, notably in clear communication and leadership, that contributes significantly in all cases of healthcare failure and avoidable error.
This is a massive potential game changer for healthcare, and it is in our simulation and training space. The essential debrief, in this case from the Black Box, remains a critical part of the simulation, training and safety industry offering, as is the remedial training then put in place.
So what else is out there that could be changing the landscape for practitioners, hospitals and patients from an S&T perspective?
Three other things spring to mind; 3D Printing, Robotic Surgery Simulation and the GNSH/PSMF low dose/high frequency training for hospital personnel. Let’s look at each in turn.
- 3D Printing – It is not too long ago that this burst upon our scene and you may feel that it is old news. I tend to disagree in terms of its impact on the healthcare space. The astonishing speed with which some surgeons began to use 3D printers to print from patient scans and then perform ‘pre operative practice’ was laudable. I suspect that take up is far from universal and thus there is much more benefit to come. It took the defense training community until fairly recently to carry out ‘mission planning’. Admittedly they were waiting for simulation technology to catch up to the requirement, and the need to synch multiple different platforms or units together to mission plan is a tad more complex; but kudos to the healthcare early adopters.
- GNSH/PSMF initiative – The linkage of simulation and training to support the deployment of the Patient Safety Movement Foundation’s 18 Actionable Patient Safety Solutions across all the departments of hospitals is a lofty aim, but the ROI is also massive. Half an hour each week for every department is many hours of new training every year for many thousands of staff. Four leading hospitals are on board to format the training and this will be well under way by mid 2019. Kudos again to both the Global Network for Simulation Healthcare and PSMF leadership!
- Robotic Surgery Simulation – As a result of our airline experience and early exposure to existing robotic surgery ‘training’ we have always questioned how an entirely new device could be deployed in healthcare without a comprehensive training program, most likely using simulation for training and assessment. The Fundamentals of Robotic Surgery has been a 6-year odyssey and we hope it will soon become mandatory for all would-be robotic surgeons. The next steps involve all of the currently known surgical robots, preferably before they are deployed, with surgeons and their teams trained to competency using evidence-based training methodologies.
We have advocated for these initiatives for many years and recommend the unstinting support of the entire S&T industry.