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CONCLUSIONS
MISSIONandVISION
Using Quality Improvement Methods to Improve Neonatal Resuscitation Simulation Based Education
Defining improvement opportunity phase Anne Ades1,2, Shela Siddiqi1, Crystal White1, Jean Marie Carroll1, John Chuo1, 2
1. Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA 2. Perelman School of Medicine at the University of Pennyslvania
CONTEXT
QUALITYIMPROVEMENTFRAMEWORKUSEDINPROJECTDEVELOPMENT
9th International Pediatric Simulation Symposium and Workshops 2017
1-3 June, Boston, MA, USA
Mission:TouserigorousqualityimprovementmethodologytoimproveNRPcoursesintheCNBCNSites
Defineanddiagnosephases:1. Iden2fiedleaders2. Developedprimaryoutcome3. BrainstormeditemsforFishbone(Figure1)andDriverDiagram(Figure2)4. Usingitemsiden2fiedintheFishboneandDriverDiagramsdevelopedsurveyforbaselinedatacollec2onandpoten2alspecificopportuni2esforimprovementSurveyfocusareas:1. Educa2onofNRPInstructorsinsimula2onanddebriefing2. AdherenceofNRPInstructorstoNRPsuggestedformat3. ResourcesavailableforNRPcourses4. Ra2ngofthequalityofNRPcoursesandInstructorsfrompar2cipant’sfeedback
Figure1 Figure2
Children’sHospitalofPhiladelphia(CHOP)NewbornCareNetwork(CNBCN)encompasses13siteswithapproximately30,000birthsannually.
SeveralclinicallyfocusedqualityimprovementprojectshavebeensuccessfullyaccomplishedthroughouttheCNBCN.
NeonatalResuscita2onProgram(NRP)recommendssimula2on(forbothforma2veandsumma2veuses)dependingonexis2ngskilllevelofpar2cipant.
TeachingNRPInstructorsinsimula2onanddebriefingbyNRPwashistoricallydoneinasta2cnon-mentoredon-lineformat.
New2015NRPGuidelinesrequirementoringofInstructorcandidatesintheirsimula2onanddebriefingskillsaZertheon-linematerialsarecompleted.
SURVEYRESULTS
Objec2ves:1. Toiden2fygapsinNRPeduca2onintheCNBCN2. Todevelopinterven2onstoresolvethegaps3. Todemonstratethattheuseofqualityimprovementmethodologycanimproveeduca2onalprocessesandoutcomes
Vision:ImprovingNRPcourseswillimprovedeliveryofcareinthedeliveryrooms
Severalques2onswereraisedbythischangeandbyself-reportofNRPProvidercoursepar2cipants:
1. ArecurrentInstructorsaswell-trainedintheirsimula2onanddebriefingskillsastheyshouldbe?2. WilltheybeabletoadequatelymentorInstructorcandidatestoensuretheInstructorcandidate’sskillareadequate?
3. Doweknowifcurrentprac2ceregardingCNBCNNRPcoursedeliveryisop2mal?
Survey:• 494Inter-professionalandmul2-disciplinaryrespondentsOverall:• 24%ofNRPInstructorshavenothadtraininginsimula2onanddebriefingoutsideoftheon-lineeduca2on• 17%ofInstructorshave“passed”alearnerthatperformedsub-op2mally• Increasingfrequencyofsimula2onswasthemostfrequentsugges2ontoimproveNRPeduca2on
Selected NRP Instructor Survey Responses Selected NRP Provider Survey Responses
Basedonsurveyresponses,thefollowingareaswereiden2fiedaspoten2alopportuni2esforimprovement:1. Increasinginterprofessionalpar2cipa2oninNRPcourses.2. Providinghands-ontraininginsimula2onanddebriefingskillsforInstructors.3. EnsuringInstructorshaveresourcesandskillstohelpthepoorlyperforminglearner.4. Discussingwithnetworkadministra2onstheneedfordedicatedequipmentandInstructorsupportsoCNBCNsitescanop2mizetheirNRPcourses.Basedonthesurvey,wehaveiden2fiedhighperformingsiteswherewecanfurtherinves2gatetheirprac2cesforincorpora2oninanimprovementstrategy.
Basedonfeedbackofpar2cipantsintheKick-Offmee2ng,wedistributedindividualSiteresultsforlocalreviewandevalua2onwithaplantomeetagaininJune,2017.Thismee2ngwillfocusonprocessmappingthestepsnecessarytoimplementspecificimprovementmeasuresandinterven2onsacrosstheCNBCN.