Gretchen Matika, MSBaltimore SUNMay 20, 2009

Penn Medicine Clinical Simulation Center

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Overview

Overview and Structure Timeline for Sim Center “Secrets of our Success”Budget BasicsOverview of Center Layout & ProgramsUtilization Operational Considerations

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Simulation at PENN

Health System Simulation Efforts – SOM, 3 hospitals and rehab facility, all disciplines

Main geographic sites :• PENN Medicine at Rittenhouse– centrally

located between 3 hospitals. Also houses rehab facility.– All simulations except cadavers and live animal

• Measey Simulation Center (SOM)– ~800 sq feet - 2 Sim Rooms and a Skills lab

• Glenolden Research & Education Facility - – Robotic Training Center & Animal Research Facility

• Brunner Center (SON)

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Penn Medicine Clinical Simulation CenterJim Mullen, MD

Chair, Steering Committee

Andrew Resnick, MD, MBAExecutive Director

Steering Committee=Bellini, Black, Brennan, Corrigan, Driscoll, Jost, Kennedy, Kinslow,

Morrison, Resnick, Volpe

Operations Committee=Luba, Matika, Palmieri, Jones,

Lipschik

Steering Committee Exec=Corrigan, Morrison, Mullen,

Resnick

Tech Advis Committee=Kochman, Kofke, Nadkarni,

Patel, Williams, Kuchenbecker

Research Committee Operations Director=Matika

Sim Tech=Luba Sim Admin Assist=

Jones

Specialty Directors Sim Educator=

Palmieri

Dir. Life Support Programs=

Lipschik

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Timeline (Concept to Current Day)

Spring 2006

1st Steering Committee MtgBudget (v.1) & Narrative

Fall 2006

Sub-Committees FormedRequest “Needs

Assessment”

Space & Capital Requested

Spring 2009Move into Center- 7/08Basic AV

B-line/AV Install Complete- 5/09

Summer 2008Staff Identified and Hired- 4/08-6/08Construction Begins- April 2008

Spring 2008

CONCEPT- WINTER 2006

Winter 2006

Sub-Committees Meet Vendor Quotes and Demos, Grant SubmissionsID Specialty Directors & Core Equipment Needs

Spring 2007

“Graduate Hosp” Space Identified/ApprovedArchitect Retained, Development & Industry Involved

FY08/09 Capital Funds ApprovedSurgery Obtains Grant- Initial Simulators Purchase

Summer 2007

Fall/ Winter 2008FY08 Ops Budget (v.4) Approved

Architectural Drawings Finalized/PricedMeet/Select AV hardware/software vendors

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Secrets of Our Success

Strike a Nerve• What are your peers/competitors up to?–Regionally–Nationally

• Public Scrutiny

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Secrets of Our Success

Discover Broad Institutional Needs• Unmet Educational Need• Regulatory accreditation• Reducing Medical Liability• Increasing Patient Safety• 80 Hour Work Week• Reducing Cost

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Secrets of Our Success

Identify Your Champions• Internal

–Departments–Physicians–Administrators

• External–Vendors–Other organizations

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Secrets of Our Success

Form Partnerships• Affiliated Medical & Nursing School, other Graduate Program and Hospitals

• External Groups

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Secrets of Our Success

Consider Alternative Funding Options• Grants – research, government, industry, charitable

• Development/Alumni Offices• Corporate Partnerships• Course Tuition• Rental Space

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Utilize the Existing Resources• Personnel• Equipment

–Medical and Simulation• Programs• Vacant Clinical/Other Space

Secrets of Our Success

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LUCK & GOOD TIMING!

Secrets of Our Success

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Initial Capital and Operational Budget

CAPITAL ~3 million to:

• Construction• Simulators• AV hardware/software

OPERATIONS~1.2 million annually

GRANTS/COMMERCIAL SUPPORT/GIFTSTotal to date: $1.7M

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Penn Simulation Facility 22,000 sq ft complex at Penn Medicine at Rittenhouse Includes:

• Administration/Reception• Standardized Patient Exam Rooms

– (12) exam rooms• Simulation Training Rooms (6)

– IR/OR– ED/ICU– LDR– In-Patient– Endovascular– FLS Trainers

• Skills Lab• Large Group Instruction and Debriefing Space

FLS EndoVasc ICU/ED

InPatientORLDR

CORE

SP EXAM ROOMS

Brk Out RmsMultiSkills LabLarge Conf Rm

ADMIN SUITE

Task

Trainer

Rms

Comp Rm

ENTRANCE

Sm Conf Rm

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ADMINISTRATIVE OFFICES

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Standardized Patient Area•SOM H & P/Board Exams•Patient Disclosure Pilot•OB/GYN Resident Training•Staff handoffs•Staff/Faculty remediation

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Simulation Core and Control Center

•Team training with remote manikin control and advanced AV capabilities

•OB-GYN•Surgical Critical Care•ED•NICU

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Simulation Core and Control Center

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Control Center

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MultiSkills Lab•Skill Sim Certification•Interns/new to practice nurses/staff/SOM •External courses

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Skill CertificationVideo/Checklist

DevelopedXXXXXX

XXXX

X

X- video/refX- video/ref

XX

IV Insertion/PhlebFoley Catheter

Normal Vaginal Delivery

Instrumentation

Skill

Cricothyrotomy

Thoracentesis

Central Line FemoralIntubation

Paracentesis

Arterial Line

Central Line Neck

Chest TubeABG

Sign-offs/HandoffsMRX Defibrillator Use

NG Tube

Lumbar PunctureScope Handling

Emergency Childbirth

Suturing/Knot Tying

Gowning/Scrubing

NEJM For Video and Article: http://content.nejm.org/cgi/content/short/358/26/e30

Competency Checklist:

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Small and Large Conference SpacesAlternative site for Skills LabsPost-session

DebriefingBreakout sessions

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Faculty Training & Credentialing•Fundamentals in Laparoscopic Surgery•Patient Disclosure/Communication Sessions•Remediation•ACLS/PALS/ATLS•Acquisition of new skills

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Simulation courses July ’08 thru April ‘09

• Students trained: >4350• ACLS = 993 (June thru April 2009)• BLS = 619 (since Jan 2009)

• Student hours: ~39,950

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User of PMCSC (excluding ACLS and BLS)

Number by % Total by Group

Number by % Total by Residency Program

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Sim Center April 2009 by Room

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Sim Center Utilization FY09

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Operational Considerations

Users charged for timeSelf supporting via external revenueFully supported by entityCombination

• Internal vs external ratesSimulator Purchases/WarranteesStaff TimeDepartmental Instructor ContributionsDisposables

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Contact information

Gretchen.Matika@uphs.upenn.edu

215-893-7707