Development of a Multi-Step Simulation for Improved Communication in a Cardiac Catheterization Lab (1090-004051) (Research Abstract Professor Rounds: Group 5)
Start time: Friday, January 29, 2021, 10:00 AM End time: Friday, January 29, 2021, 11:00 AM Session Type: Research Abstracts (Completed Studies)
The cardiac catheterization lab (cath lab) is a dynamic environment where the efficient delivery of critical, life-saving interventions is essential for maintaining high quality care. Effective communication between personnel who work in the cath lab, as well as those transporting patients to the lab, is crucial to patient safety. A needs assessment by cath lab leadership identified specific clinical scenarios where the safe delivery of care was at-risk due to ineffective communication. The aim of this project was to develop a simulation to improve communication between cath lab team members in high-risk, low-resource situations.
After review of a root cause analysis, several opportunities for improved communication in the cath lab were examined. A needs assessment was conducted with experts from the quality and safety team, simulation center, and cath lab. After the initial discussion of which simulation scenarios should be included, additional team members provided input to add details and highlight training opportunities. Participants were given a retrospective pre-post evaluation to assess their confidence in the goals of the simulation.
A simulation was developed with 3 contiguous scenarios to highlight team communication and role assignment during high-risk, low-resource situations. The simulation involves one patient’s arrival to the cath lab with communication scenarios involving an ideal sign off from the transport team, cath lab team response to patient coding, and cath lab team response to not having proper equipment. After a predetermined time and or specific goal has been reached in each scenario the simulation will pause and allow for immediate debriefing. An overall debriefing was held at the completion of the entire simulation. Participants were given a retrospective pre-post evaluation to assess their confidence in the goals of the simulation. For each question the difference in confidence (post minus pre) was calculated for each participant. A statistically significant increase in confidence was measured by each question.
Based upon feedback from learners and facilitators, we showed a statistically significant increase in knowledge and skill confidence for course participants. Annual simulations with the cath lab team to highlight additional skills were discussed with cath lab leadership. Some of the lessons learned from participants were: Team members are required to take multiple roles/switch roles as needed when staffing is short. Clear communication prevents two people from taking the same role. Code Blue workflow is best when the Code Leader is loud and gives clear directions.