Creative and Alternative Strategies to Leverage Manpower in

Creative and Alternative Strategies to Leverage Manpower in your Simulation Center Rich Fidler, Ph. D, MBA, CRNA, NP, CHSE Director, Healthcare Simulation Programs Co-Director, Fellowship in Advanced Clinical Simulation Chief Nurse Anesthetist for Education San Francisco VA Medical Center Adjunct Assistant Professor of Nursing University of California San Francisco Department of Physiological Nursing

Who is the ideal person to run a simulation program ? • Depends on what you want to do – – One part clinician One part programmer One part engineer One part stage director • Appropriate personality consistent with the goals and philosophy of your program

Steps to Building a Sim Center • Step 1—find space somewhere in your facility to house a simulation program. • Step 2—buy a manikin, preferably the most expensive you can afford. • Step 3—install the best quality AV equipment • Step 4—buy some task trainers, some training software, and other things you think you may need • Step 5—hire a simulation coordinator or educator • Step 6—devise curricula to meet institutional needs • Step 7—figure out that you have likely gotten all of this completely backwards !!!

How much space do you need to have a successful simulation program ? Control Room/Debriefing Room/Simulation Directors Office Simulation Clinical Space

What do you do if you have no space at all for simulation ?

In-Situ Simulation • 100% environmental fidelity • No travel time for the staff—you bring simulation to them • Saves recreating clinical environments • Identifies latent threats to patient safety

Benefits of In-Situ Simulation

Provide Immediate Responses to Events Through Education • Critical event in the ICU required a patient to undergo emergency cricothyrotomy • Staff infrequently perform this procedure • Rolling refreshers provided for current staff • Added this training to new staff orientation

Managers do not want to pay overtime for simulation ? • Integrate the simulations into the workday • Instead of organizing day long “courses”, provide brief simulation sessions • Adult learning theory does not support day long courses (we lose attention too quickly) • Short 1 -2 hour immersive, in-situ sim sessions where staff cover for each other • Expectation to participate in simulation should be a part of your normal job duties

What am I even supposed to do with simulation ? • My only directive was to “do something meaningful” • We already have an education department • Staff sometimes resistant to participate • Managers were not initially supportive • Cultural shift from traditional educational model of “courses” to a modern approach of integrating learning into the workday • What is your value proposition?

Make a Difference with Simulation

What can I use simulation to do ? • Education and Training • Systems and infrastructure evaluation • Systems probing for latent threats to patient safety • Process evaluation and improvement • New equipment evaluations • Exploring and improving equipment use • Competency evaluations

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Manpower • • • Human Resources Human Capital Talent Management Labor Pool Staff Employees Team Members Work Force People

Who’s in charge? • Who is the ideal candidate? • What credentials do they have or need? • What’s in a title? – Director – Manager – Coordinator – Educator

Simulation Educator • Some subject matter expertise (SME) • Training and education in education • Understands adult learning theory and practice • Creates scenarios with goals and objectives • Usually considered a faculty member in a course

Simulation Coordinator • This person coordinates the day-to-day activities for a simulation center • May also provide some education services • Supervises technical staff • Ensures equipment maintenance and inventory of supplies

Simulation Manager • • Manages the equipment and resources Responsible for budget Supervises other simulation staff Facilitates utilization of simulation

Simulation Director • Supplies the “vision” and understands or even dictates the mission of the simulation programs • Provides direction for other simulation staff • Interfaces with leadership to understand meet needs in the environment • Serves as a mentor

Simulation Technicians • • Do you need one? What do they do? What kind of training do they have? They cost $50 -90 k per year.

What do I do if I don’t have any help? • Volunteers • Fellows – Over the past 8 years • • • 12 layperson volunteers 16 registered nurses 4 physicians 1 firefighter 1 paramedic More than 100 students – 6 years of simulation fellows • Nurses 6 • Physicians 10 • Dentists 5 – Advanced Fellowship in Clinical Simulation • Graduate students • Mentoring for QI projects • Research rotations

Build a team people want to join!

Volunteers • Create a symbiotic situation – Must be mutually beneficial • Think creatively about sources – High school students – Retirees – Mid-life career changes • Contact volunteer office

Vocational Rehabilitation • Relationship with VA Voc Rehab • People that have used GI Bill $$ – Nurses – MBAs – Physicians – Engineers

Board of Nursing • Part of a supervised return to work program • Provided a meaningful experience – Transition to a new aspect of nursing

International Extension • • • Brazil Turkey Saudi Arabia Lebanon Japan Ghana

Graduate Students • Obtain and leverage your faculty role • If you don’t have a faculty role, volunteer faculty role • Graduate student preceptor

Undergraduate Students • • Pre-medicine students Pre-nursing students Nursing students Pharmacy students

Don’t forget to have fun!

Thank you for your time. I welcome any and all questions and comments!