In 2011, AHRQ funded eleven multi-year demonstration grants to evaluate the use and effectiveness of various simulation approaches and the role they play in improving the safety and quality of healthcare delivery.
For example, one project is aimed at helping medical teams deal with pediatric emergencies. Since critical consequences happen infrequently in community hospitals, medical teams in these hospitals have very few opportunities to perfect their skill in pediatric resuscitation skills.
To address pediatric resuscitations, researchers at Rhode Island Hospital in Providence are working to find effective ways to use situ medical simulation to assess how emergency departments are performing pediatric resuscitations.
In another project, researchers will assess the effectiveness of using simulator-based training in component tasks of cardiac surgery. They will examine the overall procedures based on three types of cardiac surgery plus the significant adverse events that can occur during cardiac surgery.
The researchers will use a computer-controlled, tissue-based cardiac surgery simulation that is able to duplicate an actual patient undergoing cardiac surgery. Eight institutions will participate and while the project focuses on cardiac surgery residents, the results could potentially apply across a broad spectrum of surgical practices.
At the University of North Carolina at Chapel Hill, researchers will demonstrate how training in cardiac surgery techniques can be improved by combining cardiac surgery simulation technology with a rigorous, simulation-based curriculum.
A demonstration to perfect a way to measure laparoscopic skills is taking place at Old Dominion University in Norfolk Virginia. Although clinicians can use simulators to practice their skills outside of the operating room, there is no standard method to determine whether a surgeon has achieved or maintained laparoscopic proficiency.
The goal for the researchers is to validate a new secondary task that targets the spatial skills needed to mentally translate 2-D display images into the 3-D operational space. The researchers will use laparoscopic simulators and fresh cadavers to demonstrate that the secondary task can be used to measure laparoscopic skills.
Other simulation demonstrations will:
• Develop simulation-based performance assessment tools
• Develop simulation to be used in emergency departments
• Use simulation to improve leadership and team performance
• Use simulation to improve the recognition of sepsis
• Use simulation to teach femoral arterial access
• Develop serious gaming so that physicians and nurses can improve communications
• Improve cancer care patient safety through pathology training simulation
• Improve patient safety related to medication infusion pump technology using systems engineering
• Create simulation-based performance assessment tools for practicing physicians
For more information, go to www.ahrq.gov/qual/simulproj11.htm.