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Simulation Business ModelsHaru Okuda, MD, FACEPNational Medical Director, SimLEARNVeterans Health Administration

VETERANS HEALTH ADMINISTRATION

Disclosures

• No financial interest or relationships to disclose.

VETERANS HEALTH ADMINISTRATION

SimLEARN

• Background• Mission & Vision• Who We Serve • Governance & Organizational Chart• SimLEARN Program Overview• Challenges• Outcomes

VETERANS HEALTH ADMINISTRATION

SimLEARN Background

• In July, 2009, the VA Under Secretary for Health approved the establishment of the Simulation Learning Education and Research Network (SimLEARN).

• SimLEARN is a national simulation training, education and research program which will develop the strategic vision and system-wide plan for simulation process modeling, training, education and research for VHA.

• National program includes the establishment of a National Center

VETERANS HEALTH ADMINISTRATION

MISSION & VISION

• MISSION– To promote excellence in health care provided to America's

Veterans through the use of simulation technologies for process modeling, training, education, and research and to establish VHA as the world leader in the application of simulation based strategies.

• VISION– To improve the quality of health care services for America’s

Veterans through the application of simulation based learning strategies to workforce development.

VETERANS HEALTH ADMINISTRATION

Who We Serve

• Who we are• 262,000 staff• 1400+ care sites in 21

Regions

• Care we provide• Hospital, outpatient clinic,

nursing home, counseling center

• Veterans we serve• 2.8 million enrolled, 11%

women

VETERANS HEALTH ADMINISTRATION

Who We Serve

• 122/153 VAMC’s and 2 Outpatient Clinics have affiliation agreements with 109/131 allopathic and 16/25 osteopathic medical schools

• Over 40 other health professions are represented by affiliation agreements with more than 1,200 colleges and universities, in over 5,000 individual programs

• Over 110,000 trainees rotate through VA annually

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7

VETERANS HEALTH ADMINISTRATION

Who We Serve

• Medicine– Over 20,000 medical students

• Dentistry– 614 dental residents– 666 dental students

• Associated Health– 33,000+ nursing students– 23,000+ other associated health

• 160 advanced fellows8

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VETERANS HEALTH ADMINISTRATION

Veterans Health Administration

VETERANS HEALTH ADMINISTRATION

SimLEARN National Program

• Develop National Polices, Procedures and Standards– IRB, Use of Expired Medications, Video Policy, etc.

• Develop National VHA Curricula & Programs – OOORAM– REdI (Resuscitation Education Initiative)– New Hospital Activation

• Training– Train the Trainer – Simulation Training – Invasive and High Risk Procedural Training

VETERANS HEALTH ADMINISTRATION

SimLEARN National Program

• Field Coordination (VISN and Medical Centers)– VISN Simulation Champions– Simulation Field Advisory Committees– External and Internal Collaboration

• Simulation Equipment Evaluation, Procurement, and Distribution

– Interagency Agreement with U.S. Army PEO-STRI for Acquisition

VETERANS HEALTH ADMINISTRATION

SimLEARN National Program

• Communication – VHA Simulation Leadership Conference – Annual VA Simulation Conference at the International

Meeting on Simulation in Healthcare (IMSH)– SimLEARN Website www.simlearn.va.gov– SimLEARN Quarterly Newsletter– Monthly Community of Practice Call– Intranet Site– Baseline Study of “As Is” state

VETERANS HEALTH ADMINISTRATION

Curricular Development

• Identification of Need– Simulation Field Advisory Committee– National Office (NCPS, OMLA, etc.)– Quality or Safety Priority• Assess Existing Policies and Directives

• Develop Goals and Objectives– Gap Analysis

• Assess Literature & Existing Simulation Curricula• Collaborative approach (Internal, External)• Apply SimLEARN Healthcare Simulation Lifecycle Model

VETERANS HEALTH ADMINISTRATION

Challenges

• Communication– Field (Medical Centers & VISN)– Central Office – Buy in

• Capacity– Local Simulation Infrastructure – Balancing Resources with Value – Learner Volume and Stakeholders

• Geography • Data Measures (Value)

VETERANS HEALTH ADMINISTRATION

OUTCOMES

VETERANS HEALTH ADMINISTRATION

• Veteran– Veteran centered safe, quality care – Improved clinical outcomes

• Reduced mortality and morbidity• Improved quality of life

• Learner– Improve or acquire new skills– Teamwork and communication

• Organizational– VA as a leader in healthcare simulation– Improved national clinical outcomes (data)

Outcomes