paediatric intensive care retrieval service and the new ... · jennifer scarth, jon mccormack ......
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
Paediatric Intensive Care Retrieval ServicePaediatric Intensive Care Retrieval Service and the and the
New Scottish Mobile Clinical Skills UnitNew Scottish Mobile Clinical Skills Unit
David RowneyDavid RowneyHeather Blyth, Sandra Stark, Neil Spenceley, Margaret Currer, MaHeather Blyth, Sandra Stark, Neil Spenceley, Margaret Currer, Mark Davidson, rk Davidson,
Jennifer Scarth, Jon McCormack, Jeanette Stevenson, Jean KerJennifer Scarth, Jon McCormack, Jeanette Stevenson, Jean Ker
Audit of HDC for Children and Young People in Scotland 2009Audit of HDC for Children and Young People in Scotland 2009
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
Scottish Paediatric Retrieval ServiceActivity: 2001– 08
2680 referrals 1834 retrievals from 43 hospitals
050
100
150 200 250 300 350 400
450
2003-04 2004-05 2005-06 2006-07
ReferralsTransfers
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
The Scottish Paediatric Retrieval Service• 200 children critically ill or injured in R&R Scotland annually• Role of the Paediatric Retrieval Service
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
The Scottish Paediatric Retrieval Service• 200 children critically ill or injured in R&R Scotland annually• Role of the Paediatric Retrieval Service
Critical Care Network:
Referring teamReferring team PICUPICURetrievalRetrievalServiceService
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
The Scottish Paediatric Retrieval Service• 200 children critically ill or injured in R&R Scotland annually• Role of the Paediatric Retrieval Service
Critical Care Network:
Referring teamReferring team PICUPICURetrievalRetrievalServiceService
Facilitate the provision of seamless careFacilitate the provision of seamless carefor critically ill or injured children in Scotland.for critically ill or injured children in Scotland.
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
The Scottish Paediatric Retrieval Service• 200 children critically ill or injured in R&R Scotland annually• Role of the Paediatric Retrieval Service
Critical Care Network:
Referring teamReferring team PICUPICURetrievalRetrievalServiceService
Facilitate the provision of seamless careFacilitate the provision of seamless carefor critically ill or injured children in Scotland.for critically ill or injured children in Scotland.
Skill acquisition and maintenance essential to manage emergencies
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
The Scottish Clinical Skills Strategy
4 elements to the strategy:
1. Scottish Clinical Skills Alliance
2. Managed Educational Network
3. NES Programme Board
4. Mobile clinical skills training unit
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
www.csmen.ac.uk
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
Rationale for Collaboration
• Need for national skills education programme in stabilisation of the critically ill or injured child confirmed by:
• Training needs analysis of 143 R&R practitioners• Audit of skills education currently available in Scotland
• But how to deliver the programme consistently?
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
Mobile Clinical Skills Unit
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
Mobile Clinical Skills Unit
• A key tool in addressing inequality in access to training
• Enabling mid-fidelity simulators and an integrated video debriefing system to be used in Remote & Rural areas
• 2-year pilot funded by NES
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
Pod Pod
Control Booth
Retractable LCD DisplayOne-way Glass Observation Window
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
Skills Unit Locations 2009• January – August 2009
• 8 locations• 2h driving time to unit locations
• Candidates:• Anaesthesia• Emergency medicine• Paediatric medicine• General Practice• Nurse practitioners• Medical & nursing students
Skills Unit locations
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
Paediatric Retrieval Outreach Study Day
• Consistent teaching and standards across Scotland• Core PICU/Retrieval team faculty delivering a standardised programme in all locations:
• am: lectures:– Airway– Shock– Inotropes
• am: workshops:– Airway/breathing– Shock/inotropes– Rhythm recognition
• pm: scenario simulations:– Bronchiolitis– Meningitis– Status epilepticus– Cardiac arrest
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
Evaluation of study day
• Logistics of delivering the course via mobile unit
• Educational impact to be measured using Kirkpatrick’s 4 levels as far as possible
• Post-course questionnaire on the day• focus groups after 3 months• further questionnaire after 6 months (have skills been
used, are people more confident?)
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
First Course: Fort William, January 2009
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
Candidate Feedback – study day & unit facility
• >90% excellent/good:• Overall session rating• Team organisation• Equipment quality• Tutor quality
• Comments:» 85% “informative”» 70% “instructive”» 70% “worthwhile”» 70% “practical”» 60% “valuable”
0%
20%
40%
60%
80%
100%
Overall rating Team Organisation Unit facilities Equipment Quality Tutor Quality
Very Poor
Poor
Satisfactory
Good
Excellent
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
Candidate Feedback – knowledge, skills and confidence
0%
20%
40%
60%
80%
100%
Knowledgeimproved after
lectures
Skills improvedafter workshops
Confidenceimproved after
scenarios
Observingscenarios useful
Teamworkinguseful
strongly disagreedisagreeneutralagreestrongly agree
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
Candidate Feedback – scenarios
0%
20%
40%
60%
80%
100%
Realistic Feedback constructive Trainers supportive Necessary skills covered
strongly disagree
disagree
neutral
agree
strongly agree
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
Thank you
www.paedsretrieval.com www.csmen.ac.uk
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Scottish Paediatric Retrieval Service
Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096
Kirkpatrick’s Four Levels of Evaluation• Kirkpatrick’s four levels:
• level 1 evaluation of reactions• level 2 evaluation of learning• level 3 evaluation of behaviour• level 4 evaluation of results
• The first three can be measured easily• The fourth is more difficult – how will the skill be performed
6 months after the study day?