The STRATUS Center for Medical Simulation

The simulation Suite

• Located at Hartford Hospital in Hartford, CT

• 20,000sqft facility• 5 Patient Simulation rooms

• Labor and Delivery• Resuscitation• ICU• ED/Trauma• OR

• Skills Lab• Surgical Simulation• Airway Task Training• Ultrasound Task Training

• Robotics Lab• DaVinci Robot Simulation

Description

When implemented correctly, technology can help improve the efficiency within our programs.

Technologies to improve asset and inventory management and file storage can reduce

administration time, allowing more time with learners.

Learning Objectives

1.Discuss asset and inventory management.

2.Demonstrate how to create simulation check lists.

3.Understand file storage structures and techniques to prevent data loss.

Technical Challenges

-Keep the curriculum experts focused on the action– Simplicity & Ease of use – No setup or breakdown for instructors– Remove the technology as a barrier– Consistent and reliable– Flexible Scheduling, including off-hour courses– Sim techs whom know the equipment– Having all the equipment for the course– Provide “recording studio” style services

File saving and Universal Naming Conventions

Standardized how you save your debriefs!Filing and Archiving : Universal Naming Convention for all simulators and debrief files

Networking: These files are centralized and accessible anywhere on your LANCan be accessed by PC, or MAC

Have a complete backup as redundancy in the event of a disaster or hardware failure

Saving and finding debrief video files easily

UNC = Course name > Director > Date > file extension

Example: Code Team Training Dr.Pozner-4/11/2012.sbr

Server location: \\storage1\Debriefs

5TB Space

NAS

• A large file storage device that can be accessed from any computer on the network

• Easily to install, connect to and expand

• Can be physically located anywhere with network access

• Handles many connections simultaneously

• Models with RAID support create real-time backups automatically

Simple Networking

•Centralized Playback •Files are identified by the UNC•Files are backed up from NAS1 to NAS2•Expandable/scalable storage space•Plug and play to your LAN

PC

PC

PC

NAS2

NAS1

File and Folder Permissions

Backup your dataBackup methods use client software like time machine and windows backupSet your hardware devices to backup on a pre determined automated scheduleHave your devices located away form one another in the event of a fire ,flood, or other form of Unexpected disaster that may result in loss of your data

PrimaryBackup copy

Checklists√ Checklists√ Checklists√

• Manikin specific checklist• Listing all features and Functions• All associated and critical components• Cables , connectors , hoses, compressors • Accessories, probes, cuffs, IV’s • Check fluids & Receptacle bags • Appropriate drugs for today’s scenario• Imaging ,labs, charts

SimMan Checklist √

SIMMAN CHECKLIST

COMMENTS

SERIAL # _38SM263000_________________________________________________________

ACTION TAKEN _______________________________________________________________

______________________________________________________________________________

PROBLEM NOTED IN REPAIR LOG: YES NO

REGULATOR Tubing Connected □Y □N APNEA □Y □N Valve Open □Y □N BREATHING RATE LINKBOX Down □Y □N Power Connected □Y □N Up □Y □N Manikin Connected □Y □N Pulse Ox Connected □Y □N CAN’T INTUBATE -- Can Ventilate □Y □N Remote Connected □Y □N CAN’T INTUBATE PC Connected □Y □N -- Can’t Ventilate □Y □N Monitor Connected □Y □N RESET □Y □N REMOTES Wired □Y □N Bluetooth □Y □N MONITOR □Y □N BP CUFF □Y □N TRISMUS □Y □N TONGUE EDEMA □Y □N BREATHING BLADDER □Y □N LARYNGO SPASM □Y □N PHARYNGEAL OB. □Y □N DEFIB LUNG COMPLIANCE □Y □N Pads □Y □N PNEUMOTHORAX □Y □N Paddles □Y □N STOMACH DECOMPRESSION □Y □N CERV. RANGE □Y □N CRIC MEMBRANE □Y □N PULSES Carotid □Y □N Brachial □Y □N Radial □Y □N Femoral □Y □N Pedal □Y □N Date: ________ Checked By: ____________ Checked By: ____________

SimBaby Checklist √

SimBaby CHECKLIST

COMMENTS

SERIAL # _____________________________________________________________________

ACTION TAKEN _______________________________________________________________

______________________________________________________________________________

PROBLEM NOTED IN REPAIR LOG: YES NO

REGULATOR PULSE OX Tubing Connected □Y □N 100% □Y □N Valve Open □Y □N Down □Y □N Up □Y □N LINKBOX APNEA □Y □N Power Connected □Y □N Manikin Connected □Y □N BREATHING RATE □Y □N Pulse Ox Connected □Y □N Down □Y □N Remote Connected □Y □N Up □Y □N PC Connected(SM) □Y □N Monitor Connected(SM) □Y □N CAN’T INTUBATE -- Can Ventilate □Y □N REMOTES Wired □Y □N CAN’T INTUBATE Bluetooth □Y □N -- Can’t Ventilate □Y □N MONITOR □Y □N RESET □Y □N BP CUFF □Y □N TONGUE EDEMA □Y □N BREATHING BLADDER □Y □N LARYNGO SPASM □Y □N PHARYNGEAL OB. □Y □N DEFIB LUNG COMPLIANCE □Y □N Pads □Y □N PNEUMOTHORAX □Y □N Paddles □Y □N STOMACH DECOMPRESSION □Y □N CRIC MEMBRANE □Y □N See-Saw Breathing □Y □N Subcostal Retractions □Y □N Unilateral Breathing □Y □N PULSES Brachial □Y □N Radial □Y □N Femoral □Y □N Date: ________ Checked By: ____________ Checked By: ____________

SimNewB Checklist √SimNewB CHECKLIST

COMMENTS

SERIAL NUMBER # ____________________________________________________________

ACTION TAKEN _______________________________________________________________

______________________________________________________________________________

PROBLEM NOTED IN REPAIR LOG: YES NO

REGULATOR Tubing Connected □Y □N Valve Open □Y □N LINKBOX APNEA (blue light) □Y □N Power Connected □Y □N Manikin Connected □Y □N BREATHING RATE □Y □N Down □Y □N Up □Y □N REMOTES Wireless □Y □N Cyanosis □Y □N Lung Resistance □Y □N MONITOR □Y □N PULSES

Umbilical □Y □N Brachial Pulse □Y □N BREATHING BLADDER □Y □N Date: ________ Checked By: ____________ Checked By: ____________

Mega Code ACLS √ Mega Code / ACLS CHECKLIST

COMMENTS

Tag # _____________________________________

ACTION TAKEN _______________________________________________________________

______________________________________________________________________________

PROBLEM NOTED IN REPAIR LOG: YES NO

LINKBOX Manikin Connected □Y □N TONGUE EDEMA (by bulb) □Y □N Scenarios Loaded □Y □N PNEUMOTHORAX (by bulb) □Y □N Remote Connected □Y □N Power Connected □Y □N PULSES Carotid □Y □N

Brachial □Y □N REMOTES Radial □Y □N Tethered □Y □N Wireless □Y □N DEFIB Pads □Y □N Paddles □Y □N BREATHING (ACLS Only) Respirations □Y □N Down □Y □N Up □Y □N Date: ________ Checked By: ____________ Checked By: ____________

Course Requirement Checklist

• Inventory Management is a system designed to track the use of equipment and supplies. Effective systems can also generate valuable statistics based on the captured data.

• Commonly Captured Information• Current supply inventory• Equipment location• Supply costs per course• Equipment depreciation• Reorder schedule• Maintenance schedule

• Depends on staff to locate, retrieve and track the use of consumables and equipment

• Benefits• Compliance: Employees

are trained in the system and use it frequently• Low Waste: Students

given a fixed number of supplies, no direct access to refills• Security: Expensive

Equipment is kept under lock and key• Centralized: Supplies

easy to inventory and maintain• Low Cost

• Challenges• Staffing: Available staff

member is needed to retrieve supplies as needed• After Hours: Classes

cannot access supplies after hours• Proximity: Centralized

storage requires additional transportation time in large centers

WASP • Easily track valuable organizational assets with Wasp

Mobile Asset. Mobile Asset allows you to capture important information about each asset, including location, check-in and check-out, maintenance schedules and cost, warranty contracts, and depreciation. Generate business management reports quickly and effectively.

• Mobile Asset takes asset management to a higher level,

giving you the ability to save time and money, end asset loss, improve equipment maintenance, and more accurately compute taxes based on depreciation schedules.

What assets can you track?• WASP barcode • Mobile Asset is for managing assets within your center

Commonly tracked assets include:• Company property, furniture and fixed assets • IT Assets, including laptops, PDAs and servers • Medical equipment, simulators, trainers,• Tools and Biomedical devices• Scopes, instruments, etc…• Track off-site or loaned out equipment

•Print barcode labels•Track asset specific locations•Check assets in or out of your center•Track regular maintenance•Picture of the asset•Depreciation schedule•Associate all documents/manuals to an asset

Managing your Manuals

Portable scannerQuick ROI Easy setupNeeded for asset reportingAsset locationExcellent for insurance

• Depends on students to retrieve supplies and equipment directly through the use of a “vending” type machine

• Benefits• Automated: Staff is only

required to stock supplies as depleted• Fast: Instant delivery of

supplies as needed• After Hours: Students

can access supplies at any time• Proximity: Machines

located in each room for easy access

• Challenges• Security: Relies on

students to return expensive reusable equipment• Size: Large equipment is

difficult to dispense• Waste: Students more

likely to use additional supplies• Restocking: Staff needs

to restock multiple devices in different locations• Expensive

• Some EMS programs have started using vending machines to restock supplies

• Checks ID badge before dispensing• Software generates invoice and notifies on low

stock or expired products

www.vendweb.com

• Work-In-Progress• Automated vending

system for surgical skills lab

• Low cost• Flexible container size• Individual user filters

and usage tracking• RFID badge or biometric

verification• Security video recording

• Imperative to pre-class preparation• Ensure equipment and supply availability• Record number and discipline of attendees • Calculate course costs and appropriate charge• Organize course contact information• Generate utilization reports by

department/company• Track valuable statistics such as:• Number of Courses Offered• Total Learners Trained• Total Learner-Hours Trained

• Traditional• Instructors contact simulation staff to request a timeslot• Staff list available slots and schedule the class

• Online Viewing• Instructors can view available slots online then contact staff with

request• Staff schedule the class if possible

• Online Requesting• Instructors login to view available timeslots online and submit a

request• Staff reviews the request and approves or denies it into the

schedule

• Online Scheduling• Instructors login to view available timeslots and schedule classes• Staff rarely intervene

Posting A course

Course Details

Learning Management System

• Custom system developed in-house

• Online schedule viewing• Hallway schedule

display

• A system to keep track of the individual users in a class. Also capable of administering pre and post tests as well as a course evaluation.

• Keep track of class attendance for instructors• Determine course effectiveness through pre and

post-tests • Collect evaluations of center facilities & staff• Generate training reports for users• Award skills module completion certificates• Store user contact information• Potential for CME/CEU’s

• Students browse a list of available courses and register for a specific timeslot

• Works well for institutions that have educators on staff or a few key department educators

• Difficulties arise when each class has its own educator from another department• Instructors need to schedule class with center staff• Each educator needs to send registration instructions to

students• Need to verify that all students pre-registered• Educators need to make sure students filled out post-test• Potential for varying delay between class and post-test• Provide technical support for users

Learning Management System

The LMS allows us to account for whom attended what course , when and which Department/s the participant is from.We are able to report center utilization of our center to BWH leadership by primarily by department.Our users have a individual profiles that track courses they attended at STRATUS, which they can access course materials pre & post. including post course quizzes, surveys and evaluations for that course.The system also has a library DB which provides course specific instructional videos, reading materials for a course.With an anticipated attendance list for an upcoming course We assign participants to a course and the LMS will automate reminders2 weeks,1 week and 1 day prior .Attendance is captured the day of a course for accurate reporting

A participant’s experience

Course summary Reporting

• By Department• Total # of courses• Course length• # of students in attendance per course• Total user hours• # of instructors & facilitators per course

Center usage Report

• Students sign-in to their class at kiosks upon arrival• Works well in institutions that serve many different

departments with their own educators• Potential for integration into inventory management

systems • Requires additional time before classes• Need to have enough kiosks to avoid long line

formation in large classes• Staff and instructors need to remind students to sign-

in and out• Limited length of pre and post evaluations to avoid

lines

• Custom system developed in-house

• Touchscreen kiosks in every simulation room

• Quick and easy animated process

• Course specific pre and post tests

• RFID badge reader capable