Sunnybrook Canadian Simulation Centre
Simulation for Quality SafetyAgnes Ryzynski
Outpatient Code White in Psychiatry
Challengeswithroleclarityandteamapproach
duringoutpatientcodewhite scenarios
GapsImproveteamcommunicationcoordinationand
response
Objective Solution
Impact: improve safety of patients and staff during outpatient Code White response
InsitusimulationpracticeofCodeWhiteEmphasisonroleclarityandteamcommunication
Code White Impact• Evaluations demonstrated satisfaction scores of
4.5/5 on delivery of objectives. • 3 themes emerged from learner feedback:
– Greater understanding of role clarity, scope and responsibility
– Importance of clear communication and leadership
– Developed confidence to take on leadership role, as well as greater understanding of code white policy and procedure
Simulation Centre Training of Ebola Strike Team
Intense training of 54 members
Catheter Associated Urinary Tract Infections
Sub-optimalperformanceregardingcatheterassociatedurinarytract
infections(CAUTI)
Gaps
DecreaseSBCAUTI
incidenceby60%byApril1st2016
Objective Solution
Impact: learners have shown 40% increase in competence levels
Hands-onpracticeintheSim CentreLearnersmustdemonstrate100%proficiency
CAUTI Impact
3.18%
2.11%
2.73%
1.14%
0.00%
0.50%
1.00%
1.50%
2.00%
2.50%
3.00%
3.50%
Oct-Dec2014 Jan-Mar2015 Apr-Jun2015 Jul-Sep2015
Rate(%
)
Quarter
SurgicalUTIRate(NSQIP)
Target1.7%
Trauma/ER Simulation- assessing team communication at points of transfer
Trauma Sim Outcomes• Use of downtime requisitions was inappropriately done. The wrong
coloured sheet was sent to the lab, inappropriate labels were used.
• EMS to trauma team handover occurred multiple times, and it was not always clear who was best to receive the handover
• Medical imaging revealed that they are never informed of incoming traumas until they receive a request for imaging
• Different lines of nursing staff assign different tasks to circulating versus charting nurse
• Trauma team members expressed an interest in receiving information about the incoming patient during their trauma page in order to be better prepared to treat the patient