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