O9 Intensive interprofessional ED team simulation for COVID-19 preparedness

Abstract

Background The ‘LeedsEDSim’ team have run an embedded in-situ simulation (ISS) programme successfully for 6 years involving at least twice weekly interprofessional ISS in the Emergency Departments (ED). In March 2020, the COVID-19 pandemic meant there were multiple changes to clinical processes and guidelines, the physical layout of departments and patient flow through them. This caused heightened anxiety amongst all staff members and potential threats to patient safety. Most larger educational events and regional training had been cancelled due to predicted clinical demand and need for social distancing. ISS was already active and embedded as an educational tool for all professions in the ED for clinical as well as non-clinical skills and was therefore utilised as the central education strategy for the intensive programme. Summary of Work A mixture of interprofessional ISS (at least twice weekly) and short ISS group drills (up to six per day) were used with the aim of having all staff members take part in at least one over a period of 7 weeks. Faculty included clinical staff who were on the shop floor anyway, with the usual non -patient facing education staff and technicians avoiding clinical areas as per social distancing rules. This was all coordinated by the ED simulation fellow. Larger interprofessional simulations took place in the ‘cold’ resuscitation areas involving other teams such as intensive care and infectious diseases - these dealt with the full process and guidelines of managing unwell COVID-19 patients, including the complexity of COVID-19 cardiac arrest scenarios. The simulation drills were designed to teach specific, targeted aspects of cases - eg. management of initial stages of cardiac arrest outside the resuscitation room, advanced care decision making, and communication with relatives in difficult circumstances. All scenarios ran multiple times, maximising multiple individual staff member exposure. Results 167 participants gave feedback after their session(see figure 1). Discussion and Conclusion As well as educating staff(with great success as per figure 1), both simulation drills and the larger ISS allowed the new developing system to be tested, identifying and correcting problems such as: missing kit in certain areas; how to get staff to the correct place in a timely manner and the creation of a cardiac arrest standard operating procedure. ISS has been shown to be a valuable tool for education and improving patient safety when used in an intensive programme to deal with novel, rapidly evolving situations such as the COVID-19 pandemic.