Pediatric and Med-Peds resident resuscitation quality imrovement

1. ALERT Presentation:
Pediatric and Med-Peds Resident
Resuscitation Quality Improvement
Cena Tejani MD, Shamyla Farrukh, MD
Newark Beth Israel, Children’s Hospital of NJ
INSPIRE @ IMSH 2017 – Orlando, FL, USA
International Network for Simulation-based Pediatric Innovation, Research and Education

2. • High-fidelity mannequins  simulation center
• Residency requirement
• Low frequency of critical cases1  minimal opportunities
• Pediatric mock code simulation program
 exposure to 9 additional code experiences
 optimizing learning, clinical competency, patient care and safety
International Network for Simulation-based Pediatric Innovation, Research and Education
Background
1. Mittiga M, Geis G, Kerrey B, et al. The spectrum and frequency of critical procedures performed in a pediatric emergency department: implications
of a provider-level view. Ann Emerg Med. 2012;61:263-270.

3. • Population: Pediatric and Med-Peds residents
• Intervention: Pediatric mock code simulation program
• Control/Comparison: Simulation assessment scores pre-
and post- program (2016 vs 2017)
• Outcome(s): Aim to achieve 20% improvement in
simulation assessment score during mock code
performance by 12/1/2017.2
2. Auerbach M, Roney L, Aysseh A, et al. In situ pediatric trauma simulation: assessing the impact and and feasability of an interdisciplinary pediatric in
situ trauma care quality improvement simulation program. Pediatr Emerg Care. 2014 Dec;30(12):884-91.
International Network for Simulation-based Pediatric Innovation, Research and Education
PICO / Research Question

4. • Residents – 3 codes/year, once/month cycles
• Video recordings of each mock code
• Email video and simulation assessment
• Outside physician expert completes assessment after each
mock code
• Data – physician expert assessment scores
International Network for Simulation-based Pediatric Innovation, Research and Education
Approach / Design

5. International Network for Simulation-based Pediatric Innovation, Research and Education
Approach / Design
Simulation Assessment Survey (score 0-2 or N/A per category)
• Medical knowledge
– Medication doses
– Equipment size/use
– PALS protocols
– ABCs/SAMPLE history
– Performance of procedure

6. International Network for Simulation-based Pediatric Innovation, Research and Education
Approach / Design
Simulation Assessment Survey (score 0-2 or N/A per category)
• Communication Skills
– Closed-loop communication/response to feedback
– Assignment of teams roles
– Sign-out/summary of case
– Parent/patient-provider communication
– Use of ancillary staff

7. International Network for Simulation-based Pediatric Innovation, Research and Education
Data
Start of
simulation
curriculum

8. • ALERT Presentation - 1/28/2017
• Recruitment / Data Collection – Currently recruiting PEM
attendings for score assessment
• Data Analysis – Pending recruitment
• Abstract Presentation – By June 2018
• Manuscript Preparation – By June 2018
International Network for Simulation-based Pediatric Innovation, Research and Education
Timeline

9. 1. Is it best to have mixed year resident groups or divide amongst
years?
2. How will we differentiate whether improvement is a direct result
of our simulation intervention or from going through residency in
general over the year?
3. How can we use this data to increase funding for our simulation
center?
International Network for Simulation-based Pediatric Innovation, Research and Education
3 questions to improve study

10. At INSPIRE @ IMSH 2017: Gain advice on
how to improve study application/data collection
In 2 months: Data analysis with scoring by outside
expert physicians
International Network for Simulation-based Pediatric Innovation, Research and Education
Goals to accomplish

11. Name: Cena Tejani, MD/Shamyla Farrukh, MD
Institution: Newark Beth Israel/CHoNJ
E-mail: shamylaf@aol.com
Phone: Peds ED: (973) 926-7337
International Network for Simulation-based Pediatric Innovation, Research and Education
Contact Information