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Abstract PD-002: USING “MIRROR PATIENTS” TO IMPROVE FIDELITY OF PEDIATRIC IN-SITU SIMULATIONS AND DISCOVER LATENT PATIENT SAFETY THREATS

Panesar, R.1; Harwayne-Gidansky, I.1

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 28
doi: 10.1097/01.pcc.0000537404.93225.50
Poster Discussion Abstracts
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1Stony Brook Children’s Hospital, Pediatrics, Stony Brook, USA

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Aims & Objectives:

We aimed to modify the “just-in-time” training approach with a novel “mirror patient” method to enhance the realism of in-situ simulations for pediatric patients. The mirror patient method removes the need for providing introductory clinical vignettes, allowing for hand-offs from actual healthcare providers and replication of patient safety threats. We aimed to collect data for any patient safety issues discovered during our mirror simulations. Using our hospital-based computerized patient safety event reporting system (SERS), we created a “Simulation” category to record these data.

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Methods

We identified pediatric patients whose profiles could be used to simulate scenarios wherein their clinical conditions would decompensate while on the general pediatrics ward. We used the patient’s medical chart for the simulated mirror patient mannequin. The identifying information and environment of the actual patient was replicated with the mirror patient. The simulation was completed with direct feedback debriefing. Quality and patient safety issues were recorded by the simulation facilitators and entered into the SERS for review.

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Results

To date, we have recorded six events into our reporting system. Multiple incidences within include various severity levels from unsafe conditions to communication failure (see Figure 1). These data are now reviewed by our hospital Quality Improvement Board and have prompted changes to work flow, environmental safety and resident and nursing education.

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Figure

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Conclusions

The “mirror patient” method may provide a novel approach to improving the fidelity of in-situ simulations and patient care. This method may serve as an additional tool to discover latent patient safety threats and improve overall patient safety.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies