Photo By Sgt. 1st Class Tony Lindback | A 345th Combat Support Hospital medical team in the emergency room at the Mayo...... read more read more
ROCHESTER, Minn. – In jobs where the threat of death, permanent disability or catastrophic events are very real consequences of missing information, misunderstanding or miscommunication, having every member of a team being in sync with what is going on around them is paramount. In dynamic situations like emergency medical care, however, having every person apprised to the latest set of needs and circumstances requires every person involved has an up-to-the-second understanding of the situation.
Team Strategies and Tools to Enhance Performance and Patient Safety, developed by the Defense Department's Patient Safety Program, is trained and practiced in military medical facilities of every branch. TeamSTEPPS is meant to mitigate what the Joint Commission, an independent organization that accredits medical facilities, found to be the leading root cause of adverse events in hospitals for the past decade; communication failures. TeamSTEPPS has proven its worth to many in the Joint military medical community.
"We saw a significant decrease in the number of errors due to communication issues and the number of medication errors that happened," said Dr. Shad Deering, an Army physician from Tacoma, Wash., during a "Dot Mil Docs" audio webcast on BlagTalkRadio.com Jan. 22, 2009. Deering was deployed to Iraq at the time.
“Army Medical Department ordered implementation of TeamSTEPPS across its command in May of 2011,” said Lt. Col. Paul V. Rahm, clinical operations officer, Medical Readiness and Training Command. “The current requirement does not make this training mandatory for the (United States Army Reserve) medical teams until the units or individual medics are selected for deployment.”
This training program developed by the USAR bridges this gap and provides the required training for select Train/Ready Year 3 units in the USAR. Having the same team training as the rest of their uniformed medics makes the Reserve medic (this term used for all medical personnel for brevity) a more modular Soldier, enabling the Soldier to adapt to new teams quickly, but also allowing teams to adapt to the new Soldier, stated Rahm.
Leaders at the MRTC recognized a need to get USAR medics trained on TeamSTEPPS before selection for deployment, similar to active duty AMEDD personnel.
After forming a training plan, USAR medics from the 345th Combat Support Hospital, 332nd Medical Brigade, 3d Medical Command (Deployment Support) with headquarters in Jacksonville, Florida, were introduced to TeamSTEPPS at home station. Then Rahm brainstormed and coordinated with selected MRTC staff to create the scenarios to serve as the “walk” and “run” parts of the Army’s crawl-walk-run training process.
Coordinated ideas and capable trainers are not enough, however; the MRTC still needed a place to conduct the training. For that, MTRC turned to the Mayo Clinic in Rochester, Minnesota, with whom they have partnered with in past years and already had well established ties.
“The founding brothers of the Mayo Clinic were in the Army, served the nation, so they saw the great ties between what they did in their civilian practice and the value it brings to the Army,” said Brig. Gen. Michael C. O’Guinn, commanding general of MRTC “So that relationship has been there.”
The Mayo/MRTC relationship has been cultivated over the years with other medical training being conducted there, so Rahm turned to the Mayo to arrange use of the Mayo Multidisciplinary Simulation Training Center. The MMSTC is a real-to-life, high-tech training facility that has the exact look, feel and functionality as a hospital which are well-known to the medical teams.
“Coordinating this training event was a collaboration between the Mayo Simulation Center, (Regional Training Site – Medical at Fort McCoy, Wisconsin), and MRTC was a lengthy but collaborative process that started six months prior to the event day. Working with the Mayo team was effortless because they utilize TeamSTEPPS across their institution, and the Mayo staff continually stated our success (the USAR) was their success, and they would do anything within their powers to achieve it.
“The support and flexibility provided by the Mayo and RTS-MED Fort McCoy staff made this event a true success and could not have been achieved without them. The 3rd and 807th Medical Command (Deployment Support) commands were vital to the success of this event by providing the experienced Observer Controller/Trainers necessary to carry out the scenario play and feedback to meet the TeamSTEPPS and units training objectives.”
Equipped with one-way glass, “crow’s nest” observation rooms, and dozens of cameras and microphones feeding into a bank of linked digital recording devices, OC/Ts could see every move and hear every word throughout the patient care process.
Radio headsets allowed trainers and Mayo staff to communicate with whispers throughout every step enabling key moments to be annotated on video recordings as well as tailor scenarios on the fly to improve training effectiveness.
State-of-the-art facilities and equipment are within reach for the Mayo thanks to donations from many organizations and benefactors. Renting what the Mayo created allows Army Reserve medics the benefit of operating in a top-notch facility without asking taxpayers to replicate it.
“We could not duplicate this experience for our Soldiers at the, really, very limited cost that we’re doing this … that’s really the bottom line,” said Maj. Gen. Bryan R. Kelly, commanding general, Army Reserve Medical Command. “We don’t have the capacity to build a center like this, or the capability. The resources would be well beyond our reach to offer a facility like this, or maintain it on a routine basis.”
“We’re renting the oceanfront property for a week,” said Col. James C. Post, surgeon, ARMEDCOM.
“Mayo is the land of the smart people. They get patients from all over the world,” said Post. “They put a lot of time and effort into designing this. So why should we, in the Army, sit down with a blank sheet of paper and say, ‘What’s a sim center look like?’ These guys already broke that code and we can adapt it to our ways of doing business.”
Knowing what real oceanfront property looks like, Soldiers of the 345th CSH landed in Minnesota during a time of record-setting low temperatures to break the ice on the pilot program Nov. 14-16, 2014.
Rahm coordinated support from within the MRTC and its subordinate units to work alongside MMSTC technicians to create and facilitate scenarios that would exercise every aspect of clinical care. Moulage, the art of applying makeup to simulate injuries, and the Human Worn Partial Task Surgical Simulator, or cut suit, a vest that can be human-worn and have surgical procedures performed on, were employed and applied to mannequins which represented patients in the scenarios.
The 345th CSH had to receive their patients from notional incoming aircraft and casualty evacuation vehicles and run them through the hospital as if they were live. Teams for the emergency room, operating room, laboratory and X-ray, intensive care and patient administration were all in play for the exercise. Because the different sections of USAR hospital units do not often train collectively, patient handoffs were particularly scrutinized by the OC/Ts to ensure every piece of information regarding each patient was communicated.
“This is a high payoff target,” O’Guinn said. “We get to bring the whole unit together, train them on scenarios they’re going to see, we have all the equipment, we have a state of the art facility, we have the training simulators here, we have the experts here to provide the OC/T support; everything is condensed in this one place at this one time to help them do that.
“We’re taking four or five days out of the Soldiers’ lives to do this training event; and to do that we’re putting in all these additional resources so it truly is a high-payoff target for them.”
When distinguished visitors from the United States Army Forces Command, and the United States Army Reserve Command, ARMEDCOM, and MRTC arrived to observe the exercise; they moved from room to room unnoticed behind the one-way mirrors. Seeing and hearing everything happening on the other side of the glass and on the myriad of monitors, one in the group said, “It’s like the Starship Enterprise in here.”
Staying out of the room and inconspicuous allowed the distinguished visitors to be proverbial “flies on the wall.” Seeing the relevance of the training and the technological advantages provided by the MMSTC, a discussion about how to make this training available for other Army Reserve medical units soon started.
Kelley explained that there are some medical treatment facilities that provide active Army medics some of the training capabilities found at the MMSTC, but not all. However, the Army Reserve has no training facilities that come close.
“There are certain aspects that are accessible for the active Army,” Kelly said. “… They have some simulation centers built into some of the MTFs across the country. But, the Army Reserve does not have that capacity. This fills that gap. This is an essential piece of the Army Reserve puzzle.”
Making TeamSTEPPS a training requirement and getting training schedules to include the exercise at the MMSTC, or facilities like it, has another benefit.
“It goes back to those young Soldiers,” Post said. “If they’re sitting around the drill hall all the time not doing anything – they’re not going to stay for that.”
Post explained, when they get to come, and return to work on Monday morning, someone asks,
‘What did you do this weekend?’
‘I got to go train at the Mayo Sim Center.’
Spc. Brittany Hall, a resident of Orlando, Florida, and a patient administration specialist with the 345th CSH, is a certified nurse’s assistant as a civilian and is now pursuing her nursing degree. Hall said due to the prestige and the technology in the facility, she was thrilled to have the opportunity to train at the Mayo.
“This is awesome,” Hall said. “This is a once-in-a-lifetime opportunity. My nursing instructors from home kept telling me how lucky I am to even get the chance to come here and do something like this. I feel very privileged to just come here and train in such an environment. They told me I had to bring it back and tell them all about it, so I’ve been shooting video and photos with my phone the whole time. I can’t wait to show them when I get back.”
While Hall will take home and share the experiences of her Army Reserve training at the Mayo, MRTC leaders are hopeful more Soldiers will get the same chance.
“If Army Reserve medicine is successful in getting TeamSTEPPS as a training requirement, following the Army Medical Command’s lead, funding for training and exercises like the one here at the Mayo will be made available for all Army Reserve medics.” Rahm said.
Happy with what he saw in the exercise, Post said, “I think as we are asked to do more and more with less and less, it’s this kind of training that’s going to be a force multiplier for the military.”
More information about TeamSTEPPS is available at: http://teamstepps.ahrq.gov/
Also: http://www.dvidshub.net/news/29281/program-improves-patient-safety-through-enhanced-teamwork-communication#.VHKGlP6KDZ4#ixzz3Jwflng98
| Date Taken: | 11.16.2014 |
| Date Posted: | 01.01.2015 13:05 |
| Story ID: | 151297 |
| Location: | ROCHESTER, MINNESOTA, US |
| Web Views: | 835 |
| Downloads: | 0 |
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