The Persona: Hospital Simulation Center Director

sim directorPosition: Hospital Simulation Center Director, Charlie Reynolds

Location: Vale of York Hospital; York, Pennsylvania, USA

My Background and Role

I am a Register Nurse (RN) with a clinical career in Acute Psychiatric Nursing and a Master’s Degree in Nursing Education from the University of North Carolina. I have worked as a Nurse Educator for 10 years and have just joined the team in my post as the Hospital Simulation Center Director at the Vale of York Hospital. I am new to the hospital and charged to develop a comprehensive simulation-based, Interprofessional Education Training Program. Due to expansion of other services I will soon have ownership of 2,500 square feet of our existing ER Department, which I can re-purpose within a tight (and yet to be determined) budget.

My Focus, What Is of Value to Me, and How I Am Evaluated

My work is highly focused. Whilst, I am an advocate for the simulation center, I have limited experience of simulation-based education and have never established a specialist center before. As such, I need to clearly articulate the value proposition of simulation-based education for myself, as well as the hospital stakeholders and establish the design criteria for our new space.

The Decision Maker: Hospital Simulation Center Director

The Hospital Simulation Center Director is driven by the need to demonstrate the value of simulation to stakeholders across the multi-disciplinary team in his hospital. The hospital’s mission and strategic plan drive the program and there is a need for me to produce plans and financial projections in the short-term. There is a clear intention to drive education through simulation, but there is a lack of experience in the implementation and justification of simulation-based education.

In examining the personal interests, values and characteristics of a Hospital Simulation Center Director primarily based in the hospital setting, there are many lenses through which one can look. Consequently, we have chosen to identify the common focus, values and needs of Simulation Center Directors, within Case Studies to illustrate some key differences that you may identify as you look at your own institution and its needs.

Typical value domains of those who function in the role of simulation directors are:

  • Educational Effectiveness
  • Educational Efficiency
  • Resource Management
  • Patient Safety
  • Quality of Care
  • Scholarship/Research

The Chief Nursing Officer measures my work in a variety of specific and general levels:

Educational Effectiveness

  • Clinical Effectiveness – My ability to assess the range of technical and non-technical skills deficits across the multi-disciplinary team in relation to identifiable Patient Safety and Quality Improvement Initiatives.
  • Educational Strategies – The development of simple, effective programs that have internal and external credibility, which will enable the Sim Lab to gain SSH Accreditation and assist the hospital to obtain Magnet status.

Educational Efficiency

  • Clinical Effectiveness – My ability to provide training for the widest range of hospital staff possible, without adversely affecting staffing levels during training and promoting measurable improvements in clinical efficacy.
  • Competence – The development of effective simulation-based educational programs that address the inherent friction between our multi-disciplinary team members, whilst also improving the delivery of care and reducing adverse events.
  • Preparedness – I am going to be involved in developing new training opportunities for Mass Casualty and Emerging Threat situations between the hospital and all external agencies e.g. Emergency Medical Services (EMS), Fire, Federal Emergency Management Agency (FEMA in USA), Police (Polizei, Politie), Special Weapons and Tactics (SWAT in USA) Squad, etc.

Resource Management

  • Clinical Effectiveness – I have been challenged to identify metrics that will link the course(s) we run to improvements in clinical practice.
  • Competence – I need to identify the metrics that will be used to assess center use by programs, individuals and adapt them to demonstrate cost effectiveness to the hospital stakeholders. They will also be used to ensure that I get the maximum number of learners through our programs.
  • Preparedness – I need to identify and project a capital expenditure and operating budget for the first three years of the simulation centers operation. This will include the re-purposing of the existing 2,500 square feet of space.

Patient Safety

  • Clinical Effectiveness – We are tracking changes at an organizational level in relation to four specific areas of clinical education and associated interventions: CAUTI, CLABSI, Culture of Safety and TeamSTEPPS.
  • Research & Development – The hospital education team is keen to develop programs that can be marketed to other external healthcare organizations including: ambulatory care, EMS, Fire, Police, SWAT, Family and Rural Medicine Teams.

Quality of Care

  • Clinical Effectiveness – The hospital is focused on the evolution of “true” Patient-Centered Care and I have been invited to join a working group that includes Patient Advocates to promote Patient Involvement in the creation of all of our simulation-based programs.
  • Preparedness – The hospital is applying for Magnet status within two years and I have been tasked with ensuring that everything we plan is aligned with the pending application to prevent duplication of effort.
  • Research & Development – I will be involved in assessing the outcomes of the Patient Centered Working Group, which will include patient satisfaction score measurement and metrics on Patient Advocate involvement in internal programs.

Scholarship / Research

  • Educational Strategies – I am working on my CHSE qualification and hope that this will assist me in developing more effective educational strategies. The Chief Nursing Officer will be looking for direct evidence of the effect of this certification. Successful completion of this course will enable me to promote the need for CHSE & CHSOS certification of future Sim Center team members. I plan to enroll myself and then subsequent years my staff in the INACSL-CAE Healthcare Simulation Fellow program to learn how to fully integrate the INACSL Standards of Best Practice: SimulationSM into our work.
  • Research & Development – There are a number of individuals that the hospital is supporting to address their professional development objectives. I must ensure that there is no conflict of interest and that the simulation lab and the hospital benefit directly from their efforts in relation to profile development and practice improvement. Future goals include collaborating multi-disciplinary teams to conduct research on the use on simulation and the impact to patient outcomes.

Strategic Approach/Messaging

  • Use your knowledge of the Hospital Simulation Center Director and the institution to customize your message and select the metrics that indicate how the resources needed for the project will be offset by its benefits/outcomes.
  • Review the case-based scenarios on the website [insert link] to identify one or more that is similar to yours. Customize and use it as a successful example.
  • Use the tool [insert link] to select the value domains that you believe are a match for those of the Hospital Simulation Center Director and rank order them. The tool will generate a list of messages that match each domain with suggested measurement metrics and related articles that support the message and metrics.
  • Begin with how your proposal aligns with the institution mission and strategic goals to ensure that you couches all your plans within their language with metrics that link back to the strategic plan.
  • Focus on improved outcomes related to: teamwork, communication, and collaboration that lead to quick wins for your stakeholders.
  • Also focus on shared educational goals across professions and how simulation allows for improved teamwork and communication while also reducing duplication of effort across departments and divisions.
  • If the Hospital Simulation Center Director is not familiar with the benefits of simulation, integrate relevant advantages of simulation into your proposal. Consider selecting some seminal articles from the resource list [insert link] and providing copies as supplemental material, such as that provided by the American Hospital Associations Healthcare Engagement Networks that are aimed at tackling CAUTI, CLABSI and a Culture of Safety. Alternatively, you could review the Patient Safety Movement’s Actionable Safety Solutions for Healthcare-Associated Infections and the Culture of Safety. You can then identify opportunities and evidence that support simulation-based education and metrics that demonstrate improvement linked to these activities.
  • If you intend to apply for grant funds to support all or part of your proposal, include information about the grant, and include the time and resources you will need to prepare it.
  • Collaborate with the Hospital Nurse Education Director to design the comprehensive simulation-based, Interprofessional Education Training Program.