Winning Poster: Expect the unexpected: How emergency response simulation prepared an outpatient pediatric clinic

Abstract

This educational intervention was intended for all healthcare practitioners who work in a multidisciplinary pediatric specialty clinic within an academic medical center. This outpatient clinic hosts 22 pediatric specialties with approximately 75,000 patient visits annually, staffed by 10 different interdisciplinary roles. The gap was identified during debriefing following an emergency event in the clinic in 2022. Specifically, staff reported lack of comfort in early recognition of patient emergencies, role delegation, communication, and use and location of emergency equipment. The needs assessed during this event review were the catalyst for this work. Evidence was reviewed on best practices for emergency preparedness in the outpatient setting. Pediatric emergencies in the outpatient setting have been considered low- frequency and high- stakes events and pediatric emergency preparedness in this setting has been found to be suboptimal (Abulebda et al., 2021; Garrow et al., 2020). Simulation is a widely used education strategy, yet not commonly used in the outpatient setting (Carr and Gormley, 2022). Collaboration with the organization's simulation committee and the associated College of Nursing helped to design the simulation strategy. The in- situ simulation program focused on the first 5 min of a patient emergency, including a prebrief, scenario, and debrief. This intervention aimed to seek whether simulation in the outpatient setting would improve staff comfort, skill development, and communication during pediatric emergencies. Pre and post surveys were used to measure outcomes using a Likert scale and open-ended questions. Post- simulation surveys showed increase in confidence (8 %), comfort (4 %), and knowledge (10 %). Implications for this work have demonstrated that repeated exposure to emergency events, through simulation and real- time patient emergencies, have observable positive effects on staff response. This has improved patient safety and outcomes in this setting. While this work focused on nursing and support staff, future work includes further collaboration with a greater scope of multi-disciplinary healthcare practitioners.