Article Text

0147 Does Targeted Multiprofessional Simulation Improve Outcomes And Can It Be Cost-effective?
  1. Ranjit Kumar Gunda,
  2. Alok Sharma MPROvE Group
  1. University Hospital Southampton NHS Foundation Trust, Southampton, UK

Abstract

Background Drivers for introducing Multiprofessional simulation in education include changes in junior doctor’s hours,1 endorsement by the NPSA,2 CMO,3 and need to reduce medical error4. The use of simulation across different specialties allows for acquisition of skills and team-work training in a realistic safe clinical environment. The question is whether multi professional simulation training can be demonstrated as an evidence based cost-effective education intervention to improve clinical outcomes.

Methodology An intervention study assessing the potential impact of Multiprofessional simulation on certain neonatal outcomes has been performed over a 4 year period. The MPROvE programme is a Multiprofessional curriculum mapped modular programme (neonatal nurses, doctors and nurse practitioners) categorised into neonatal airway, access, respiratory and preterm care, surgical, and cardiac care modules. Areas of high risk (preterm golden hour management, accidental extubation and vascular access) have been incorporated into the programme to evaluate if deliberate multiprofessional practice can positively impact these areas. These areas are covered at the beginning of each training cycle.

Results Total of 5 cycles (45 training sessions) have been delivered over 4 years. Incidence of hypothermia from 2010 to 2014 in neonates under 32 weeks has significantly improved annually (14.2%; 4.3%; 3.2%; 0.9% p = 0.0001). The incidence of UVC (umbilical venous catheter) extravasation has been reduced by 50% (4.5% vs 2.2% p = 0.1) during the same period. Serious complications related to UVC extravasation (Death, Ascites, and Intracranial haemorrhage) have been reduced from 3.1% to 0% (p = 0.03). We have done cost analysis keeping these improvements in context.

Conclusions This programme demonstrates that deliberate multiprofessional simulation can improve patient outcomes. Along with improving patient outcomes, we present cost-effectiveness of the programme to maintain such a model. It serves as an example for provision of multiprofessional curriculum mapped educational intervention which is reproducible, sustainable and improves quality of care.

References

  1. Templeton J. A Review of the Impact of European Working Time Directive on the Quality of Training. England, Med Educ 2010

  2. National Patient Safety Agency. Review of patient safety for children and young people (June2009). NPSA Website http://www.nrls.npsa.nhs.uk/EasySiteWeb/getresource.axd?AssetID=60227&type=full&servicetype=Attachment. Accessed October 13, 2012

  3. Donaldson L. Safer medical practice: machines, manikins and polo mints, 150 Years of the Annual Report of the Chief Medical Officer: On the State of the Public Health 2008. Department of Health, 2009, pp49–55

  4. Kohn LT, Donaldson MS, Corrigan JM. To Err is Human: Building a Safer Health System. Washington, DC, National Academy Press, 1999

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