Building Seamless Teamwork Through Simulation
Westfields Hospital
Background
In the western corner of Wisconsin is the city of New Richmond. In addition to being one of four cities in St. Croix County it is also home to Westerfields Hospital & Clinic. For more than 70 years, it has garnered a reputation that has extended beyond not only its local community, but the entire Old Northwest region.
As a vital member of the HealthPartners care system, Westfields Hospital is tasked with servicing a very large area. A task they have done to a high degree.
The National Rural Health Association has, for four, consecutive years, recognized Westerfields as a Top 20 Critical Access Hospital, the only hospital in the Badger State to receive this honor. The medical center has also been recognized by U.S. News & World Report receiving their High Performing Hospital award.
What has been their key to success?
Westfields, through their "patient-centered" approach, understands successful, patient care starts with ensuring everyone is on the same page. The best way to build collaboration is through practice which is why Westfields employs simulation training regularly.
"(Our) staff finds the simulation (training) to be very beneficial as they provide a significant amount of education, practice, and discussion."
- Jean Meier, the Women's Health & Birth Center Manager at Westfields Hospital
By being able to train for situations that mirror actual medical emergencies, individual, medical personnel learn how they need to work together, doing their specific tasks, for a positive outcome. The rarer an emergent situation, the more crucial that the members of the team are both confident in the team's ability to be successful and their role in the team.
But how does Simulation prepare each team member?
Quite simply. Through familiarization. Being put into a high-fidelity situation allows for trial and error in a safe and encouraging environment. But it goes further, as Meier explains, "Simulation has allowed us to go through the steps outlined in our workflows and policies as well as utilize our order sets." And, at the conclusion of the simulation, there is an opportunity to follow up with each other. "Everyone is involved, and everyone is learning," Meier shares. "Following the simulation, we discuss it. What went well? What could we have done differently? What challenges came up? This discussion has provided a tremendous amount of insight and learnings."
From there, individual learning can progress further. Members are encouraged to ask questions and plan for different outcomes or variables. A sense of analysis which ultimately contributes to the entire team improving. As Meier says, this post-simulation reflection"...allows staff to utilize critical thinking skills, looking ahead and anticipating.”
How does training work in practice?
As we mentioned in our previous insight article, emergency maternal care is an area requiring extensive and detailed training to ensure positive outcomes. Westfield trains for the various possibilities with simulation training, both at the individual as well as team level.
"Since we are a small, critical-access hospital and we don't deliver a large number of OB patients on a monthly basis, it is even more important that we be well-educated and prepared for any OB emergency that may occur at any given time. Participating in the Sims events allows staff the opportunity to put our policies and workflows into play while also addressing any additional learnings we may discover."
The event
The skills learned during these simulations were put to good use in May 2022.
A woman, with a history of not following the prenatal program as well as drug abuse, suffered a post-partum hemorrhage after giving birth.
Each member of the team stepped in to perform their tasks.
CRNA ordering more blood
Primary nurse ordering the Rapid Response and administering hands-on care
Emergency Department Physician and General Surgeon arriving for support to hand off to the OB Doctor to finish off the intervention in the OR
The flawless execution of the procedure led to a healthy mother and baby leaving the hospital soon after the intervention. Even more incredible, Westfields had trained for the exact same scenario less than a year before the incident.
"Simulations are planned twice a year for a 4-hour period of time," Meier says. And why did she choose the Post-Partum Hemorrhage scenario for the simulation? "I make the decision based on what situations or OB emergencies are most significant in regard to outcomes, care, critical thinking skills, etc. I also base it on what OB emergencies are not seen as often here but have a huge impact on our patients and their outcome. When I chose the PPH and HTN simulations it was based on new Joint Commission standards and the fact that these emergencies require immediate attention and action."
With simulation training, Westfield is able to create strong teams that make emergent interventions for patient care. It means a few hours a year of training, but also more mothers and babies beginning their lives together.