presents The Inter-professional Simulation Center ...

1 presents The Inter-professional Simulation Center : opportunities , challenges , Solutions Presented by: Colleen O Connor Grochowski, Mary Jo Olenick, AIA Sidney Ward, AIA, LEED AP Mary Jo Olenick, AIA Principal The S/L/A/M Collaborative Colleen O Connor Grochowski, Associate Dean, Curricular Affairs Duke University School of Medicine Sidney Ward, AIA, LEED AP Principal The S/L/A/M Collaborative Agenda Current State of Simulation Planning Considerations Case Studies Emory University Western Michigan University Duke University inter professional Education Strategic Integration of Simulation into the Duke Curriculum Learning Objectives Program and Planning Benchmarks Planning a Simulation Center for Maximum Efficiency Cost Benefit Consideration Future Impacts Current State of Simulation Today s Physician Tomorrow s Physician Impacts on Medical Education Halstedian approach Increased emphasis on patient safety Changes in health care delivery Simulation opportunities Outcomes Accreditations Undergraduate Medical Education Liaison Committee for Medical Education United States Medical Licensing Exam Step

2 2CS Graduate Medical Education American Council for Graduate Medical Education Educational Commission for Foreign Medical Graduates Continuing Medical Education American Council for Continuing Medical Education Expanding Role in Health Prof. Training & Certification Regulatory Drivers Joint Commission documentation of improvement Patient Safety Drivers Continuum of care logistics and handoff Training Drivers Procedure rehearsal Team training Specialty team training Identification of knowledge into actions Competency-Based Education & Assessment SIM Aggarwal R et al. Qual Saf Health Care 2010;19:i34-i43 Medical Simulation Time Line 1960 s-1970 s Resusi-Anne developed for mouth to mouth resuscitation training University of Miami developed Harvey: Cardiology Patient Simulator Rise & fall of Sim One (USC) 1990 s Sim Man developed with support of the University of Pittsburg METI brings Human Patient Simulator to market (technology developed at the University of Florida) 2000+ Pediasim & EC5 available Dramatic increases in technological sophistication as market is establish John, I saved a.

3 Ppt slide of this in the folder. Maybe Tara can do a better job extracting the images. Can you get names of the 1970, 1990 and 2010 models for reference? True interdisciplinary collaboration of physicians, scientists, engineers and educators Strategic Mission & Business Plan Know the utilization by experience Plan for learner thru-put in order to plan for FTE support Number of Hours Per Learner Per Year Critical to know FTE operational support before design Too many have large sites unused due to lack of $$$ planning before design Emerging Trends Synthetic cadavers instead of manikins Virtual Simulation Expanding standardized patient use for Nursing All striving to be a Center of Excellence in order to differentiate and be able to charge for sharing space / equipment / personnel Intra and inter professional Training Synthetic cadavers instead of manikins Expanding standardized patient use for Nursing All trying to be a Center of excellence for something in order to

4 Differentiate and be able to charge for sharing space/equipment/personnel Intra and inter professional training lots of talk but few real curriculum integrations for shared experiences other than ad hoc personality driven Duke Immersive Virtual Environment Planning Considerations Organic Evolution in Simulation Space Programs Simulation Program vs. Center Renovation & Opportunity Strategic Mission & Business Plan Rightsizing: Aligning Program, Mission, Budget & Facilities Emerging Trends Educational Program vs. Simulation Center Facilities grow as learner experience and desired outcomes expand Procedural Basic Skills Development Decision Making Group Dynamics Patient Interaction General Procedures Surgical Procedures Research Clinical Trials Nursing Research Staff PhD Residents Medical Students M 1, 2, 3,4 Undergraduate Medical Education Inter-professional Education Cost Complexity Flexibility Square Footage Requirements Regional Immersive Virtual Reality Continuum of Care Disaster Response $ Physicians Assistant Pharmacy Emergency Medical Service Industry Clinics UME GME Health-Related Professions Strategic Partners Hospitals class size 100 100 120 200 125 150 150 150 50 completion 2014 2013 2011 2014 2010 2008 2006 2005 1999 10,886 4,995 4,775 7,043 6,578 5.

5 811 1,375 4,798 3,720 3,772 3,734 2,907 6,412 3,830 4,685 3,510 4,147 1,838 3,991 1,441 2,768 449 846 2,200 571 1,194 3,401 04,0008,00012,00016,00020,000 WMUDukeCMCVCUS tanfordEmoryJHUWash UMayon e t s q u a r e f e e t Virtual/ComputerCommonClinical SkillsSimulationSimulation Center Space Benchmarking TOTAL AREA (NSF) 18,650 NSF 10,500 NSF 7,080 NSF 8,950 NSF 6,750 NSF 14,650 NSF 13,450 NSF 8,230 NSF 10,170 NSF 432 449 307 439 765 614 317 314 367 150 123 130 123 158 140 130 95 134 10 3 6 6 2 3 3 4 4 12 12 12 16 12 16 12 13 6 0246810121416180100200300400500600700800 900 WMUDukeCMCVCUS tanfordEmoryJHUWash UMayon u m b e r o f r o o m s r o o m a r e a ( N S F ) avg sim rm sizeavg exam rm size# of sim rms# of exam rmsSimulation Center Space Benchmarking ROOM SIZES & QTY 430 NSF 130 NSF 186 102 87 56 117 70 47 63 135 1,695 925 2,612 993 1,628 2,624 1,417 793 965 -3,000-2,400-1,800-1,200-60006001,2001,8 002,4003,0000408012016020024028032036040 0 WMUDukeCMCVCUS tanfordEmoryJHUWash UMayoN S F / s t a f f s p a c e N S F / M S 1 s t u d e n t NSF / MS1 NSF / staff100 100 120 200 125 150 150 150 50 class size 11 11 4 14 9 4 5 12 7 pers cap average benchmark range : 70-100 NSF/MS1 750-1,000 NSF/staff group 1400-1,600 NSF/staff group 2,600 NSF/staff group Simulation Center Benchmarking NSF/MS1 & STAFF SPACE Task Trainers Fundamental Skills Case Simulation Clinical Skills Experiential Learning Environments.

6 Spectrum Modeling Utilization ## Exercises/DurationRoomHours/ClassExercis eAbrGroup sizeGroupsWeek(hours)TypeWeek1Hx & & rotation preparationPrep81341med & rotation Exercises*Res/Sim60815med & Management & Teamwork# Res/Sim 2????med & lg?Surg ResSurgical Skills#Surg?????Allied HealthTeamwork & large room exercises#AH????large?MS1: 3 hours / wk MS2: 4 hours / wk MS3: hours every 6-8 wks 0%10%20%30%40%50%60%70%80%90%100%12-exam rooms3-sim rooms1-bio skills labm e d s t u d e n t u t i l i z a t i o n ( a s s u m e 1 0 0 s t u c l a s s ) Available CapacityMS3 DemandMS2 DemandMS1 DemandModeling Utilization 42% 17% 84% 8% 33% Sim & Exam Rooms available 50% of the time Skills Lab available 84% of the time - Design exam rooms to flex as sim rooms - Design skills lab to flex as sim support (pre event breifing, debreif, etc.)

7 - Design sim studio that can also function as a skills lab Strategic Mission & Business Plan PROCEDURE ROOM RECEPTION CONTROL ROOM PROCEDURE ROOM OPERATING ROOM Simulation MAN. OFFICES PROCEDURE ROOM SP TRAINING & FACULTY VIEWING CONF ROOM SL SUR. SIM. BOXES STORAGE DEBRIEFING ROOM PROCEDURAL Simulation SUITE 4,250 NSF CLINICAL SKILLS SUITE 2,975 NSF SHARED 810 NSF CLASSROOM EX EX EX EX EX EX PR PR CR SUPPORT WRITE-UP CORE OFFICES EX EX EX EX Critical Adjacencies Flow of Anatomy to Wet/Dry Procedure to US/Robotics/Haptics to Clinic to In Patient with centralized shared technology control & supply work area Case Studies Lab & Support6,940 Simulation ROOM (in-patient)360 Simulation ROOM (LDR)360 Simulation ROOM (HPS)360 Simulation ROOM (IR/OR)440 Simulation ROOM (ED)440 Simulation ROOM (ICU/PACU)4702,430 TASK ROOM (2 @ 300 nsf)600 SKILLS LAB1,400 CONTROL CENTER250 CONTROL ROOM70 FACULTY VIEWING ROOM160 SCRUB SINKS100 STORAGE300AV ROOM80 LOCKER ROOMS (2)1,300 LOUNGE250 Debrief/Conference2,700 DEBREIFING/CLASSROOM (40 sts)

8 1,600 BREAKOUT ROOMS (6 @ 150 nsf)900 DEBRIEF STORAGE75 TOILET (3 @ 25 nsf)75 DEBRIEF PANTRY/KITCHEN50 Office & Support480 RECEPTION/WAITING300 PRIVATE OFFICE (2 @ 90 nsf)18010,120 Emory University (UME) User Profile Utilization Design & Layout First Cost FTE s Operational Cost spaceroom area (NSF)area subtotal (NSF)Lab & Support3,855 Simulation OR578 Simulation ER730 Simulation ER384 Simulation LAB SUPPORT1,142 MASTER CONTROL ROOM385 STORAGE497 SCRUB139 Office & Support343 OFFICE122 OFFICE118 RECEPTION104 Study1,582 GROUP DISCUSSION234 GROUP DISCUSSION245 WORK AREA1,1035,780 NSF# NSFC linical Skills AreaStandardized Patient (SP) SuiteLarge SP Exam w/ Observ. Window1401632,240AV Control12323246 Patient Lounge 23713237 Student Write-up/ Group Area429431,716SP Suite OfficesCoordinator12313123 Assist.

9 Coordinator12313123 Subtotal: Clinical Skills Area4,685 Simulation Lab SuiteSimulation Workarea1,1031B1,103 Simulation OR5901B590 Master Control Room/Tech Space (per Waveguide)3831B383 Medical Supply/Storage5001B500 Debriefing Room2502B500 Reception1001B100 Simulation ER7301B730 Simulation Patient Room3841B384 Scrub1391B139 Task Trainers1,1421B1,142 Subtotal: Teaching Laboratories5,571 Total10,256 Emory University Building Section SID Emory University Simulation Center Emory University Beneficial Adjacencies Emory University Simulation Center GROUND FLOOR Emory University Standardized Patient/Clinical Skills Lab Emory University Computer Classrooms Emory University Standardized Patient/Clinical Skills Lab Atlanta, GA EST. 1854 NEW BUILDING 2007 CLASS SIZE 138- 150 11,520 SIM LEARNER HOURS / YEAR 15,360 SP LEARNER HOURS / YEAR 19,200 TASK LEARNER HOURS / YEAR FIRST COST $ 320 / SF $ ANNUAL BUDGET 800K FULL TIME EMPLOYEES 1 2 1 3.

10 6 10,676 SF EQUIPMENT COST +$ REVENUE 5K 73K TUITION SF 5,571K Simulation SF 4,865K STANDARD PATIENT 4685 5811 Clinical SkillsSimulationSF SF AV EQUIPMENT COST Western Michigan University (Regional) User Profile Utilization Design & Layout First Cost FTE s Operational Cost Lab & Support6,940 Simulation ROOM (in-patient)360 Simulation ROOM (LDR)360 Simulation ROOM (HPS)360 Simulation ROOM (IR/OR)440 Simulation ROOM (ED)440 Simulation ROOM (ICU/PACU)4702,430 TASK ROOM (2 @ 300 nsf)600 SKILLS LAB1,400 CONTROL CENTER250 CONTROL ROOM70 FACULTY VIEWING ROOM160 SCRUB SINKS100 STORAGE300AV ROOM80 LOCKER ROOMS (2)1,300 LOUNGE250 Debrief/Conference2,700 DEBREIFING/CLASSROOM (40 sts)1,600 BREAKOUT ROOMS (6 @ 150 nsf)900 DEBRIEF STORAGE75 TOILET (3 @ 25 nsf)75 DEBRIEF PANTRY/KITCHEN50 Office & Support480 RECEPTION/WAITING300 PRIVATE OFFICE (2 @ 90 nsf)18010,120 NSF# NSFC linical Skills AreaStandardized Patient (SP) SuiteLarge SP Exam w/ Observ.