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North Shore-LIJ Opens New, Larger Patient Safety Institute

From coast to coast, the two major buzzwords in hospitals and health care now are quality and safety. Taking lessons from Harvard and Stamford universities, and training procedures in the airplane industry, the North Shore-LIJ Health System has just opened one of the nation’s largest simulation centers using mannequins for fostering patient safety and quality of care through advanced technology designed to avoid medical errors and respond to emergencies

The newly expanded Patient Safety Institute (PSI) and Simulation Center which had encompassed 20,000 square feet has grown to 45,000 square feet and was built at a cost of $3.8 million– one of the largest medical simulation training centers in the country. Adult mannequins cost about $38,000 and baby models cost about $29,000

PSI is part of North Shore-LIJ’s Center for Learning and Innovation, the largest healthcare “corporate university” in the country, said Michael Dowling, president and CEO of the health system. “The Center is a place for continuous learning for the medical staff, private doctors, and students, especially after the medical school with Hofstra opens next year.

“We can never be satisfied with the old ways of teaching and training, and it is better to make a mistake on a mannequin than on a real patient,” he added. It is located in the medical campus at 450 Lakeville Road (across from LIJ), home to many outpatients with different conditions.

PSI features cutting-edge simulation technology, including an operating room, a procedure room, a labor and delivery suite, and eight critical care rooms, enabling physicians and nurses to hone their clinical and communication skills in a realistic hospital setting without risk to real patients. The facility includes numerous computerized patient mannequins (men, women and babies) that can be programmed to mimic a range of high-risk medical scenarios, such as respiratory failure, cardiac arrest and other life-threatening conditions in a variety of clinical settings — an operating room, emergency room, Labor & Delivery, or other critical care area. All simulations are video recorded and reviewed during post-scenario debriefings. At the press event where the announcement was made, attendees got to watch professional medical staff analyze, diagnose and treat an infant who had trouble breathing, followed by simulated de-briefing in which the good and bad of this patient’s care and communication were analyzed.

New to PSI are 14 standardized patient rooms in which actors will portray patients presenting with various illnesses, testing physicians’ diagnostic skills. Activities in all 14 rooms can be viewed simultaneously on video in real time in a master control room. PSI also houses an endovascular simulation lab where physicians can practice cardiac, vascular and neurosurgical procedures. Staff members at PSI expect to train about 7,000 clinicians through medical simulation this year.

“The Patient Safety Institute is a major asset and we must continually invest in the development of our physicians and nurses to practice life-saving skills before a real-life error or tragedy occurs,” said Dowling. “The new facility greatly expands our ability to train clinicians in a state-of-the-art learning environment and to improve quality and safety for the patients we care for throughout the health system.”

According to a 2000 landmark report by the U.S. Institute of Medicine, approximately 98,000 people die every year in the nation’s hospitals from medical errors and hospital-acquired infections. The North Shore-LIJ Patient Safety Institute’s comprehensive and innovative programs are aligned with the health system’s goal of zero tolerance for medical errors and infections throughout its 15 hospitals across Long Island, Queens, Manhattan and Staten Island.

Borrowing lessons learned in the aviation industry to train pilots with simulator technology to improve their performance and avoid catastrophes in the air, North Shore-LIJ is using a similar approach with its nurses and doctors, helping them improve their clinical and decision-making skills – and avoid serious medical errors in the hospital.

“This procedure training is radically different from traditional training,” declared Lawrence Smith, MD, chief medical officer at NSLIJ and founding dean of the Hofstra medical school. A major advantage is that the situations are reproducible and help teach students reliance and resilience in learning, as they put knowledge into training. “We are raising the bar for competency.”

“Health care is a team sport,” said Kathleen Gallo, PhD, RN, the health system’s chief learning officer. “At the Patient Safety Institute we emphasize that those who work in teams, train in teams, so communication and skills are learned in a realistic, fast-paced hospital setting, and practicing rare medical events become second nature.”

“Medical simulation allows us to put new doctors into critical situations that you would never allow them to get involved in with real patients,” said Dr. Smith. “Learning doesn’t happen without being emotionally engaged and the life-like mannequins replicate stressful medical scenarios, so the simulated setting is as real as it gets, and people will make mistakes.”

Dr. Smith said the debriefing sessions are equally important because this is when healthcare teams can critique their own performance.

“The power of simulation is to recreate rare medical events that you’d never be proficient in real practice,” added Dr. Smith. “The litmus test of a medical student is if you can put knowledge into action in real time under the most stressful situations.”

In summing up, Dowling concluded by saying “The health system PSI is a major investment in making our patients better and safer.