Authors (including presenting author) :
Tsoi SCT (1)(3), Leung YWN (1)(2), Chan CMV (4)(5)
Affiliation :
(1) Nethersole Clinical Simulation Training Centre, Pamela Youde Nethersole Eastern Hospital, HKEC (2) Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, HKEC (3) Nursing Services Division, Pamela Youde Nethersole Eastern Hospital, HKEC (4) Department of Paediatrics and Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital, HKEC (5) Quality & Safety Office, HKEC
Introduction :
Medical mishaps occur in the healthcare organization. Incident management is far more than immediate medical treatment, which also includes open disclosure, reporting, system-based incident analysis, patient (and care giver) support, peer-to-peer support, complaint and feedback management, medical-legal issues, etc. While medical professionals are usually well-trained in clinical knowledge and skills, training on incident management is relatively inadequate generally. Traditionally, teaching on incident management is usually delivered by lecture, demonstration, or role-play. However, realism and fidelity of the teaching content is limited. Besides, most of the training focuses on individual management skills, like work-related responsibilities and management plans. Other essential elements like teamwork, emotional and interpersonal components are lacking. Simulation-based learning has been shown by many studies to deliver a better learning outcome through practicing and experiencing in a high fidelity environment. It enables theory application and skills development through immersive scenarios and debriefing.
Objectives :
To enhance the knowledge and skills in managing patient safety incidents (PSI) in the workplace, a simulation-based incident management training course was organized for the Paediatric team.
Methodology :
A simulation training course focusing on incident management was organized in May 2021 in Nethersole Clinical Simulation Training Centre (NCSTC). Three different paediatric-specific scenarios were designed by a paediatician, members of NCSTC, representatives from Quality and Safety (Q&S) office, and a Patient Relationship Officer (PRO). To increase the realism of the scenario, experienced instructors played as confederates in the scenarios. Debriefing was held after each scenario to reflect management skills, emotional competencies, and communication skills. Q&S representatives and PRO joined in the debriefing session and shared principles of incident handling, conflict resolution, reporting, as well as medical-legal concepts. The teamwork component was emphasized during debriefing. Questionnaires focusing on incident management were collected before and after the course. The following questions were asked: 1. I know what are incidents. 2. I know the duties of a Patient Relations Officer. 3. I know the functions of AIRS. 4. I am ready to manage the medical incident in my ward. Likert scale 1 to 6 was used, 1 means disagree and 6 means agree.
Result & Outcome :
Eleven participants (5 doctors, 6 nurses) from the PYNEH Department of Paediatrics participated in this training course. The pre and post results are as follows, and all the results are statistically significant with p< 0.05 Pre Post 1. I know what are incidents. 3.5 5 2. I know the duties of a Patient Relations Officer 3.2 5.2 3. I know the functions of AIRS. 3.6 5 4. I am ready to manage the medical incident in my ward. 3 4.9 Conclusion: Simulation-based training is an effective tool to enhance the knowledge and skills in managing patient safety incidents for the Paediatric team. Realistic scenarios and environment, followed by debriefing allows participants to understand and to increase confidence of medical incident management.
