As one of the country’s leaders in providing quality pediatric healthcare, The Children's Hospital of Philadelphia (CHOP) faces the constant need to meet the highest quality standards. The need to improve patient safety and quality of patient care became the cornerstone for CHOP to implement a simulation based education, training and research program.

The Customer

Since its creation in 1855, The Children's Hospital of Philadelphia has been recognized as one of the world's leading pediatric hospitals and research facilities. The nation's first children's hospital and largest comprehensive pediatric healthcare network, CHOP has facilities throughout the tri-state region (Pennsylvania, New Jersey and Delaware)

The Journey

CHOP’s mission to improve patient safety and quality of patient care became the foundation to improve team performance and communication throughout the institution. In November 2005, the medical simulation program commenced with the major user being the pediatric intensive care unit (PICU). In the first year, the simulation program quickly flourished by building champions in many different areas, PICU, newborn intensive care unit (NICU), cardiac intensive care unit (CICU), emergency transport team, and pediatric residency program, to enhance education and training for the healthcare providers.

The Solution

CHOP embraced medical simulation as a learning tool to enhance clinical education. In the beginning, the PICU utilized simulation to provide fellow and multidisciplinary team training, while the NICU used simulation to augment fellow education and the Neonatal Resuscitation Program. Additionally, simulation helped uncover latent errors and other issues of how to organize supplies and area, identify unanticipated supplies and the use of new equipment, all prior to the actual opening of the new units.

By employing a mix of task trainers, human patient simulators and standardized patients, the staff was able to improve cognitive, psychomotor and behavioral skills as well as team performance. “The staff enjoys being able to practice the skills that are relevant to their everyday practice” says Roberta Hales MHA, RRT-NPS, RN.

The Implementation

As part of the programs, simulation sessions include bimonthly/monthly fellow sessions, quarterly training for SDU, multidisciplinary team training, nursing skills fair, central venous and umbilical line training, and basic and difficult airway management sessions. To boot, some of these simulation sessions are based on real life cases/events and identified problems that have occurred within the institution. By recreating real cases, the staff can identify things that went well and areas that need improvement for the future. With the use of high fidelity simulation, “there is less interaction between the facilitator and the team” says Dr. Anne Ades MD. “It’s much more realistic”. “The goal is that during an actual serious event, things run more smoothly” says Dr. Ades. Participation in the events is voluntary and attendance is good because the staff enjoy the hands-on time with the simulators.

The Results

In the past three years, simulation has grown remarkably. The key to their success is the empowerment of clinical champions. These champions have endorsed the Center for Simulation mission. CHOP is currently operating a multitude of programs including the PICU, NICU, emergency department, cardiac ICU, SDU neonatal and obstetrical, fetal surgery, ambulatory, resident, anesthesia, trauma, behavioral management, sedation and nursing; along with many 1-2 day courses like the PICU and NICU boot camps, otolaryngology foreign body course, cardiology simulation pre-conference, sedation provider and anesthesia conferences, and operation smile.