A New Standard in Medical Training

Dr. John Vozenilek, Jump Trading Simulation and Education Center, and Nikki Delinski, OSF HealthCare

It’s the mission of Jump Trading Simulation and Education Center to improve outcomes and lower costs through innovative simulation training of medical professionals. Hundreds of novice clinicians from OSF HealthCare and medical students from the University of Illinois College of Medicine at Peoria utilize our center to practice scenarios in a realistic environment.

The idea is for our future medical professionals to be trained in everything from communication skills to surgery before they interact with patients. It also allows those who’ve been practicing medicine for some time to further sharpen their skills. The goal is to reduce errors at the bedside and ensure patient safety.

But that doesn’t even scratch the surface of the remarkable work we do at Jump. We are thinking “outside the box” to develop innovative tools and ways to improve care. The fact is, mistakes still occur in hospitals around the world—even during routine work that nurses and doctors face every day.

We have found it’s necessary to look outside the scope of healthcare to solve these problems. This includes pairing clinicians with engineers to tackle issues together. We also partner with incubators, accelerators and technology companies to discover and advance innovative ideas that can transform our workflow.

Problems with Current Nurse Training
An ongoing partnership between OSF HealthCare, Jump, SIMnext and CSE Software aims to standardize nurse training and decrease some of the most common errors made in medical institutions. The collaboration will launch the Health Scholars app this spring. This first-of-its-kind tool will revolutionize how new nurses are integrated into healthcare systems.

New nurses are typically prepared for their new roles via hours-long classroom instruction and computer-based training modules on high-risk concepts such as programming smart infusion pumps that deliver medications, fluids and nutrients to patients at controlled rates. Then they are expected to absorb much of their knowledge by shadowing superiors, otherwise known as “preceptors,” in the world of healthcare. Trainers observe trainees in patient care directives, and then these preceptors assert when learners can practice on their own.

These elements still have a place in nursing education, but there are some inefficiencies that need to be addressed:

  1. New nurses don’t always retain the information learned in lectures or computer-based training;
  2. Seasoned nurses, in many cases, don’t have a standard way of doing things; and
  3. There are no real criteria establishing readiness.

The Health Scholars app aims to tackle these issues by providing a guided, interactive platform that measures the performance of each trainee while standardizing how all nurses approach certain processes.

Health Scholars At the Bedside
Health Scholars is a commercial-scale simulator application for use on any mobile tablet. It’s designed for new nurses to use at the bedside, with preceptors guiding the learning process. The app will first launch with short interactive training modules focused on medication and patient safety, as well as infection prevention.

For example, a common mistake made in hospitals is the programming of a smart pump to administer high-risk medications. A nurse-in-training using the Health Scholars app could pull up the high-risk medication training module in a patient’s room and practice going through the process before touching the real pump. A preceptor could watch the trainee as he/she goes through each step and double-check the work.

The app gives instructors a great reference tool to ensure all trainees are receiving the same education. It’s also a subtle reminder for superiors on task standards.

Health Scholars offers fun ways to learn various procedures. If you’ve visited a hospital recently, you might have noticed different-colored garbage cans found in patient rooms. Each color is designated for different types of hazardous materials. New nurses can bring up a game in the app to recall proper disposal of certain waste.

The App’s Progression
The idea to create an interactive training application was initially conceived as a way to streamline and improve how nurses are oriented into OSF HealthCare. Subject matter experts from OSF and SIMnext and software developers from CSE put their minds together to design an app targeting smart pump training. Jump is instrumental in testing the product and determining whether it’s positively impacting learning, and preliminary results have been promising.

New nurses at OSF were given the option of smart pump training during a two-hour instruction session or using the app, which takes anywhere from 15 to 30 minutes to complete. Learners overwhelmingly chose the mobile tool. We found those who practiced on the app received the same quality education they would have received in the classroom.

“I feel more confident after completing the smart pump app, then doing the competency on the actual pump, as opposed to traditional training,” said Erin Jones, a cardiothoracic unit nurse at OSF Saint Francis Medical Center. “On the app, you can push the exact buttons a nurse will touch on the smart pump. It will go through the motions as though you are using the real device. It’s extremely user-friendly.”

The smart pump app was later expanded to include a module for high-risk medication administration training. This was also implemented into OSF nurse training, and there were significant improvements in the handing of this medication as a result. About 800 nurses were assessed and trained in one month’s time, without the need for overtime or time away from the patient’s bedside.

These positive outcomes have led OSF to incorporate the app training into nursing orientation and reducing the time spent in a classroom. This year, nurses will use the mobile simulation exercises on their respective floors with guidance from preceptors. The results have also led to the evolution of the app to include more training scenarios. There’s still more work to be done to ensure its success.

Getting It Right
SIMnext and CSE have reached out to the nursing program at St. Louis University to build valuable research around the smart pump component of the application. It will compare the effectiveness of training on the app versus traditional classroom education in a simulated environment.

Health Scholars will go live in January within OSF. This will give our collaboration the opportunity to collect user feedback on the entire application. We will determine return on investment and whether we’ve truly transformed orientation into a better process.

When we’re confident we have a superior product, we want to test the limits of this new technology. We are going to ask the tough questions: Does using Health Scholars result in fewer smart pump programming mistakes? Are we decreasing medication administration inaccuracies? Are we reducing hospital-acquired infections? Those are broad statements that are hard to prove, but we want to go there. We want to make sure we have a valid product before it’s launched to the broader public.

Partnering with CSE
If you define innovation as addressing a need through an alternative path or with alternative techniques or tools, the development of Health Scholars meets all of those criteria. It would be easy to assume only medical professionals could design solutions to the persistent problems surrounding patient safety.

But we chose to take a chance. We reached out to a company with a long history of providing training applications to find out if it could give us a new perspective on old issues. Now we have an application we believe will transform training as we know it and save patient lives. Health Scholars would not be possible if it weren’t for the innovative thinking of OSF, SIMnext, Jump and CSE leaders that working together would result in great things.

We all look forward to the successful launch of this app in April—and continuing this partnership to tackle other obstacles plaguing the healthcare industry. iBi

Dr. John Vozenilek is vice president and chief medical officer for simulation at Jump Trading Simulation and Education Center. Nikki Delinski is clinical education programs specialist for OSF HealthCare and project manager for SIMnext and Health Scholars.