Founded in 1855, The Children’s Hospital of Philadelphia has emerged as one of the world’s leading paediatric hospitals and research facilities. The nation’s first children’s hospital and largest paediatric healthcare network, CHOP has facilities throughout the tri-state region (Pennsylvania, New Jersey and Delaware). The hospital is highly acclaimed for its quality training that has created successive generations of paediatric healthcare professionals, as well as for its pioneering research initiatives, which have resulted in being ranked second in the National Institutes of Health Funding.

Widening access to simulation
In November 2005, CHOP embarked on a medical simulation program designed to improve team performance and communication skills throughout the institution in support of its mission to improve patient safety and quality of patient care. The major user at this time was the Paediatric Intensive Care Unit (PICU). In the first year, the success of the simulation programme promoted the creation of additional ‘champions’ in many other departments including, the Newborn Intensive Care Unit (NICU), the Cardiac Intensive Care Unit (CICU), the Emergency Transport team and the Paediatric Residency Programme.

CHOP embraced medical simulation as an effective learning tool to enhance clinical education. By employing a mix of task trainers, human patient simulators and standardized patients, the staff improved their cognitive, psychomotor and behavioral skills as well as team performance. Roberta Hales (MHA, RRT-NPS, RN), Simulation Educator, at the Center for Simulation, Advanced Education and Innovation, said, “The staff enjoy being able to practice the skills that are relevant to their everyday practice.”

As part of the programme, simulation sessions include:

• Bi-monthly / monthly fellow sessions
• Quarterly training for the Special Delivery Unit (SDU)
• Multi-disciplinary team training
• Nursing skills fair
• Central venous and umbilical line training
• Basic and advanced difficult airway management sessions

Correcting identified problems in patient care
Some of these simulation sessions have been built on real life cases with identified problems that have occurred within the institution. By re-creating these real cases with simulated scenarios, the staff can identify things that went well and areas that need improvement for the future. Commenting on the use of high fidelity simulation, Dr. Anne Ades, Neonatologist, Associate Neonatal Director, at the Center for Simulation, Advanced Education and Innovation, said, “There is less interaction between the facilitator and the team. It’s much more realistic.”

Since its introduction at the hospital, simulation has grown at a remarkable rate. CHOP is currently operating a multitude of programmes including 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.