Swedish Opens Region's First Pediatric and Perinatal Simulation Center on First Hill Campus; Care Te

Swedish Opens Region's First Pediatric and Perinatal Simulation Center on First Hill Campus; Care Teams Can Train Safely on Life-Like Infant, Child Mannequins

SEATTLE, Dec. 2, 2008 – Today, Swedish opened the Gossman Center for Advanced Pediatric and Perinatal Simulation. The only facility of its kind in the Northwest, the $2 million Center was created to continuously sharpen the skills of health-care teams in critical clinical situations – without the direct involvement of real and vulnerable young patients.

The 6,500-square-foot Gossman Center is located on the third floor of the 600 Broadway Building near Swedish's pediatric, infant and obstetric units on the First Hill Campus.

Leadership donors to establish the Center included Seattle residents Cheryl and Bill Gossman, who donated $1 million, and the Moyer Foundation, which contributed $250,000.

The Gossman Center uses life-sized, computer-controlled patient mannequins that represent children of all ages – infants, toddlers, school-age youngsters – and mothers during childbirth. Each is integrated with wireless hardware and advanced software that create preplanned training scenarios mirroring situations calling for rapid response by medical teams. The mannequins can mimic human sounds made by the lungs, heart or bowel. They will cry, exhale, inhale, move their arms and legs, blink, and ‘talk' to practitioners, just like real children. Scenarios can even simulate the appearance of blood or urine.

The Center incorporates realistic medical spaces that perfectly replicate an exam room, an emergency department and surgical suite. Among many other processes, care teams can train in normal and high-risk clinical situations including pediatric and neonatal resuscitation, childbirth and triage of critical patients. In addition to clinical skills, simulation allows caregivers to practice teamwork, coordination and effective communication.

"Without having to work on real kids, care teams learn how to anticipate potential problems and avoid them," said Greg Sorensen, M.D., executive director of Swedish Pediatric Specialty Care. "Simulation allows professionals to test advanced procedures and discover new approaches. Best of all, they can practice over and over again, in a completely safe setting."

Simulation training technologies have been available in adult specialties – anesthesiology, surgery, cardiology, critical care and others – for some time. But it has been only within the past five years that they have been applied to infant and pediatric mannequins.

While simulation is often used to train medical students and residents, the Gossman Center is geared primarily to experienced, working professionals. That includes pediatric specialty physicians in emergency medicine, surgery, anesthesiology, cardiology, neonatology and critical care as well obstetricians, perinatologists, registered nurses, respiratory therapists and others. The Center can also accommodate groups of clinicians going through Swedish's Neonatal Resuscitation Program.
Tasha Burwinkle, Ph.D., who holds a doctorate degree in clinical psychology with an emphasis on behavioral medicine and pediatrics, is director of the Gossman Center. She is the primary educator and will create many of the tailored training scenarios, drawing from real-world experiences. Previously, Burwinkle worked in simulation at Texas A&M College of Medicine, where she was research manager and medical educator for the Department of Pediatrics.

How the Scenarios Work

The average scenario and debriefing lasts 90 minutes on average (10-15 minutes for the scenario followed by a 45- to 60-minute debrief) and is designed to be as realistic as possible. The team being trained is presented with a fairly complicated clinical situation – anything from a vaginal hemorrhage in delivery to a child's severe asthma attack to cardiac arrest – and the mannequins respond accordingly. Drs. Sorensen, Burwinkle and other Swedish clinicians create a ‘fictional contract' with the team in the room, often assuming the roles of distraught parents or other potentially disruptive forces.

Dr. Sorensen noted that for trainees to be in receptive learning mode, they have to be excited in some way. "If we don't get their adrenalin pumping a bit, people don't process important information as well or as quickly. We create just enough discomfort to get them fully engaged, without being so overwhelmed they can't act effectively."

According to the national Institute of Medicine, how well hospital care teams function together is one of the biggest influences on preventing adverse medical events. In an emergency, poor communication is often the culprit.

"We will really focus on team performance and on leadership skills," said Dr. Sorensen. "Each scenario will have a specific teaching objective and some will highlight potential conflicts and barriers to effective interaction. Obviously, we'll see some human failings in the room, but this is a completely safe environment for learning."

There is a high-tech control room adjacent to the training areas where clinical team leaders and a coordinator oversee simulations. Everyone in a simulation wears a microphone and each session is videotaped, so the team can do a thorough and candid debrief afterwards.

"Not too many professionals get to live their life in reverse and see exactly what they did right or wrong in a given situation," said Burwinkle. "Of course, everyone in the room is smart and always has the best intentions, but sometimes human factors can get in the way."

At full capacity, the Gossman Center can run up to six scenarios a day, and Dr. Sorensen estimates several hundred clinicians will participate each year. A software program allows Swedish to track trainee progress, so they don't undergo the same scenario more than once and are always practicing at the appropriate level of expertise.

In addition to training, Gossman Center staff also will conduct original research into pediatric simulation. "Very little work has been done in this area of medical technology," said Burwinkle. "By carefully observing numerous groups, we will be able to identify and promote best practices in pediatric simulation and team training."

After the Gossman Center is fully operational and training modules have been tested and validated, Swedish will make training on the technology available to neonatal and pediatric practitioners from other non-Swedish-affiliated hospitals, emergency medicine providers, ambulance operators, and home-health providers across the region.

Swedish is the largest provider of obstetrical, neonatal, and pediatric services in the Pacific Northwest. Its Neonatal Intensive Care Unit (NICU) is among a handful of Level-III nurseries in Washington state, and each year Swedish cares for more than 900 premature or fragile newborns facing life-threatening surgical and medical conditions at the beginning of their lives. Additionally, Swedish provides pediatric specialty care for many older infants and children with virtually all surgical and medical conditions.

About Swedish

Swedish is the largest, most comprehensive, nonprofit health provider in the Greater Seattle area. It is comprised of three hospital campuses (First Hill, Cherry Hill and Ballard), a freestanding emergency room and specialty center in Issaquah, Swedish Home Care Services, and the Swedish Physician Division, which is a network of about 40 primary- and specialty-care clinics located throughout the Puget Sound region. In addition to general medical and surgical care, Swedish is known as a regional referral center, providing specialized treatment in areas such as cardiovascular care, cancer care, neuroscience, orthopedics, high-risk obstetrics, organ transplantation and clinical research. For more information, visit www.swedish.org

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Fact Sheet

Snapshot of the Gossman Center for Advanced Pediatric and Perinatal Simulation

• Overview: The Gossman Center uses medical simulation to continuously sharpen the skills of pediatric and perinatal health-care teams in critical clinical situations, without the direct involvement of real and vulnerable young patients. Care teams can train safely on amazingly life-like infant and child mannequins at the only facility of its kind in the Pacific Northwest.

• Opening date: Tuesday, Dec. 2, 2008

• Location: The 6,500-square-foot Gossman Center is located on the third floor of the 600 Broadway Building near Swedish's pediatric, infant and obstetric units on the First Hill Campus.

• Size: 6,500 square feet

• Development cost: $2,000,000

• Leadership donors: Cheryl and Bill Gossman of Seattle, who donated $1 million, and the Moyer Foundation, Seattle, which contributed $250,000.

Question & Answer (Q&A)

Q. Exactly what happens at the Gossman Center?
A. The Center incorporates realistic medical spaces that perfectly replicate an exam room, an emergency department and surgical suite. Among many other processes, care teams can train in normal and high-risk clinical situations including pediatric and neonatal resuscitation, childbirth and triage of critical patients. Medical teams practice procedures on life-size, computer-controlled patient mannequins that represent children of all ages – infants, toddlers, school-age youngsters – and mothers during childbirth. Each is integrated with wireless hardware and advanced software that creates preplanned training scenarios mirroring situations calling for rapid evaluation and response.

Q. Are the training mannequins life-like?
A. Extremely so. They can mimic the exact sounds made by human lungs, heart or bowel. They will cry, exhale, inhale, move their arms and legs, blink, and ‘talk' to practitioners, just like real children. Scenarios can even simulate the appearance of blood or urine

Q. Why is pediatric simulation so important?
A. Without having to work on real kids, care teams learn how to anticipate potential problems and avoid them. Simulation also allows professionals to test advanced procedures and discover new approaches. Best of all, clinicians can practice over and over again, in a completely safe setting.

Q. Who will be trained at the Center?
A. While simulation is often used to train medical students and residents, the Gossman Center is geared primarily to experienced, working professionals. That includes pediatric specialty physicians in emergency medicine, surgery, anesthesiology, cardiology, neonatology and critical care as well obstetricians, perinatologists, registered nurses, respiratory therapists and others. The Center can also accommodate groups of clinicians going through Swedish's Neonatal Resuscitation Program.

Q. What types of procedures do the care teams practice?
A. Among many other processes, teams train in normal and high-risk childbirth, neonatal intubation, umbilical catheterization and chest compression. In addition to clinical skills, medical simulation allows caregivers to practice teamwork, coordination and effective communication.

Q. How do the scenarios work?
A. The average scenario and debriefing lasts 90 minutes on average (10-15 minutes for the scenario followed by a 45- to 60-minute debrief) and is designed to be as realistic as possible. The team being trained is presented with a fairly complicated clinical situation – anything from a vaginal hemorrhage in delivery to a child's severe asthma attack to cardiac arrest – and the mannequins respond accordingly. Swedish clinicians create a ‘fictional contract' with the team in the room, often assuming the roles of distraught parents or other potentially disruptive forces.

Q. Are the scenarios stressful?
A. For trainees to be in receptive learning mode, they have to be excited in some way. If their adrenalin isn't pumping a bit, people don't process important information as well or as quickly. The scenarios create just enough discomfort to get team members fully engaged, without being so overwhelmed they can't act effectively.

Q. Why all the emphasis on teamwork?
A. According to the national Institute of Medicine, how well hospital care teams function together is one of the biggest influences on preventing adverse medical events. In an emergency, poor communication is often the culprit. Two focus points of the training are team performance and leadership skills. Each scenario will have a specific teaching objective and some will highlight potential conflicts and barriers to effective interaction. Obviously, there will be some human failings in the room, but it is a completely safe environment for learning.

Q. Who oversees the simulation and debriefs the team?
A. There is a high-tech control room adjacent to the training areas where clinical team leaders and a coordinator watch the simulations. Everyone in a simulation wears a microphone and each session is videotaped, so the team can do a thorough and candid debrief afterwards. Not too many professionals get to live their life in reverse and see exactly what they did right or wrong in a given situation.

Q. How is training like this used elsewhere in medicine?
A. Simulation training technologies have been available in adult specialties – anesthesiology, surgery, cardiology, critical care and others – for some time. But it has been only within the past five years that they have been applied to infant and pediatric mannequins.

Q. How many people will be trained at the Center?
A. At full capacity, the Gossman Center can run up to six scenarios a day, so several hundred clinicians will participate each year. A software program allows Swedish to track trainee progress, so they don't undergo the same scenario more than once and are always practicing at the appropriate level of expertise.

Q. Who are the key people at the Gossman Center?
A. Greg Sorensen, M.D., executive director of Swedish Pediatric Specialty Care, was instrumental in formulating the idea for the Center and in bringing it to life. He is a board-certified pediatrician and pediatric anesthesiologist who oversees all aspects of pediatrics at Swedish and has been on the medical staff since 1998. Center Director Tasha Burwinkle, Ph.D., who holds a doctorate degree in clinical psychology with an emphasis in behavioral medicine and pediatrics. She is the Center's primary educator and will create many of the tailored training scenarios, drawing from real-world experiences. Previously, Burwinkle worked in simulation at Texas A&M College of Medicine, where she was research manager and medical educator for the Department of Pediatrics.

Q. Why was the Gossman Center established at Swedish?
A. In part, because Swedish is the largest provider of obstetrical, neonatal and pediatric services in the Pacific Northwest. Its Neonatal Intensive Care Unit (NICU) is among a handful of Level-III nurseries in Washington state, and each year Swedish cares for more than 900 premature or fragile newborns facing life-threatening surgical and medical conditions at the beginning of their lives. Additionally, Swedish provides pediatric specialty care for many older infants and children with virtually all surgical and medical conditions.

Q. Can teams outside of Swedish use the Center?
A. After the facility is fully operational and training modules have been tested and validated, Swedish will make training on the technology available to neonatal and pediatric practitioners from other non-Swedish-affiliated hospitals, emergency medicine providers, ambulance operators, and home-health providers across the region.

Q. What is the Gossman Center planning in the future?
A. In addition to training, Center staff will conduct original research into pediatric simulation. Very little work has been done to date in this area of medical technology. By carefully observing numerous groups, Center leaders will be able to identify and promote best practices in pediatric simulation and team training that anyone in the world can use.

Q. How was the Gossman Center funded?
A. It was entirely funded by philanthropy, which amounted to $2 million to build the Center and $400,000 to endow it in perpetuity.

Gossman Center Contacts

• Greg Sorensen, M.D., executive director of Swedish Pediatric Specialty Care,
206-215-6555, greg.sorensen@swedish.org

• Tasha Burwinkle, Ph.D., Gossman Center director, 206-215-5907, tasha.burwinkle@swedish.org

Media Contact

• media relations manager, Swedish Corporate Communications, 206-998-5028; media@swedish.org

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Media Coverage

  • To read and view a related story that the Puget Sound Business Journal's TechFlash.com Web site posted online, click here.
  • To read a related story posted on the Nurse.com Web site, click here.
  • To read a related 'In Person' profile article posted on the Puget Sound Business Journal Web site Dec. 12, click here.
  • To to read and view a related story that KING Television (Channel 5; NBC) aired Jan. 10, click here.
  • To listen to a related story that KPLU Radio (88.5 FM, NPR) aired Jan. 15, click here.


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