Penn Medicine Clinical Simulation Center

1. Penn Medicine Clinical Simulation Center Gretchen Matika, MS Baltimore SUN May 20, 2009

2. Overview • Overview and Structure • Timeline for Sim Center • “Secrets of our Success” • Budget Basics • Overview of Center Layout & Programs • Utilization • Operational Considerations

3. Simulation at PENN • Health System Simulation Efforts – SOM, 3 hospitals and rehab facility, all disciplines • Main geographic sites : • PENN Medicine at Rittenhouse– centrally located between 3 hospitals. Also houses rehab facility. • All simulations except cadavers and live animal • Measey Simulation Center (SOM) • ~800 sq feet - 2 Sim Rooms and a Skills lab • Glenolden Research & Education Facility - • Robotic Training Center & Animal Research Facility • Brunner Center (SON)

4. Penn Medicine Clinical Simulation Center Jim Mullen, MD Chair, Steering Committee Steering Committee= Bellini, Black, Brennan, Corrigan, Driscoll, Jost, Kennedy, Kinslow, Morrison, Resnick, Volpe Steering Committee Exec= Corrigan, Morrison, Mullen, Resnick Andrew Resnick, MD, MBA Executive Director Tech Advis Committee= Kochman, Kofke, Nadkarni, Patel, Williams, Kuchenbecker Operations Committee= Luba, Matika, Palmieri, Jones, Lipschik Research Committee Operations Director= Matika Dir. Life Support Programs= Lipschik Specialty Directors Sim Educator= Palmieri Sim Tech= Luba Sim Admin Assist= Jones

5. Timeline (Concept to Current Day) B-line/AV Install Complete- 5/09 Spring 2009 Move into Center- 7/08 Basic AV Staff Identified and Hired- 4/08-6/08 Construction Begins- April 2008 Summer 2008 Spring 2008 Architectural Drawings Finalized/Priced Meet/Select AV hardware/software vendors Fall/ Winter 2008 FY08 Ops Budget (v.4) Approved “Graduate Hosp” Space Identified/Approved Architect Retained, Development & Industry Involved FY08/09 Capital Funds Approved Surgery Obtains Grant- Initial Simulators Purchase Summer 2007 Sub-Committees Meet Vendor Quotes and Demos, Grant Submissions ID Specialty Directors & Core Equipment Needs Spring 2007 Space & Capital Requested Winter 2006 Sub-Committees Formed Request “Needs Assessment” Fall 2006 1st Steering Committee Mtg Budget (v.1) & Narrative Spring 2006 CONCEPT- WINTER 2006

6. Secrets of Our Success • Strike a Nerve • What are your peers/competitors up to? • Regionally • Nationally • Public Scrutiny

7. Secrets of Our Success • Discover Broad Institutional Needs • Unmet Educational Need • Regulatory accreditation • Reducing Medical Liability • Increasing Patient Safety • 80 Hour Work Week • Reducing Cost

8. Secrets of Our Success • Identify Your Champions • Internal • Departments • Physicians • Administrators • External • Vendors • Other organizations

9. Secrets of Our Success • Form Partnerships • Affiliated Medical & Nursing School, other Graduate Program and Hospitals • External Groups

10. Secrets of Our Success • Consider Alternative Funding Options • Grants – research, government, industry, charitable • Development/Alumni Offices • Corporate Partnerships • Course Tuition • Rental Space

11. Secrets of Our Success • Utilize the Existing Resources • Personnel • Equipment • Medical and Simulation • Programs • Vacant Clinical/Other Space

12. Secrets of Our Success LUCK & GOOD TIMING!

13. Initial Capital and Operational Budget CAPITAL • ~3 million to: • Construction • Simulators • AV hardware/software OPERATIONS • ~1.2 million annually GRANTS/COMMERCIAL SUPPORT/GIFTS • Total to date: $1.7M

14. Penn Simulation Facility • 22,000 sq ft complex at Penn Medicine at Rittenhouse • Includes: • Administration/Reception • Standardized Patient Exam Rooms • (12) exam rooms • Simulation Training Rooms (6) • IR/OR • ED/ICU • LDR • In-Patient • Endovascular • FLS Trainers • Skills Lab • Large Group Instruction and Debriefing Space

15. SP EXAM ROOMS ADMIN SUITE Comp Rm ENTRANCE FLS ICU/ED EndoVasc Task Trainer Rms CORE LDR OR InPatient Sm Conf Rm Brk Out Rms MultiSkills Lab Large Conf Rm

17. ADMINISTRATIVE OFFICES

18. Standardized Patient Area • SOM H & P/Board Exams • Patient Disclosure Pilot • OB/GYN Resident Training • Staff handoffs • Staff/Faculty remediation

19. Simulation Core and Control Center • Team training with remote manikin control and advanced AV capabilities • OB-GYN • Surgical Critical Care • ED • NICU

20. Simulation Core and Control Center

21. Control Center

22. MultiSkills Lab • Skill Sim Certification • Interns/new to practice nurses/staff/SOM • External courses

23. Skill Certification Competency Checklist: NEJM For Video and Article: http://content.nejm.org/cgi/content/short/358/26/e30

24. Alternative site for Skills Labs Post-session Debriefing Breakout sessions Small and Large Conference Spaces

25. Faculty Training & Credentialing • Fundamentals in Laparoscopic Surgery • Patient Disclosure/Communication Sessions • Remediation • ACLS/PALS/ATLS • Acquisition of new skills

26. Simulation courses July ’08 thru April ‘09 • Students trained: >4350 • ACLS = 993 (June thru April 2009) • BLS = 619 (since Jan 2009) • Student hours: ~39,950

27. User of PMCSC (excluding ACLS and BLS) Number by % Total by Group Number by % Total by Residency Program

28. Sim Center April 2009 by Room

29. Sim Center Utilization FY09

30. Operational Considerations • Users charged for time • Self supporting via external revenue • Fully supported by entity • Combination • Internal vs external rates • Simulator Purchases/Warrantees • Staff Time • Departmental Instructor Contributions • Disposables

31. Contact information • Gretchen.Matika@uphs.upenn.edu • 215-893-7707