In Situ comes to the ED

Have you ever responded to a “code blue” to find a manikin in a bed waiting for you? If so, then you have experienced in-situ simulation. These unannounced simulations that take place in the clinical environment are designed to test processes.  

Dr. Andrew Bloom and Sarah Shipley are leading the effort in partnership with UAB Clinical Simulation to regularly bring in-situ resuscitation simulation to the UAB Emergency Department (UED). The UED simulation program was designed with input from respiratory therapy and pharmacy as well. UAB Clinical Simulation team members developed and offered an in-situ facilitator course to UED interprofessional leaders. Clinical Simulation has also provided coaching to the UED leaders as they have deployed these simulations. Next steps are to review quality metrics and develop a process to feed information back to other UED team members. 

The simulations include nurses, pharmacists, providers, respiratory therapists, and technicians.  This interdisciplinary approach allows everyone to work together and get to know one another in a less stressful environment. ED participants indicate that resuscitation simulations have been a real game changer. In the past, the only way code team members were able to learn what to do during a code was to participate in an actual code.  Many times, those responsible for onboarding did not have time to stop and educate about what they were doing.  Usually, due to the emergent nature of the situation, there was not time to stop and review the code with team members. Simulation, however, gives an opportunity to really break down what we are doing, the why behind it, and opportunities for improved efficiencies. Shipley has noticed that these simulations have also helped improve teamwork and communication.  Shipley says, “This has really stepped up the camaraderie within the department and makes for a more enjoyable environment even during the extremely stressful situations our staff are faced with.  I look forward to seeing how these simulations continue to improve the care that we give within our department.” 

If you are interested in bringing in-situ simulation to your team or to train as a facilitator, please contact us at simulation@uabmc.edu.