Systems sim sharpens emergency skills at Gardendale clinic

When UAB Gardendale Primary and Specialty Care prepared to open its Echo Lab and Stress Test services, clinic leadership knew they had a unique resource—and an equally unique challenge.

Although the clinic is part of UAB Medicine and physically connected to the Gardendale Freestanding Emergency Department (GFED), its offsite status meant staff would need to be especially proactive when planning for emergency situations.

Nick Boshell, Gardendale’s manager of ambulatory services, had previously managed clinics at UAB Medicine’s downtown Birmingham campus, where “we had a STAT team and a MET team to help manage (emergency situations),” he said. “But not here. As I reviewed the process that was established when this clinic opened in 2019 and interviewed staff, I could see that most were unfamiliar with the process and that it may not be the smoothest process given our location.”

Simultaneously, the clinic was ramping up to begin stress tests for cardiology—further underscoring the need for a smooth, clear emergency response process.

“I felt it best to do a run-through of our process, evaluate it, make modifications and then do a run-through to ensure our staff was well prepared to handle these situations,” Boshell said.

In collaboration with UAB Clinical Simulation and UAB Medicine ambulatory leadership, the clinic hosted a systems simulation designed to test the logistics of navigating the space and processes related to emergency medical responses. Key personnel worked through the care of a simulated adult patient experiencing cardiopulmonary arrest during a stress test—allowing the team to activate the clinic’s emergency protocol, practice cardiopulmonary resuscitation and transfer the patient to GFED.

According to April Belle, director of systems simulation with UAB Clinical Simulation, the event provided valuable insights.

“From recognizing and initiating the code blue response to ensuring the defibrillator was used within two minutes, the team did an excellent job,” Belle said. “They also quickly accessed the overhead intercom system to activate the emergency response not only within the clinic but also at GFED and demonstrated strong judgment when transferring the patient from the floor to a stretcher.”

Belle noted that communication and space navigation were identified as the two categories posing the highest potential threats to patient safety—insights that allowed the team to plan refinements, including adjusting room layouts and practicing emergency announcements outside of clinic hours.

For Boshell and his team, the experience was invaluable.

“The simulation definitely helped my staff to feel comfortable handling these situations and gave us a solid foundation for moving forward in the event of an emergency,” Boshell said, adding that although such scenarios are rare, his team is grateful for the practice. “The simulation team was great, and I look forward to scheduling these at least annually to ensure we are prepared.”

To learn more about systems simulation, visit here. How can systems simulation work for you? Email simulation@uabmc.edu to find out.

UAB Medicine’s Clinical Simulation program offers opportunities for individuals and teams across UAB Medicine and beyond to practice before they deliver care. We encourage all who provide and support patient care to “Sim First.” Together, we can put our patients’ safety first.