Systems Management. Part 4 of the 7-Part Series Dissecting the Sim Ops Standard
By: Tonya Schneidereith and Crystel L. Farina
Previously in this series we helped you think about simulation readiness, the importance of strategic planning, and different ways to conceptualize staffing models. Now in Part 4, we identify the importance of systems to manage space, equipment, and personnel resources.
Criterion 3 of the INACSL Standard of Best Practice: SimulationSM: Operations is: “Use a system to manage space, equipment, and personnel resources” (INACSL Standards Committee, 2017, p. 683). What does that mean for simulation? A system, according to Merriam-Webster, is “a regularly interacting or interdependent group of items forming a unified whole.” Systems integration for simulation programs requires detailed organization to ensure that space, equipment, and personnel resources are managed efficiently.
Written policies are important to delineate how educational activities are planned. Simulations should address programmatic needs, align with educational outcomes, and have clear, measurable objectives (Society for Simulation in Healthcare, 2016a). During the planning stage, note whether objectives require low-fidelity task trainers, high-fidelity manikins, or standardized participants. Also consider what supplies, equipment, and personnel are needed to address the level of learning objectives and make these part of a “preflight” checklist for use during scenario set-up. Run a pilot test to confirm that you have all of the supplies needed for a realistic scenario and to ensure the accuracy of the checklist. Finally, don’t forget to build time into the schedule for set-up, pre-brief, facilitation, debrief, and breakdown. Having a schedule that gives time between scenarios will allow facilitators precious minutes for lunch, bathroom breaks, and mental downtime!
Next, identify the systems used to manage your simulation space. If you don’t have clearly established policies and procedures, this can easily derail simulation operations. Think about how you prioritize and document room requests (Society for Simulation in Healthcare, 2016b). Is it first come, first served or do you prioritize based on the size of the program? Do prelicensure program requests supersede graduate programs? Or vice versa? How do you ensure that you have enough people to facilitate the simulation, voice the patient, and/or operate the manikin?
At the University of Maryland School of Nursing, course faculty must plan a semester ahead to ensure that simulations are included on the master simulation calendar. Before the start of the current semester, all requests must be received via email with the desired day(s) of the week, week(s) of the semester, and name of the scenario. Graduate program nurse practitioner (NP) simulations are placed on the calendar first because they are the most resource-intensive. For example, simulations typically run in two to three rooms simultaneously and each room requires a facilitator, operations specialist, content expert NP faculty, and a teaching assistant in the role of bedside nurse. So, for one room, four people are needed. Multiply that times three rooms and this single scenario requires 12 people. If each room runs scenarios back-to-back, all 12 people are engaged for four to five hours. Therefore, the ability to schedule any additional simulations on these days is limited.
At George Washington University School of Nursing, course faculty schedule simulations one to two semesters ahead. The master simulation schedule includes dates and times for graduate and undergraduate programs. Here, the graduate programs are also the most resource intensive. The APN programs have three events per semester and use 12 exam rooms simultaneously. Because of the capabilities of the A/V recording platform, only one simulation operations technician is needed; however, each room requires one faculty member and one standardized participant. Students rotate through the cases with each student participating in three to six cases. With each student participating in the simulation for approximately one hour, the event can last eight to twelve hours for faculty and SPs. It is not uncommon to have multiple simulation events running concurrently with the graduate simulation events.
Having an inventory control system is vital for managing supplies. Prior planning regarding stocked IV solutions, IV tubing, medications, and other materials is essential for simulation fidelity. Using an inventory management system, including commercially available products, can make the process of inventory management streamlined and efficient, and provide a means to manage and track assets, simulator usage, and supplies. This information is used to increase efficiency of restocking, provide cost analyses for each simulation event, and predict future capital spending needs. Not to mention, such systems can clearly identify fiscal resources spent on overall simulations scenarios and labs, data that can be used to painlessly create budgets and five-year budget projections.
Tracking assets also provides a schedule for preventive maintenance, simulator/equipment replacements, and warranty tracking. Inventory and asset management software can increase efficiency and demonstrate the need for budget increases. These resources are incredibly helpful to simulation directors responsible for tracking all of this information!
Finally, personnel resources must be managed so that enough facilitators, operations specialists, and content experts are on hand to provide quality simulation experiences. This includes identifying those responsible for the tasks associated with set-up, facilitation, and break-down. With clear communication, the processes involved to coordinate simulation experiences can run smoothly and harmoniously.
So, what systematic approaches do you use? What advice do you have for educators who are looking for an effective system to manage their simulation program?
INACSL Standards Committee. (2017). INACSL Standards of Best Practice: SimulationSM: Operations. Clinical Simulation in Nursing, 13, 681-687. doi:10.1016/j.ecns.2017.10.005
Society for Simulation in Healthcare. (2016a). Accreditation Standards. In Teaching/Education standards and measurement criteria (pp. 1-3). Retrieved from https://www.ssih.org/Accreditation/Full-Accreditation
Society for Simulation in Healthcare. (2016b). Accreditation Standards. In Core standards and measurement criteria (pp. 1-5). Retrieved from https://www.ssih.org/Accreditation/Full-Accreditation