Authors: (including presenting author): :
Tsang PL(2), Chan KMA(1), Ng K(1), Leung CK(1), Chan HTA(1), Lau NMV(1), Chan CCC(2), Ko SF(2), Leung MCV(2), Lam WMT(2), Wong SM(2), Wai CYT(1), Yau KC(1), Leung KMJ(1)
Affiliation: :
(1)NTEC Simulation and Training Centre, North District Hospital, (2)Department of Psychiatry, Shatin Hospital
Keyword 1: :
In-situ simulation training
Keyword 2: :
Crew Resource Management
Keyword 4: :
In-patient attempt suicide
Keyword 5: :
Suspected sexual harassmemnt
Keyword 6: :
Multi-disciplinary collaboration
Introduction: :
Incident management plays a key role in the quality improvement cycle in healthcare settings. The Department of Psychiatry, PWH/SH, in conjunction with NTEC Simulation and Training Centre, identified two key risk areas, namely in-patient suicide and suspected sexual assault in psychiatric ward setting, and developed an innovative tailor made in-situ, interprofessional simulation training program in the actual clinical environment to enhance staff competency and teamwork in managing such incidents.
Objectives: :
(1)To build staff capacity in CRM principles including: situational awareness, teamwork , leadership, speak up, closed-loop communication. (2)To promote understanding in handling of in-patient suicide and familiarization of resuscitation protocols. (3)To ensure team collaboration and decision making in handling of suspected sexual assault incident. (4)Foster a safety culture to improve patient safety. (5)Identify latent safety threats in the psychiatric ward setting.
Methodology: :
A one-day training program was conducted in Shatin Hospital Psychiatric Ward, with a focus on application of CRM principles in two high-risk scenarios – in-patient suicide and sexual assault in the psychiatric ward setting. Each scenario was followed by inter-professional team debriefing, where resuscitation skills and CRM principles were reinforced. Psychiatric workflows in managing such incidents were bolstered, and latent safety threats were identified and discussed.
Result & Outcome: :
Total 3 doctors, 11 nurses and 1 PCA of Department of Psychiatry participated in the training. All participants (100%) self-reported enhancement in confidence in managing such scenarios, and appreciated the opportunity to practice such challenging situations and apply CRM principles. 3 latent safety threats – including enhancing communication in critical situations and equipment issues were identified. Patient safety culture was reinforced, and the simulation allowed for process improvement based on pre-identified high risk areas based on clinical incidents. In-situ interprofessional simulation in psychiatric setting was a novel endeavor, and demonstrated efficacy in enhancing staff competency in CRM principles, understanding of workflows and identification of latent safety threats as part of the quality improvement cycle to enhance patient safety.
