April 9, 2013 9:45 – 11:15am
Bonnie Mobley, BSN, Mark Adler, MD
Ann & Robert H. Lurie Children's Hospital of Chicago
As an exclusive pediatric facility, we were faced with an increased number of emergency response calls for outpatients and adult visitors. Upon review of code data from our previous facility, 42% of codes were for non-inpatients. In response to these concerns, a new Emergency Response model was developed, the Non-Inpatient Emergency Assessment & Response (NEAR) Team. The challenge was to efficiently and effectively educate two groups, a small group of responders and a larger more diverse group encompassing all hospital staff, in order to successfully transition non-inpatient response from a CODE to a NEAR call. Using a formal process improvement methodology a systems integration project using simulation was developed. We implemented this in three pilot areas of the hospital that were pre-identified as having high non-inpatient related calls. After testing the process, amending and re-evaluating it with further simulations, the process was implemented housewide with further impromptu simulation to educate and reinforce the change. Simulated code events and focused debriefing in the three pilot areas promptly identified process issues and departmental policies that created barriers to meeting the objectives and allowed for iterative revision and improvement of the process. Impromptu simulations were continued to reinforce the process implementation and prevent decay of education.