1. Marshall (Mark) Smith, MD, PhD
Banner Health
We exist to make a difference in people's lives through excellent patient care.
Marshall (Mark) Smith, MD, PhD
Carol Cheney, MS

2. Banner Health One of largest, nonprofit healthcare systems in US
Over 30,000 employees and 3060 licensed beds
One hospitalized patient in 200 in US at Banner
in the US is in a Banner facility

3. Banner Simulation System
Improving patient care through
simulation, learning and education

4. To Err Is Human: Building a Safer Health System Institute of Medicine
1999

5. – Crossing the Quality Chasm, IOM, 2001
“The current care system cannot do the job. Trying harder will not work. Changing systems of care will.”
– Crossing the Quality Chasm, IOM, 2001

6. Simulation Training
Ability to practice, and make mistakes, in a consequence free environment
Ability to objectively measure psychomotor and cognitive skills

7. Banner Simulation Medical Center
Improving patient care through
simulation, learning and research…

8. Doctor and Patient Practicing on Patients, Real and Otherwise By PAULINE W. CHEN, M.D. Published: January 28, 2010
Banner Health, a nonprofit system that just opened a 55,000-square-foot simulation training center in Arizona, the largest of its kind in the United States.

9. 55,000 sq ft center
55 bed virtual hospital simulation learning center
Will eventually train all disciplines/specialties

10. 55 bed virtual hospital
Emergency department
Intensive care unit
Neonatal ICU
Pediatric ICU
General pediatrics
Lecture classrooms
Skill stations
Medical surgical floor
Labor and delivery suite
Operating room suite
Standardized patients

11. Skill Simulator Training in Aviation

12. C VC Placement
EVERY entering new resident since 2006 has passed the CVC course before seeing a patient

13. 92% decrease in pneumothorax 83% decrease in infections
One billion in cost of complications of CVCs per year
Cost of complication for CVC is ~ $20,000 to 25,000 / line
5,000,000 placed in US / yr
Thus, 25,000 at Banner per year
15% complication rate = 3,500 comps / yr
Cost to Banner of CVC comps =

14. ACLS
Training

15. Revision of Traditional ACLS Training Course
Weighted Checklists
Train to errors
High fidelity simulation

16. increases learning
by 300%

17. Evaluation Systems

18. Evaluation Systems

19. Warm Up in Surgery

20. Nintendo Wii
Gaming extensions to Wii can be modified for surgical instruments.
Wii Mote

21. Full System in Action

22. Wii and Rehabilitation

23. Nursing Onboarding Highest rate of attrition is in 1st yr
New nurses are overwhelmed when placed into patient care
Many individual systems that provide varying bridge training for nurses from graduation to independent care of patients
Very significant costs to institutions
Length varies from 3 to 12 months
Unlike physician residencies and fellowships, there is no standardization as to curricula or length of program

24. Our Mission Standardized simulation curricula with:
Validated adult learning techniques
Objective measurements of competencies!

25. Goals Standardize training across Banner
Competency based rather than time
Decrease onboarding time required
Increase retention of new nurses
Reduce errors in patient care
Many individual systems that provide varying bridge training for nurses from graduation to independent care of patients
Very significant costs to institutions
Length varies from 3 to 12 months
Unlike physician residencies and fellowships, there is no standardization as to curricula or length of program

26. New Employee Orientation
On-Boarding Pathway
Unit Preceptorship
Simulation New Employee Orientation (Skills and Scenarios
Clinical
New Employee Orientation
2 days to 11 total weeks DOE
NEO
Professional
Development
Clinical Academies
1 day at facility
3-4 days at facility
Started at month 3 after hire
10 (4) hour sessions Completed at 1 year
5 days over 2 weeks if new grad
4 days if new to service
1.5 days if experienced
Up to 3 months if new to service (Peri-Op 6 months)
Ongoing continuing education, CE direct, BLC, Learning and Development, etc…

28. Teamwork

29. Research and Learning Initiatives
Qualities of Teamwork
Communication
Leadership
Mutual Support
Situation Monitoring

30. Clinical Excellence Clinical education and simulation technologies
Cognitive learning and critical decision making
Team training and communication skills
Maintenance of provider clinical proficiencies
Errors reduction in delivery of patient care
Peer review (OPPE) and evaluation of competencies
Evaluation of new delivery models for clinical care

31. Banner Simulation Medical Center
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