Generalizing TESTPILOT to New Single Family Room NICUs

Age Range:Any
Start Date:September 2014
End Date:March 2018
Contact:Megan Hennessey-Green, CRA

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Generalizing TESTPILOT-NICU: Transportable Enhanced Simulation Technologies for Pre-Implementation Limited Operations Testing in Neonatal Intensive Care Units

Complex service interventions are neither smooth nor easy in any transitioning healthcare
facility. Simulations performed in the new environment reinforce patient safety by
uncovering safety threats, enabling their correction, and orienting hospital staff. This
study expands upon patient safety successes at several institutions to measurably enhance
patient safety at upcoming new inpatient facilities.

Prior to opening the nation's largest single family room NICU in 2009, Women & Infants
Hospital developed TESTPILOT: Transportable Enhanced Simulation Technologies for
Pre-Implementation Limited Operations Testing. The investigators simulated a functional
NICU. 164 latent safety threats (LST) were identified without exposing a single neonate to
risk. Practical changes were made to a) verbal and written communication protocols, b)
admissions workflows, c) rapid team responses, d) family centered care e) scripting, f)
facilities, g) supplies and equipment, and h) staffing and training issues.

"Generalizing TESTPILOT" studies how learnable and applicable this simulation-based
methodology is at other institutions. Six institutions have successfully implemented
TESTPILOT-NICU as of 2015. The investigators hypothesize implementations will succeed across
a spectrum of care delivery structures, simulation experience and magnitudes of culture
change, resulting in a broad blueprint for integrating simulation into transitioning
healthcare services. Our goals include:

1. Share lessons learned and support local simulation teams in their preparations;

2. Quantitatively demonstrate improvement in system readiness and staff preparedness at
each institution

3. Assess saturation of latent safety threats over successive TESTPILOT implementations,
resulting in a blueprint for similar transitions.

During Phase I the investigators standardized, refined and validated survey instruments with
NICU staff and process experts. Phase II includes implementation of TESTPILOT at 15
institutions over three years. The Principal Investigator recruits each institution and
guides them through the methodology, typically lasting six to eight months. Each
institution's Co-Investigator and core simulation team recruits local staff for simulation,
LST discovery and resolution, and survey completion.

Inclusion Criteria:

- NICUs transitioning during the study period will be recruited.

- Active NICU staff at each institution will be encouraged to participate without
regard to age, gender, race, pregnancy or health status.

- The participants will be a representative sample of the overall staff, which includes
primarily women in most NICUs.

Exclusion Criteria:

- Institutions unable to commit resources for simulation preparation, latent safety
threat correction, or study reporting requirements
We found this trial at
Providence, Rhode Island 02905
Principal Investigator: Jesse Bender, MD
Phone: 401-274-1122
Providence, RI
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