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Using Multidisciplinary Simulation To Prepare The Community For Pediatric Trauma Designation
*Katherine M Gautreaux, *John A. Coley, *Julie M. Hollan, *Christi M. Reeves, Gemma F. Elegores
Texas Children's Hospital, Houston, TX

BACKGROUND
It is important that a well-thought out organizational plan is in place when applying for trauma center designation, particularly in reference to establishing a trauma activation process. We employed multidisciplinary simulation to test the system, identify latent safety threats (LSTs), and resolve process issues in our trauma activation before designation at two community hospitals.
METHODS
A multidisciplinary workgroup was formed with representation from emergency medicine, critical care, surgery, nursing, ancillary services, and the simulation center. A needs assessment was conducted to identify system testing priorities: communication, equipment functionality, role and responsibility identification, and interdisciplinary synchronization. A large scale in situ simulation was held to provide the team with a realistic experience. The case scenario was developed based on historical campus data with components written to test the priorities identified in the needs assessment. Following the scenario, a robust debriefing ensued. A failure modes and effects analysis (FMEA) report was generated, including findings and recommendations discussed by the group.
RESULTS
We had a total of 24 participants and 48 observers at the two campuses. The multidisciplinary team identified 23 LSTs from each campus. Action items were generated with responsible parties and deadlines for each LST on the FMEA report.
CONCLUSION
Pre-designation simulation uncovered the system's weaknesses and provided an opportunity for the care team and leadership to mitigate future system issues. The use of simulation in the trauma designation activation process provides a safe learning environment in which healthcare providers can test new clinical processes.


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