CE Webinar:

Hospital at Home: Development of New Care Model for Medical Simulation

Presented by: Cheng-Kai Kao, MD,  Priti Jani, MD
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This CE webinar will host an interprofessional panel who will discuss their collaborative effort to use medical simulation to validate workflows and identify latent safety threats before implementing a new Hospital at Home program that provides acute hospital care in a patient’s home.
  • Recorded: July 17th, 2024
  • Access: FREE for Live Event,
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  • Certificate: 1 Contact Hour of RN CE
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  • Method: Lecture with Slides
  • Duration: 1 Hour
  • Level: Beginner

Presentation Abstract:

The interdisciplinary panel of speakers will discuss their experience of using system-focused simulation to test the quality and safety of a new and complex clinical care model, Hospital at Home, in the pre-implementation phase. Hospital at Home is an innovative care model providing hospital-level care in the patient's home, which allows eligible patients to receive acute care and recover in the comfort of their homes. It entails many of the same care processes occurring in the brick and mortal hospital, including clinician visits, vital signs, lab and diagnostic studies, medications, auxiliary therapies, and meals. In essence, this entailed developing a new hospital system outside the hospital, inclusive of the workflows, communication patterns, information technology infrastructure and care processes. A large interdisciplinary effort was undertaken to delineate the processes and best workflows from entry into the program through discharge. Kaizen events, steering committee meetings, and patient-centered focus groups drove the creation of the standard work.
Upon creation of the standard work, several tabletop simulations were conducted to confirm the appropriate processes and personnel, and identify potential system stress-points. This was then followed by “Day in The Life” (DiTL) simulations that included realistic scenarios with simulated patients and were designed to (1) validate and test – equipment, communication, procedures, and workflows and (2) discover – latent safety threats, resolutions to issues, opportunities to optimize quality of care and patient safety. Simulations encompassed the Hospital at Home process by beginning with patient eligibility and consent, the hospital stay, transitioning to home, care at home as a Hospital at Home patient and lastly discharge. Each simulation had participants in-person and via Zoom with members from the full interprofessional team (e.g., nursing, physicians, pharmacists, social workers, home nursing) and the hospital system team (e.g., IT, supply chain, pharmacy, operational excellence, simulation). Throughout the phases of the Hospital at Home program, the teams participated in focused interval debriefs centered on the SEIPS 2.0 (Systems Engineering Initiative for Patient Safety) human factors framework. The debriefs culminated in approximately 120 opportunities for improvement that were then triaged by criticality and importance to be addressed longitudinally.
Following the simulated sessions, the clinical team was equipped with valuable insights that significantly improved readiness to enroll the first patient in the Hospital at Home program. The team analyzed the outcomes, feedback, and learning points from the simulations and promptly integrated them into protocols and procedures. This involved refining the patient enrollment approach, fine-tuning equipment use, honing emergency response protocols, and enhancing interpersonal communication strategies to ensure a patient-centric approach. By learning from the simulated experiences, the team created a more robust and effective system, significantly reducing the potential for errors or mishaps. As a result, the team members were more confident in their ability to provide acute hospital-level care at home and better prepared to meet the unique needs and preferences of the first patient in the program. This iterative learning process ultimately elevated the standard of care provided, optimizing the patient experience from the get-go.

Learning Objectives:

  1. Characterize the integration of simulation into a multidisciplinary effort for the development of a new clinical care model.
  2. Describe the collaborative use of simulation and operational excellence programs in the pre-implementation testing of the new Hospital at Home program.
  3. Demonstrate the impact of using the collective approaches of systems-focused simulation and operational excellence on process design and improvement, patient safety, and care delivery for new clinical models

Meet the Presenter:

Cheng-Kai Kao, MD

Chief Medical Information Officer at University of Chicago Medicine
Cheng-Kai Kao, MD, is an academic hospitalist board-certified in clinical informatics. In addition to clinical practice and residency education, his areas of interest in informatics include clinical decision support, mobile health, data analytics, and healthcare innovation. As chief medical information officer, he leads multiple initiatives that leverage information technology to provide decision support for the frontline clinicians to ensure patient safety, optimize clinical workflow to increase work efficiency, enhance the usability of the electronic health record system to reduce screen time, and make innovations to improve care quality and patient experience. He is the course instructor of clinical informatics at the Pritzker School of Medicine and Graham School Master Program of Biomedical Informatics at the University of Chicago.
Dr. Kao also serves as the Medical Director in the Office of International Programs. He oversees the clinical course of international patients from all over the world, optimizes their care quality and patient experience, promotes the knowledge transfer service, and fosters collaboration with overseas academic medical centers and healthcare organizations.
Dr. Kao is also the site principal investigator of several phase III clinical trials on novel oral anticoagulants, one of which led to the FDA approval of a new oral anticoagulant. Dr. Kao was named as Top Hospitalist by the American College of Physicians Hospitalist magazine in 2017.
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Disclosures:  None.

Priti Jani, MD

Faculty Director UChicago Simulation Center at University of Chicago Medicine
Priti Jani, MD, MPH, is a specialist in pediatric critical care medicine. Dr. Jani’s scholarly focus lies at the intersection of research in simulation-based medical education and resuscitation quality improvement. She develops and investigates simulation-based educational curricula and quality improvement initiatives towards improving individual team and system-level performance with the goal of translation to improved patient outcomes. A dedicated educator, she utilizes her expertise in simulation to direct and develop curricula for trainees and healthcare teams. Serving as the Chair of the Pediatric CPR Committee and Pediatric Resuscitation Quality Committee, as well as the Faculty Director of the UChicago Simulation Center. Dr. Jani is highly invested in using simulation to further advance education safety and quality at the University of Chicago Medicine and Comer Children’s Hospital.
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Disclosures: None.

Melissa Cappaert, MA

Executive Director at University of Chicago Medicine
Melissa Cappaert, MA, is the Executive Director of the University of Chicago Medicine Simulation Center, providing administrative leadership and strategic planning. With over 15 years in the field of medical simulation, she offers expertise in simulation-based curriculum development, continuous healthcare quality improvement scholarship, and innovation in medical education.
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Disclosures: None.

Hasime Adili

Director at University of Chicago Medicine
Hasime Adili serves as the Director of Operational Excellence at UChicago Medicine. In this role, she leads a team of Operational Excellence Partners who coach and mentor on UChicago Medicine's Leadership Philosophy E4 Leadership, and lead Capability Development Performance Improvement, and Integrated Facility Design across the system. Hasime joined the University of Chicago Medicine in 2016. Before joining the Operational Excellence Team, she was the Project Manager for the Women’s and Children’s Service Line. She was primarily responsible for data analytics process improvement and projects across facilities information technology and strategic initiatives for the Children’s Hospital and Women’s Care Center. Within Operational Excellence, she led performance improvement initiatives and Integrated Facility Design projects for Patient Care Services and Women’s & Children’s Services. Hasime holds an undergraduate degree in Health Systems Management from Loyola University Chicago.
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Disclosures: None.

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Meet the Webinar Hosts:

Lance Baily, BA, EMT-B

Founder / CEO - HealthySimulation.com
Lance W. Baily, BA, EMT-B is the Founder / CEO of HealthySimulation.com, the world’s leading healthcare simulation resource website which supports thousands healthcare professionals a month. As an experienced entrepreneur, digital media producer and administrative professional, Lance has the background and the experience necessary to help guide the clinical simulation industry to mass adoption.

Lance is also the Founder of SimGHOSTS.org, the leading 501(c)3 non-profit organization dedicated to supporting healthcare professionals operating clinical simulation technologies which has organized over twenty hands-on training conferences around the globe since 2011. His co-edited  book “Comprehensive Healthcare Simulation: Operations, Technology, and Innovative Practice” provides 400 pages of in-depth articles supporting the technical integration of medical simulation in any sized program.

Formerly he served as Director of the Nevada System of Higher Education’s Clinical Simulation Center of Las Vegas, Simulation Technician for the LA Community College District, and volunteer Fire-Fighter, after receiving his BA in Film and Digital Media Production and working on Hollywood production sets. He currently lives with his wife and two young daughters in Las Vegas.
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Disclosures: Founder/CEO/Owner of HealthySimulation.com, Founder of SimGHOSTS.org

Teresa Gore, PhD, DNP, APRN, FNP-BC, CHSE-A, FSSH, FAAN

Content Manager at HealthySimulation.com
Teresa Gore, PhD, DNP, APRN, FNP-BC, CHSE-A, FSSH, FAAN - Dr. Gore has experience in educating future nurses in the undergraduate and graduate nursing programs. Dr. Gore has a PhD in Adult Education, a DNP as a family nurse practitioner, and a certificate in Simulation Education. Dr. Gore is an innovative, compassionate educator and an expert in the field of healthcare simulation. In 2007l Teresa started her journey in healthcare simulation. She is involved in INACSL and SSH. She is a Past-President of INACSL and is a Certified Healthcare Simulation Educator Advanced (CHSE-A). In 2018, she was inducted as a Fellow in the American Academy of Nursing (FAAN). In 2021, she was inducted as a Fellow in the Society of Simulation in Healthcare Academy (FSSH) and selected as a Visionary Leader University of Alabama at Birmingham School of Nursing Alumni. During her career, Dr. Gore has led in the development and integration of simulation into all undergraduate clinical courses and started an OSCE program for APRN students. Her research interests and scholarly work focus on simulation, online course development and faculty development. She has numerous invited presentations nationally and internationally on simulation topics.
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Disclosures: Dr. Gore is employed by HealthySimulation.com

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