Paediatric Intensive Care Retrieval Service and the New ... · Jennifer Scarth, Jon McCormack ......

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

Paediatric Intensive Care Retrieval ServicePaediatric Intensive Care Retrieval Service and the and the

New Scottish Mobile Clinical Skills UnitNew Scottish Mobile Clinical Skills Unit

David RowneyDavid RowneyHeather Blyth, Sandra Stark, Neil Spenceley, Margaret Currer, MaHeather Blyth, Sandra Stark, Neil Spenceley, Margaret Currer, Mark Davidson, rk Davidson,

Jennifer Scarth, Jon McCormack, Jeanette Stevenson, Jean KerJennifer Scarth, Jon McCormack, Jeanette Stevenson, Jean Ker

Audit of HDC for Children and Young People in Scotland 2009Audit of HDC for Children and Young People in Scotland 2009

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

Scottish Paediatric Retrieval ServiceActivity: 2001– 08

2680 referrals 1834 retrievals from 43 hospitals

050

100

150 200 250 300 350 400

450

2003-04 2004-05 2005-06 2006-07

ReferralsTransfers

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

The Scottish Paediatric Retrieval Service• 200 children critically ill or injured in R&R Scotland annually• Role of the Paediatric Retrieval Service

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

The Scottish Paediatric Retrieval Service• 200 children critically ill or injured in R&R Scotland annually• Role of the Paediatric Retrieval Service

Critical Care Network:

Referring teamReferring team PICUPICURetrievalRetrievalServiceService

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

The Scottish Paediatric Retrieval Service• 200 children critically ill or injured in R&R Scotland annually• Role of the Paediatric Retrieval Service

Critical Care Network:

Referring teamReferring team PICUPICURetrievalRetrievalServiceService

Facilitate the provision of seamless careFacilitate the provision of seamless carefor critically ill or injured children in Scotland.for critically ill or injured children in Scotland.

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

The Scottish Paediatric Retrieval Service• 200 children critically ill or injured in R&R Scotland annually• Role of the Paediatric Retrieval Service

Critical Care Network:

Referring teamReferring team PICUPICURetrievalRetrievalServiceService

Facilitate the provision of seamless careFacilitate the provision of seamless carefor critically ill or injured children in Scotland.for critically ill or injured children in Scotland.

Skill acquisition and maintenance essential to manage emergencies

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

The Scottish Clinical Skills Strategy

4 elements to the strategy:

1. Scottish Clinical Skills Alliance

2. Managed Educational Network

3. NES Programme Board

4. Mobile clinical skills training unit

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

www.csmen.ac.uk

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

Rationale for Collaboration

• Need for national skills education programme in stabilisation of the critically ill or injured child confirmed by:

• Training needs analysis of 143 R&R practitioners• Audit of skills education currently available in Scotland

• But how to deliver the programme consistently?

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

Mobile Clinical Skills Unit

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

Mobile Clinical Skills Unit

• A key tool in addressing inequality in access to training

• Enabling mid-fidelity simulators and an integrated video debriefing system to be used in Remote & Rural areas

• 2-year pilot funded by NES

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

Pod Pod

Control Booth

Retractable LCD DisplayOne-way Glass Observation Window

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

Skills Unit Locations 2009• January – August 2009

• 8 locations• 2h driving time to unit locations

• Candidates:• Anaesthesia• Emergency medicine• Paediatric medicine• General Practice• Nurse practitioners• Medical & nursing students

Skills Unit locations

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

Paediatric Retrieval Outreach Study Day

• Consistent teaching and standards across Scotland• Core PICU/Retrieval team faculty delivering a standardised programme in all locations:

• am: lectures:– Airway– Shock– Inotropes

• am: workshops:– Airway/breathing– Shock/inotropes– Rhythm recognition

• pm: scenario simulations:– Bronchiolitis– Meningitis– Status epilepticus– Cardiac arrest

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

Evaluation of study day

• Logistics of delivering the course via mobile unit

• Educational impact to be measured using Kirkpatrick’s 4 levels as far as possible

• Post-course questionnaire on the day• focus groups after 3 months• further questionnaire after 6 months (have skills been

used, are people more confident?)

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

First Course: Fort William, January 2009

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

Candidate Feedback – study day & unit facility

• >90% excellent/good:• Overall session rating• Team organisation• Equipment quality• Tutor quality

• Comments:» 85% “informative”» 70% “instructive”» 70% “worthwhile”» 70% “practical”» 60% “valuable”

0%

20%

40%

60%

80%

100%

Overall rating Team Organisation Unit facilities Equipment Quality Tutor Quality

Very Poor

Poor

Satisfactory

Good

Excellent

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

Candidate Feedback – knowledge, skills and confidence

0%

20%

40%

60%

80%

100%

Knowledgeimproved after

lectures

Skills improvedafter workshops

Confidenceimproved after

scenarios

Observingscenarios useful

Teamworkinguseful

strongly disagreedisagreeneutralagreestrongly agree

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

Candidate Feedback – scenarios

0%

20%

40%

60%

80%

100%

Realistic Feedback constructive Trainers supportive Necessary skills covered

strongly disagree

disagree

neutral

agree

strongly agree

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

Thank you

www.paedsretrieval.com www.csmen.ac.uk

Scottish Paediatric Retrieval Service

Hosted by the University of DundeeA Scottish Registered Charity - No. SC015096

Kirkpatrick’s Four Levels of Evaluation• Kirkpatrick’s four levels:

• level 1 evaluation of reactions• level 2 evaluation of learning• level 3 evaluation of behaviour• level 4 evaluation of results

• The first three can be measured easily• The fourth is more difficult – how will the skill be performed

6 months after the study day?