527 - Resuscitation and Simulation Curriculum for Pediatric Residents to Improve Provider Communication During Pediatric Rapid Response Team Events

Sunday, April 30, 2023

3:30 PM – 6:00 PM ET

Poster Number: 527
Publication Number: 527.327

James W. Beal, Johns Hopkins Children's Center, Baltimore, MD, United States

Presenting Author(s)

James W. Beal, DO (he/him/his)

Pediatric Critical Care Fellow
Johns Hopkins Children's Center
Baltimore, Maryland, United States

Background: Communication errors are major determinants of medical errors and patient harm. Communication in emergencies becomes more important as there is less time to convey critical information. Emergency situations on pediatric inpatient units are managed by pediatric residents until the arrival of a rapid response team (RRT). Pediatric residents may not have significant experience to manage pediatric emergencies and to give effective emergency handoff to RRT members. The communication at RRT events can be poor between the two teams. Additional education and simulation training on how to manage pediatric emergencies is needed for pediatric residents as well as focused training for communicating effectively with emergency handoff.

Objective:

We proposed that implementing a multimodal simulation-based educational curriculum for pediatric resident physicians focused on: 1) emergency management and resuscitation 2) standardization of communication using ABC-SBAR (Airway, Breathing, Circulation, Situation, Background, Assessment, Recommendation) 3) utilization of an ABC-SBAR cognitive aid, and 4) RRT event focused simulations will improve communication between pediatric residents and RRT members during real patient emergencies.

Design/Methods: A curriculum was designed to include ABC-SBAR training sessions, quarterly case-based didactics, and twice monthly high-fidelity simulations. Surveys focused on critical resuscitation skills, components of ABC-SBAR, and assessment of emergency handoff communication were completed by pediatric residents, pediatric critical care fellows, and nursing shift coordinators and were collected after real RRT events before and after the implementation of the curriculum.

Results: Retrospective analysis of survey results included data from residents (n=80), pediatric critical care fellows (n=124), and nursing shift coordinators (n=23). Fellow assessment of emergency handoff communication on a 4 point Likert scale demonstrated mean scores pre and post-intervention of 2.78 (SD 1.09) and 3.23 (SD 0.79) with p=0.019. Resident self-assessment of communication on a 4 point Likert scale showed mean scores pre and post-intervention of 2.26 (SD 0.83) and 2.33 (SD 0.79), p=0.71.

Conclusion(s): Results demonstrate that emergency management and communication focused training for pediatric residents using a multimodal and simulation-based curriculum can improve the efficacy of communication between providers during acute pediatric emergencies.