A novel in situ simulation framework for introduction of a new technology: the 3-Act-3-Debrief model

Lisa T Barker; William F Bond; Andrew L Vincent; Kimberly L Cooley; Jeremy S McGarvey; John A Vozenilek; Emilie S Powell

doi:10.1186/s41077-020-00145-x

A novel in situ simulation framework for introduction of a new technology: the 3-Act-3-Debrief model

Lisa T Barker, William F Bond, Andrew L Vincent, Kimberly L Cooley, Jeremy S McGarvey, John A Vozenilek, Emilie S Powell

Research output: Contribution to journal › Article › peer-review

Abstract

Background: New technologies for clinical staff are typically introduced via an "in-service" that focuses on knowledge and technical skill. Successful adoption of new healthcare technologies is influenced by multiple other factors as described by the Consolidated Framework in Implementation Research (CFIR). A simulation-based introduction to new technologies provides opportunity to intentionally address specific factors that influence adoption.

Methods: The new technology proposed for adoption was a telehealth cart that provided direct video communication with electronic intensive care unit (eICU) staff for a rural Emergency Department (ED). A novel 3-Act-3-Debrief in situ simulation structure was created to target predictive constructs from the CFIR and connect debriefing to specific workflows. The structure and content of the simulation in relation to the framework is described. Participants completed surveys pre-simulation/post-simulation to measure change in their readiness to adopt the new technology.

Results: The scenario was designed and pilot tested before implementation at two rural EDs. There were 60 interprofessional participants across the 2 sites, with 58 pre-simulation and 59 post-simulation surveys completed. The post-simulation mean ratings for each readiness measure (feasibility, quality, resource availability, role clarity, staff receptiveness, and tech usability) increased significantly as a result of the simulation experience.

Conclusions: A novel 3-stage simulation-debriefing structure positively targets factors influencing the adoption of new healthcare technologies.

Original language	English (US)
Article number	25
Pages (from-to)	25
Journal	Advances in simulation (London, England)
Volume	5
Issue number	1
Early online date	Sep 25 2020
DOIs	https://doi.org/10.1186/s41077-020-00145-x
State	Published - Dec 2020

Keywords

Healthcare simulation, Telehealth, Debriefing, Sepsis, Interprofessional simulations, Health information technology, Implementation research

ASJC Scopus subject areas

Ecology, Evolution, Behavior and Systematics
Cognitive Neuroscience
Developmental Neuroscience
Phychiatric Mental Health
General Social Sciences
General Psychology

Online availability

10.1186/s41077-020-00145-xLicense: CC BY

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title = "A novel in situ simulation framework for introduction of a new technology: the 3-Act-3-Debrief model",

abstract = "Background: New technologies for clinical staff are typically introduced via an {"}in-service{"} that focuses on knowledge and technical skill. Successful adoption of new healthcare technologies is influenced by multiple other factors as described by the Consolidated Framework in Implementation Research (CFIR). A simulation-based introduction to new technologies provides opportunity to intentionally address specific factors that influence adoption.Methods: The new technology proposed for adoption was a telehealth cart that provided direct video communication with electronic intensive care unit (eICU) staff for a rural Emergency Department (ED). A novel 3-Act-3-Debrief in situ simulation structure was created to target predictive constructs from the CFIR and connect debriefing to specific workflows. The structure and content of the simulation in relation to the framework is described. Participants completed surveys pre-simulation/post-simulation to measure change in their readiness to adopt the new technology.Results: The scenario was designed and pilot tested before implementation at two rural EDs. There were 60 interprofessional participants across the 2 sites, with 58 pre-simulation and 59 post-simulation surveys completed. The post-simulation mean ratings for each readiness measure (feasibility, quality, resource availability, role clarity, staff receptiveness, and tech usability) increased significantly as a result of the simulation experience.Conclusions: A novel 3-stage simulation-debriefing structure positively targets factors influencing the adoption of new healthcare technologies.",

keywords = "Healthcare simulation, Telehealth, Debriefing, Sepsis, Interprofessional simulations, Health information technology, Implementation research",

author = "Barker, {Lisa T} and Bond, {William F} and Vincent, {Andrew L} and Cooley, {Kimberly L} and McGarvey, {Jeremy S} and Vozenilek, {John A} and Powell, {Emilie S}",

note = "This study has been funded by Agency for Healthcare Research and Quality Grant 1 R18 HS024027-01 “In-situ Simulation for Adoption of New Technology to Enhance Safety in Rural EDs”. The authors would like to acknowledge simulation specialist, Dustin Holzwarth; Jump Simulation Research Assistant Chase Salazar; the Standardized Participant Program at Jump Simulation; OSF ConstantCare eICU staff: William Tillis, MD, Toni Bortell, RN; Sarah Metzger, RN; Lori Nelson, RN; Courtney Pilat, RN; Erika Shaw, RN, and Vicki Weatherington, RN; Rural ED leadership: Erin Nimbler, RN and Lisa Sopher, RN; and all other OSF Saint James ED and OSF St. Mary{\textquoteright}s ED staff who participated and provided feedback during the study. For the manuscript, we also acknowledge Kyle Formella, MS for the graphics designed to visually convey the concepts presented.",

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doi = "10.1186/s41077-020-00145-x",

language = "English (US)",

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AU - Barker, Lisa T

AU - Bond, William F

AU - Vincent, Andrew L

AU - Cooley, Kimberly L

AU - McGarvey, Jeremy S

AU - Vozenilek, John A

AU - Powell, Emilie S

N1 - This study has been funded by Agency for Healthcare Research and Quality Grant 1 R18 HS024027-01 “In-situ Simulation for Adoption of New Technology to Enhance Safety in Rural EDs”. The authors would like to acknowledge simulation specialist, Dustin Holzwarth; Jump Simulation Research Assistant Chase Salazar; the Standardized Participant Program at Jump Simulation; OSF ConstantCare eICU staff: William Tillis, MD, Toni Bortell, RN; Sarah Metzger, RN; Lori Nelson, RN; Courtney Pilat, RN; Erika Shaw, RN, and Vicki Weatherington, RN; Rural ED leadership: Erin Nimbler, RN and Lisa Sopher, RN; and all other OSF Saint James ED and OSF St. Mary’s ED staff who participated and provided feedback during the study. For the manuscript, we also acknowledge Kyle Formella, MS for the graphics designed to visually convey the concepts presented.

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N2 - Background: New technologies for clinical staff are typically introduced via an "in-service" that focuses on knowledge and technical skill. Successful adoption of new healthcare technologies is influenced by multiple other factors as described by the Consolidated Framework in Implementation Research (CFIR). A simulation-based introduction to new technologies provides opportunity to intentionally address specific factors that influence adoption.Methods: The new technology proposed for adoption was a telehealth cart that provided direct video communication with electronic intensive care unit (eICU) staff for a rural Emergency Department (ED). A novel 3-Act-3-Debrief in situ simulation structure was created to target predictive constructs from the CFIR and connect debriefing to specific workflows. The structure and content of the simulation in relation to the framework is described. Participants completed surveys pre-simulation/post-simulation to measure change in their readiness to adopt the new technology.Results: The scenario was designed and pilot tested before implementation at two rural EDs. There were 60 interprofessional participants across the 2 sites, with 58 pre-simulation and 59 post-simulation surveys completed. The post-simulation mean ratings for each readiness measure (feasibility, quality, resource availability, role clarity, staff receptiveness, and tech usability) increased significantly as a result of the simulation experience.Conclusions: A novel 3-stage simulation-debriefing structure positively targets factors influencing the adoption of new healthcare technologies.

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A novel in situ simulation framework for introduction of a new technology: the 3-Act-3-Debrief model

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