Ten clinicians stride into a hospital room and immediately begin to examine the scene.
An IV bin is bursting with syringes. Unclamped oxygen sensors hang idly on the bed. And bloodied gauze, an open vial of antibiotics and a poorly placed toileting chair expose this patient – a computerized high-fidelity “Sim Man” in the University of Virginia School of Nursing’s Clinical Simulation Learning Center – to a multitude of hazards.
Welcome to the “Room of Errors.”
The exercise, organized by the Center for ASPIRE – Academic Strategic Partnerships for Interprofessional Research and Education, the hub of interprofessional research, activities and education for U.Va.’s schools of Nursing and Medicine – recently rallied 11 nurses, six physicians, four pharmacists and two physical and occupational therapists, who had seven minutes to identify more than 30 pre-planted errors. The idea, said organizer Dr. Julie Haizlip, ASPIRE’s co-director and a nursing and medical professor, is to drive home the Institute of Medicine’s interprofessional mandate – an integral part of nursing and medical education at U.Va. – beyond the classroom and into the unit to practicing caregivers.
"Safe, excellent care of patients requires the collaborative work of an effective team of health care professionals,” said Dr. Randolph Canterbury, senior associate dean of the School of Medicine and the Wilford W. Spradlin Professor. “Nurses, doctors, pharmacists, therapists and many others have specific and complementary roles in patient care and each team member has the responsibility of ensuring our patients receive the safest and best care available. ASPIRE is evidence of U.Va.’s commitment to effective interprofessional team care."
There is ample evidence to back U.Va.’s interprofessional focus. Clinicians adept at working as part of health care teams cause fewer medical errors. Hospitals where collaborative practice is the norm experience fewer errors and adverse events. Health care professionals who work as part of highly functional care teams are less stressed, more compassionate, more resilient caregivers. And patients treated by those with a strong ability to collaborate receive safer, more empathic, higher-quality care.
The Room of Errors is one of a host of interprofessional education exercises and activities for students and clinicians that received more than $1 million in funding from the U.S. Health Resources and Services Administration earlier this year. The three-year grant will include in its latter phase a measurement of the activities’ effects on clinicians, and places a particular focus on building teamwork skills of nurses, doctors and others who care for patients with multiple chronic conditions.
U.Va.’s interprofessional education efforts began in 2009, and culminated in the establishment of the Center for ASPIRE in early 2013. More than 25 interprofessional learning opportunities are now available for nursing and medical students, while a wide variety of research on their effects, measurability and long-term efficacy is also being studied.
“There is not one of us who can’t use some skill-sharpening in the area of teamwork,” said Dr. Valentina Brashers, ASPIRE’s founder and co-director. “Our efforts are moving beyond the classroom to engage practicing clinicians as well, and our ability to test how we’re doing through novel protocols we’ve developed will indicate whether we’re on the right road to success – or if our methods need tweaking.”
“This exercise emphasizes the importance of everyone’s knowledge and skill set,” Haizlip added. “By demonstrating that we each approach the patient and the room differently, it becomes apparent how much we rely on one another.”