Mount Sinai training grounds for better critical care

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Charlie, a Mount Sinai Hospital patient, suffers from complex maladies and is in critical condition. His pneumonia has gotten worse and his breathing is failing.

Fortunately for Charlie, he was surrounded by an interprofessional team of registered nurses and respiratory therapists who have come from across Ontario to learn more about how to better treat him. So far, this seems like a normal scene in many a teaching hospital.

Not so. It’s actually a remarkable situation, since the unique aspect of Charlie’s condition is that he’s made of plastic. Charlie, better known as “SimMan,” is a $50,000 synthetic patient used to train health-care professionals at Mount Sinai Hospital how to respond to a variety of life-threatening conditions.

The Canadian Resuscitation Institute (CRI), with funding from the Ministry of Health and Long-term Care, has established the Training Centre at Mount Sinai Hospital. The CRI Training Centre, in collaboration with the existing Mount Sinai Program for Resuscitation Education and Patient Safety, is the training site for more than 240 health-care providers from across Ontario to teach them how to work in interprofessional Critical Care Response Teams (CCRT), consisting of intensive care physicians, intensive care nurses and respiratory therapists. The teams are designed to improve patient care through earlier recognition of deteriorating patients and more rapid access to expert care from ICU nurses and respiratory therapists guided by a critical care physician. The team brings the ICU to the bedside of ill patients. CCRTs have the potential to help decrease the number of patients admitted to the expensive and frequently overcrowded ICU.

“Mount Sinai Hospital is recognized internationally as a centre of excellence in providing simulation-based education to interprofessional teams,” explains Dr. Randy Wax, Medical Director of the Mount Sinai Program for Resuscitation Education and Patient Safety (PREPS) and Intensivist in Mount Sinai Hospital Critical Care Unit. “The CCRT training allows teams of professionals to learn and work together, which is necessary in enhancing patient safety. We are incredibly pleased that we have this opportunity to work with the Canadian Resuscitation Institute in the delivery of courses through the CRI Training Centre established here at Mount Sinai.”

The CCRT training uses patient simulators to create critical care situations. The machines, similar to those used to train pilots how to fly, can be monitored for vital signs and require the same care as real patients. In fact, the “SimMan” is so realistic it can speak to the healthcare professionals just as a patient would.

“The training introduces a new approach to critical care, which takes down the ICU walls as ICU healthcare providers collaborate with outside departments to detect deteriorating patients before they enter the ICU,” says Dr.Wax. “For instance, the patient simulators train Registered Nurses and Respiratory Therapists to recognize a patient who is going into cardiac arrest before it happens. Patient outcomes are usually better when we can prevent cardiac arrest, rather than struggling to bring them back to life.”

“Overall the training is a great review to brush up on our skills,” explains Maria Kobylecky, Credit Valley Hospital RN. “The simulation training creates realistic life scenarios we encounter every day.”

The Ontario Ministry of Health and Long-term Care plan to fund and implement the Critical Care Response Team program in 22 Ontario hospitals, including Mount Sinai Hospital, is equivalent to adding over 50 ICU beds to provincial resources at half the cost due to more efficient use of existing ICU beds.