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The Emergency Department Team at Ascension's St. Mary's Healthcare, Amsterdam, New York, recently worked with the Yale School of Medicine training team to help improve health outcomes and survival for critically ill and injured infants and children through simulation-based interventions.

A mobile team from Yale, including a pediatric ED physician, a pediatric nurse educator and a parent actor, brought high-fidelity mannequins of infants and toddlers that imitate real-life health threats in the young population. The St. Mary's Emergency Department Team was observed as they engaged in treatment of the young [simulated] patients. The care team participated in several scenarios, which were digitally recorded to assist the staff with their review of team communication and processes during the interaction.

After each simulated scenario, the involved ED staff participated in a post-performance debriefing, discussing their comfort levels and questions about the situation. Open discussion enabled staff and the Yale facilitation team to analyze and identify actions, thought processes, and organizational structures that they considered strengths, and provided an opportunity to highlight ideas for improvement, such as specialized equipment for pediatric patients.

Iain Holmes, Manager of the St. Mary's Emergency Department, was enthusiastic about the unique training experience. "Research shows that the majority of critically ill pediatric patients present to community hospitals like ours," Iain said. "While we care for many sick children, it is not a common occurrence for St. Mary's to care for a young patient experiencing a life or death condition. … Having Yale School of Medicine come to us with their vast knowledge and resources is one tool we are using to ensure that when a young member of our community is critically ill, we will be ready."

Marc Auerbach, MD, FAAP, MSc, Associate Professor of Pediatrics (Emergency Medicine) and of Emergency Medicine with the Yale School and Medicine, served as facilitator for the mobile team at St. Mary's.

While initially nervous about the visible recording equipment, Emergency Department staff quickly embraced the value of the hands-on, real-time evaluation of their response to pediatric patients and the immediate ability to develop ideas to improve the process. Staff members were expected to respond using normal procedures including equipment, medication administration and team communication.

The recommendations and outcomes of the teams will be reviewed and a plan of action implemented to further strengthen the ability of the St. Mary's Emergency Department to serve pediatric patients. The process was described as a "win-win" for the ED staff and the pediatric patients that they serve.

Pictured from left:​ Donna McClements, RN, St. Mary's Healthcare Emergency Department; Thomas Isenovski, MD, St. Mary's ED; an actress from Yale School of Medicine; and Michelle Hale, RN, St. Mary's ED, demonstrate a simulation-based intervention.​