Using simulation to prepare multidisciplinary teams and clinical environments for complex fetal interventions and resuscitation.

OBJECTIVE

Identify overt and latent weaknesses in preliminary plans for initiating a Fetoscopic Endoluminal Tracheal Occlusion program.

STUDY

DESIGN

Clinical scenarios involving placement and removal of a fetal tracheal occlusion device for fetuses with severe congenital diaphragmatic hernia were simulated. All sessions took place in the actual hospital environments and were captured on video for later playback, transcription and analysis.

RESULTS

Simulation-based investigation produced: • a list of plausible scenarios • lists of equipment required • diagrams of room setup and positioning of personnel • decision trees for each scenario • situation awareness issues • workflow issues • areas requiring additional planning.

CONCLUSIONS

Using appropriate patient simulators and task trainers, teams experienced multiple realistic scenarios that facilitated the development of equipment lists, room setup diagrams, and tactics to remediate identified weaknesses. Simulation is a useful strategy to prepare for the implementation of new, high-risk clinical programs.