Canadian Network for Simulation in Healthcare (CNSH) Meeting Summary Canadian Network for Simulation in Healthcare Meeting Summary (September 24, 2008) 1. Introductory Comments Joe Gebran (CPSI) set the stage for the meeting by highlighting that the major purpose for the day was to validate the work that was undertaken based on decisions made in March 2008. In particular, it was agreed that Working Groups would initiate planning in several key areas and that a Business Plan would be developed for an arms-length and inclusive national organization dedicated to advancement and promotion of simulation in healthcare. 2. Business Plan Review As a representative of the small group who developed the draft Business Plan for a Canadian Network for Simulation in Healthcare (CNSH), Pam Morgan reviewed key components of the draft plan. The remainder of the morning was dedicated to reviewing and providing feedback to sections of the plan. Major consultation questions that were posed include: • Are the vision, mission and core roles, as articulated in the business plan, appropriate for this network? • Given your understanding of the core roles of the CNSH, will the proposed value propositions be sufficiently attractive to entice support and involvement in the CNSH? • Given your understanding of Canada’s patient simulation community, do the proposed elements of a leadership model form a sufficient basis for further development of the CNSH? − Are the principles appropriate? − Do you agree that a small Steering Committee with Working Groups is the right approach to promote involvement from a range of stakeholders? − Can you support the notion of an interim Steering Committee with defined responsibilities? 1 CPSI and the Canadian Network for Simulation in Healthcare would like to acknowledge funding support from Health Canada. The views expressed here do not necessarily represent the views of Health Canada. Canadian Network for Simulation in Healthcare (CNSH) Meeting Summary • Do you support a funding strategy where the CNSH generates revenue largely on the basis of value-added services over the longer term? Is the proposed revenue stream in the “order of magnitude” that you would expect for the CNSH to fulfill the proposed roles? • Do the proposed Priority Actions for 2008/2009 strike an appropriate balance between demonstrating sufficient value to Canada’s patient simulation stakeholders and building organizational capacity to deliver on the range of roles proposed in this plan? • Are there other major risks that you believe the CNSH needs to proactively manage? Comments that are specific to sections of the plan are noted below. In addition, overall comments were provided that apply throughout the document including the following: • The term “patient simulation” is confusing given the narrower historical applications of patient simulation as a tool for teaching technical skills and the broad interpretation of “simulation”. The term “patient-centred simulation” was suggested as appropriately describing what is intended as the focus for the CNSH. • The document needs to reflect that simulation is increasingly being used for a wide range of purposes including teaching, research, certification and regulation. • Enhancing appropriate use of patient-centred simulation is important as opposed to blindly advocating for enhanced simulation in general. Vision • The vision was generally supported, subject to describing a stronger connection between enhanced simulation and improved patient outcomes. Mission • There was mixed reaction to the notion of the CNSH being a platform for promotion and advancement of simulation. While some felt that a platform is necessary and accurately describing the mission of the CNSH, others felt that something more action-oriented would be more appropriate. 2 CPSI and the Canadian Network for Simulation in Healthcare would like to acknowledge funding support from Health Canada. The views expressed here do not necessarily represent the views of Health Canada. Canadian Network for Simulation in Healthcare (CNSH) Meeting Summary • Regulators were missing from the list of key stakeholders in the mission statement. Core Roles General support was received for the five proposed roles subject to the following suggested improvements: • Develop and foster relationships − Community of practice needs to be more fully explained as this is a new concept for several people. − Development of relationships with industry stakeholders needs to be reflected. • Build capacity − Any certification or accreditation activities must be undertaken with existing organizations dedicated to these activities. It was noted that certification may not be appropriate for all technicians or educators. − Questions were raised regarding the feasibility of facilitating collective purchasing. − Specific references to the Society for Simulation in Healthcare should be removed as this is just one international organization among many. − Capacity needs for simulation centres and programs will vary across the country and the CNSH must respond appropriately to regional variation. Capacity to collaborate is likely one common need. • Develop Canadian standards − Guidelines more appropriately reflects what the CNSH can facilitate. Standards may be too restrictive. It was also noted that the CNSH would not have accreditation within its mandate. − Guidelines should enable process improvement, be evidence-informed and have sufficient flexibility to evolve with changes in the simulation industry. − Guidelines are an important component of a national learning management system centred on expanded appropriate use of patient-centred simulation. 3 CPSI and the Canadian Network for Simulation in Healthcare would like to acknowledge funding support from Health Canada. The views expressed here do not necessarily represent the views of Health Canada. Canadian Network for Simulation in Healthcare (CNSH) Meeting Summary • Broker knowledge − Exchange or transfer of evidence-informed knowledge may be a more appropriate description of this role. − Acknowledgement of the generators of knowledge is important as the CNSH builds its knowledge base. − Some confusion was expressed regarding the notion of an Executive Roundtable. • Build the case − Generating evidence regarding health system efficiency and improved processes should be included in the role statement. Value Proposition General support was received for the value propositions proposed in the plan, subject to addition of health service providers as a stakeholder group. It was acknowledged that additional work is required before returns on investment in the CNSH can be specifically articulated. Leadership Model The notion of an interim Steering Committee with a 9-12 month and defined responsibilities was supported. Joe Gebran identified several options for consideration including the CPSI Special Interest Group and the group who developed the draft Business Plan. After discussion, it was decided that the CPSI will select 6-8 individuals to serve on an interim Steering Committee. Selections will be informed by a call for nominations that includes competency-based criteria. Resourcing Model The concept of a value-based network with multiple sources of revenue was supported. However, it was noted that ongoing government support will be required for long-term sustainability of the network. It was also felt that an annual budget in the order of $2-3 million will be required to effectively fulfill the proposed roles. A cautionary note was also raised to ensure that revenue-generating functions of the CNSH do not inadvertently 4 CPSI and the Canadian Network for Simulation in Healthcare would like to acknowledge funding support from Health Canada. The views expressed here do not necessarily represent the views of Health Canada. Canadian Network for Simulation in Healthcare (CNSH) Meeting Summary take away from revenue-generating opportunities that key stakeholders would otherwise have. Priority Actions for 2008/2009 The proposed priority actions for 2008/2009 were largely supported with two major additions: • Work needs to begin outlining basic concepts and components of a national learning management system centred on expanded appropriate use of patientcentred simulation. • It was clarified that a major focus of the Steering Committee’s work should be marketing of its vision for enhanced appropriate use of patient-centred simulation across Canada and the CNSH as a central vehicle for accomplishing this vision. Risks and Mitigation There was general agreement with the identified risks with the one reservation that some felt that the Society for Simulation in Healthcare may not pose much of a risk. Most of the discussion centred on funding sustainability as the key risk. Additional mitigation strategies identified include: • Engage Steering Committee and Working Group members who have the ability to connect with and influence government decision-makers. • Ensure that CNSH services enhance and promote simulation programs and other stakeholders, as opposed to offering services that inadvertently put the CNSH in competition with those stakeholders. • Focus on public awareness of the benefits of patient-centred simulation as a mechanism to improve patient safety and quality of care. Call to Action Each person in the meeting was given the opportunity to identify their support or concerns with proceeding to operationalize the draft Business Plan. Subject to proposed improvements to the plan (noted in above sections), unanimous support was received for proceeding with establishment of an interim Steering Committee and to implement the plan. 5 CPSI and the Canadian Network for Simulation in Healthcare would like to acknowledge funding support from Health Canada. The views expressed here do not necessarily represent the views of Health Canada. Canadian Network for Simulation in Healthcare (CNSH) Meeting Summary Canadian Network for Simulation in Healthcare (CNSH) Meeting - September 24, 2008 List of Participants NAME Byrick, Robert Chiniara, Gilles JOB TITLE / ORGANIZATION Centennial College Interprofessional Simulation Centre University of Toronto Centre Apprentiss, Laval University Cole, Gary Royal College of Physicians and Surgeons of Canada (613) 730-6241 gcole@rcpsc.edu Cragg, Betty Patient Care Simulation Centre, University of Ottawa (613) 562-5800 x8394 bcragg@uottawa.ca (416) 967-2600 x228 dfaulkner@cpso.on.ca (613) 738-8400 x82377 efine@ottawahospital.on.ca (613) 727-4723 x5428 (416) 596-3101 x3361 (780) 498-7251 (514) 412-4400 x22696 fouldsb@algonquincollege.com pgamble@michener.ca jgebran@cpsi-icsp.ca ronald.gottesman@muhc.mcgill.ca (613) 945 6798 Hall.FH@forces.gc.ca Bull, Ellen Faulkner, Dan Fine, Esther Foulds, Barbara Gamble, Paul Gebran, Joseph Gottesman, Ronald Hall, Frances 6 Federation of Medical Regulatory Authorities of Canada Canadian Association of Occupational Therapists (CAOT) Algonquin College Simulation Centre Michener Institute Canadian Patient Safety Institute (CPSI) McGill University National Association of Pharmacy Regulatory Authorities (NAPRA) PHONE NUMBER EMAIL ADDRESS (416) 289-5000 x8031 ebull@centennialcollege.ca (416) 864-5825 (418) 656-2131 x3902 robert.byrick@utoronto.ca gilles.chiniara@fmed.ulaval.ca CPSI and the Canadian Network for Simulation in Healthcare would like to acknowledge funding support from Health Canada. The views expressed here do not necessarily represent the views of Health Canada. Canadian Network for Simulation in Healthcare (CNSH) Meeting Summary Helmer, Janet Hubble, Ray Huffman, Dan Kelly, Peter Kim, John Koval, Valentyna Lachapelle, Kevin Lamacchia, Mike Lawless, Venetia LeBlanc, Derek Lee, Lily Martin, Bruce McGraw, Bob Morgan, Pam Morley, Michelle Musson, Dave Norman, Dianne Parker, John Patenaude, JeanVictor 7 Canadian Association of Schools of Nursing Canadian Society of Respiratory Therapists Capital Health Regional Simulation Centre EMS Chiefs of Canada Critical Care Education Network Centre of Excellence for Surgical Education & Innovation (CESEI) / UBC McGill Medical Simulation Centre Shock Trauma Air Rescue Society (STARS) Health Canada Atlantic Health Training & Simulation Centre Canadian Nurses Association University of Manitoba Simulation Centre Queens University University of Toronto Algonquin College McMaster University McMaster Children's Hospital Canadian Surgical Technologies & Advanced Robotics (CSTAR) (613) 235-3150 x32 (506) 648-6023 (780) 735-6961 (613) 580-2424 x22465 (613) 364-1803 jhelmer@casn.ca ray.hubble@gnb.ca dan.huffman@capitalhealth.ca peter.kelly@ottawa.ca jkim@aserty.com (604) 875-4111 x66540 valentyna@cesei.org (514) 934-1934 x34980 403-516-3559 (613) 957-3763 (902) 473-1423 (604) 875-3763 (204) 789-3627 416-323-6400 x4087 613-727-4723 x5339 905-525-9140 x20201 (905) 521-2100 x73998 kevin.lachapelle@muhc.mcgill.ca mlamacchia@stars.ca venetia_lawless@hc-sc.gc.ca leblancd@cdha.nshealth.ca LLee-02@phsa.ca bmartin@cc.umanitoba.ca 3rcm4@queensu.ca pam.morgan@utoronto.ca morleym@algonquincollege.com musson@mcmaster.ca norman@hhsc.ca (519) 685-8500 x35897 john.parker@lhsc.on.ca University of Montreal (514) 890-8070 jvpatenaude@sympatico.ca CPSI and the Canadian Network for Simulation in Healthcare would like to acknowledge funding support from Health Canada. The views expressed here do not necessarily represent the views of Health Canada. Canadian Network for Simulation in Healthcare (CNSH) Meeting Summary Centre of Excellence for Surgical Education & Innovation (CESEI) / UBC Canadian Patient Safety Institute (CPSI) (604) 875-5176 qayumi@interchange.ubc.ca (780) 498-7256 ereardon@cpsi-icsp.ca Skrypnek, Rob (Facilitator) sumera management consulting (780) 982-6902 rob@sumeramc.com Steinberg, Arnold CPSI Board Member 514-931-7500 x23 arnoldsteinberg@clsinc.ca Tarshis, Jordan The Canadian Simulation Centre for Human Performance and Crisis Management Training (at Sunnybrook Health Sciences Centre) (416) 480-6100 x1716 jordan.tarshis@sunnybrook.ca (613) 738-4424 ltaylor@cpsi-icsp.ca (418) 656-2131 x3065 carmen.vezina@pha.ulaval.ca (204) 488-0637 wade@mts.net (416) 586-4518 rwax@mtsinai.on.ca Qayumi, Karim Reardon, Erin Taylor, Laurel Vézina, Carmen Wade, John Wax, Randy Canadian Patient Safety Institute (CPSI) Canadian Council for Accreditation of Pharmacy Programs Canadian Patient Safety Institute (CPSI) Program for Resuscitation Education & Patient Safety (PREPS) Werner, Norbert Canadian Association of Allied Health Professionals / Northern Alberta Institute of Technology (780) 378-5368 norbertw@nait.ca Youell, Linda University of Alberta, Faculty of Nursing (780) 492-0435 linda.youell@ualberta.ca 8 CPSI and the Canadian Network for Simulation in Healthcare would like to acknowledge funding support from Health Canada. The views expressed here do not necessarily represent the views of Health Canada.