VisionVisionVi The Simulation program: Will be recognized nationally for its positive impact and integration in quality and safety, patient care and the clinical environment Will be a national leader in research and implementation of emerging safety concepts Will be a national leader in healthcare education, especially inter-professional education

Simulation Decreases onboarding time and increases nursing retention rates Decreases Serious Safety Events Improves Safety Attitudes Questionnaire scores Identifies Latent safety threats Is recommended by the ACGME CLER Report, Joint Commission, Required for USNWR Best Hospitals Survey OUR SIMULATION STRUCTURE IS NOT SUFFICIENT TO MEET THE CURRENT AND FUTURE NEEDS OF OUR HOSPITAL.

Current State Smallest top 10 Children’s Hospital Simulation program Next smallest program has more than double our square footage Comparable hospitals have simulation budgets up to 3.2 million Currently: 1.15 Physician paid through medicine 1.6 RN and 1 simulator technician paid through nursing\ 1.0 RN in Special Purpose Fund (SPF) $828,345 being paid in salaries /fringe Simulation Center and much of equipment has outlived useful life and is in need of replacement Supplemented by CMO ad hoc to ensure continuity of operations

How to achieve the Vision: Increase reach of simulation by focused and intensive training for educators across the organization Increase simulation technicians and administrative support Modernize simulation equipment Enhance and upgrade the simulation program space The simulation program should be a separate entity with dedicated funding and a reporting structure to optimize agility Develop and enhance the skills of the core simulation team as well as increasing the reach of simulation by focused and intensive training for nursing and physician educators across the organization in the use of simulation. This will increase the number of individuals with expertise as simulation facilitators across the organization and allow us to substantially and rapidly escalate the frequency and availability of simulation training for frontline staff. This directly aligns with our organizational safety goals To that end, we should increase the number of simulation technician and administrative assistant. A larger number of simulation technicians is a fiscally sound approach to simulation as it allows us to leverage educators (who are more highly trained and more expensive.) An administrative assistant who can handle scheduling and clerical work currently performed by nursing educators would provide more bandwidth to our nurse educators and again is a more cost effective option than using educators for routine clerical work. Modernize the simulation equipment that is utilized to train Children’s National staff, faculty and trainees. Many of our current simulators and trainers are outdated and at the end of their useful life. The recent USNWR simulations have highlighted the challenges of the simulation program related to aging and broken down equipment. In order to expand in situ simulation across the organization, we need additional as well as more modern simulators and trainers that more accurately reflect our patients’ physiology, signs and symptoms. There is a need to enhance and upgrade the simulation program space. Current space and configuration does not meet simulation accreditation standards. Specifically, additional storage space, dedicated debriefing space and flexible simulation space are required. In order to best meet the organizational needs relative to simulation, the simulation program should be a separate entity with dedicated funding and a reporting structure that allows it to function in an adaptable and nimble fashion.

Proposed State Addition of 1.0 Administrative Assistant and additional 1.0 Simulator technician in FY18 Begin ongoing program to replace capital equipment on rotating basis Emphasis on in situ simulation. Minimal renovations to existing simulation space with need to expand simulation space as Facility Master Plan permits.

Simulation Budget Proposal Current Proposed (FY 18) Ideal Annual Operating - 231,500 283,663 Salaries & Benefits 828,345 937,245 1,312,345 Capital 100,000 150,000 Renovations 30,000 Total 1,298, 745 1,746, 008 February 25, 2019