Simulated hospital center would be first of its kind

An ambitious plan has been launched to create the Chicago Regional Medical Simulation Center, a complete simulated hospital environment that would be available for training and assessment of physicians, medical teams and paramedics throughout the Midwest.

The project is being led by anesthesiologist Stephen D. Small, MD, the director of the University of Chicago's Developing Center for Patient Safety, who said it would be the first civilian adoption of a $20 million combat trauma patient safety simulation system developed by the U.S. military.

"It's not about a big building with 100 simulators. It's about event management and a system of care," said Dr. Small. "There will be ER, OR and recovery simulations, even simulated elevator trips, and then threading it all together."

Dr. Small worked at the simulation centers at both Harvard and Stanford universities, but said he was frustrated by the slow growth of simulation in the general medical settings.

He said Chicago may be the ideal site for a regional simulation center because of its proximity to potential users, the robust research environment that includes Argonne National Laboratory and several universities, and the number of health care "standard setting and policy-making" organizations headquartered there.

"I can name 60 hospitals within an hour of where I'm standing," Dr. Small said. "But how many can afford $20 million to do this? Zero."

Creating an office environment

Primary care doctors would also be able to use the center for refreshing seldom-used skills, learning new procedures, team training of office staff and auditioning new equipment, said Tom Doyle, RN, senior program manager for education with Sarasota-based Medical Education Technologies Inc., which would be the center's "industry partner."

Doyle said a doctor-office environment could be created where a primary care physician and his or her staff could come in for emergency office training. They could also test new equipment or computer systems to see which ones fit best.

"If we can create an intensive care pod, we can simulate just about anything," he said. "A good rule of thumb is that it's limited only by one's imagination and creativity."

The simulation center is an outgrowth of the Chicago Patient Safety Forum, which was funded by the Otho A.O. Sprague Memorial Institute and operated by the Institute of Medicine Chicago, a local organization founded in 1915 that is not formally affiliated with the national IOM.

James Webster, MD, president of the Chicago Dept. of Health and IOMC immediate past president, is one of the center's biggest supporters.

"Without any question, you're seeing the future," he said. "The future in terms of education, the future in terms of certification, the future in terms of accountability. We'll have to prove to the public that we know what we're doing and that we can do it competently. This is how it will be done."

ABMS, JCAHO interest

The American Board of Medical Specialties is one of the Chicago-based national standard-setting organizations paying attention to the project.

"This type of system will be a major teaching and evaluation tool," said ABMS Executive Vice President Stephen H. Miller, MD. "I think it has a lot of promise, and we will see what is requested of us and then see what level of involvement we will have."

Robert Wise, MD, vice president of standards for the Joint Commission on Accreditation of Healthcare Organizations, echoed these sentiments. "There's certainly something of interest there for us, so we'll actively pursue it with them," he said. "We have no commitments right now, but we're interested in a number of areas."

Dr. Small said people from many organizations have been working on the center, but only as interested individuals and not as representatives of their institutions. One of these individuals is Donald W. Walsh, PhD, assistant chief paramedic for the Chicago Fire Dept.

"I'm handling the pre-hospital, first-responder portion of this," Dr. Walsh said, explaining that, along with basic paramedic training and skills assessment, he is exploring how the center could provide training for attacks from chemical, biological and even nuclear weapons. "It's not just the Chicago Fire Dept. that would be involved, it would also be the suburban departments and those on the outskirts plus National Guard and military reserve units."

Homeland security grants may help with some initial funding, said Medical Education Technologies Inc. Director of New Business Development Ron Carovano. "You're talking a few million bucks to put this in place, and that kind of funding you're only going to find in a few places -- mostly in the federal government," he said. "I think the first-responder community is absolutely a giant opportunity because that's where the funding is flowing right now."

He added that both Health and Human Services and Labor departments might see the center as a tool to test nursing competency, thereby reducing an education "bottleneck" that is exacerbating the nursing shortage.