By Dr. Tania Tajirian, Medical Head for Hospitalist Service, CAMH; Assistant Professor, Department of Family and Community Medicine, University of Toronto
Recently, our Simulation Team worked with the Code Blue Project to develop comprehensive training for CAMH staff. We asked Tania Tajirian to tell us a little more about the training and how it capitalizes on our simulation tools.
Who are you and what is your position at CAMH?
My name is Dr. Tania Tajirian, and I'm the medical head for the Hospitalist service at CAMH.
What project are you currently involved with?
Over the past four years, I’ve been the physician lead and key collaborator on a CAMH-wide educational/training initiative called the Code Blue Project. First, we identified knowledge and practice gaps within the organization regarding Code Blue medical emergencies. Next, we instituted a task force overhauling CAMH’s Code Blue training program and policy. This task force has worked tirelessly to do the following:
- Revamp CAMH’s Code Blue policy and update its procedural changes.
- Review and update crash cart medications and equipment, including adding a laptop and printer.
- Develop a CAMH Code Blue simulation training video. See these roles in action here.
- Develop Code Blue task cards and make them available on all crash carts.
- Develop a print-friendly clinical summary document in I-CARE that will be available during medical emergencies and in the EMR for safely transferring medical information.
- Develop standardized post-Code Blue debriefing sessions to further identify and target educational needs.
- Review CAMH’s CPR (Heart to Heart) vendor certification course content and adapt scenarios so they are more relevant to a mental health hospital setting.
- Develop evidence-based protocols for managing the most common Code Blue scenarios at CAMH.
- Develop standardized mock Code Blue training sessions across CAMH. Future plans include integration with the new CAMH simulation lab.
What is the goal of this project?
The aim is to develop a substantial comfort level with Code Blues throughout CAMH, where medical emergencies are uncommon but require a sustained level of practice to maintain skills, knowledge and attitudes.
Per CAMH policy—
Code Blue: The emergency code "designed to respond to a medical emergency, when a person is experiencing a real or suspected imminent loss of life" (Ontario Hospital Association, 2008). Examples of life-threatening medical emergencies include airway compromise, circulation compromise including absent pulse, cardiac and/or respiratory arrest, laryngospasm, seizure, choking, drowning, multiple injuries (spinal cord or cranial injuries), poisoning, shock, unconsciousness, hemorrhage, excessive bleeding, extensive burns, anaphylaxis, overdose and suspected suicide.
Simulation training provides an opportunity to apply theory and gain experience in skills or procedures that would otherwise be difficult without potentially putting patients at risk, such as managing emergency situations and resuscitation.
By using Simpson (CAMH Simulation’s SimMan), I believe this will allow us to gain such experience, which is essential for any health care professional.
Who is this project geared toward?
Our first physician CPR SimMan training in July was a big success. The training group involved six duty doctors and 10 hospitalists, led by an excellent facilitator who is also a paramedic.
It will be important to continue developing this training under our integrated care strategy, as part of our mandate to upskill our physicians.
My vision is not only to develop the practical emergency skills of our physicians, but also to integrate these skills in an interprofessional team setting. Our aim is to develop highly cohesive and well-trained Code Blue teams.
Where can someone get more information about your project, course or event?
Contact Tania Tajirian or the CAMH Simulation Centre.
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