By Leslie Dubow
Associate Director for Educational Gaming

ORLANDO, Fla. – The VHA’s Goals of Care Conversations game-based learning module was nominated as a finalist and then chosen as the Best Government Game Nov. 30 during the 12th annual Serious Games Showcase and Challenge (SGS&C) at the 2017 Interservice/Industry Training Simulation and Education Conference (I/ITSEC) here. It was among several other educational products selected as finalists in the showcase.

Serious games are educational products that employ game technology in design and development to provide an immersive and engaging learning experience. The Employee Education System (EES) Educational Gaming office developed the “Goals of Care Conversations” game-based learning, or serious game product, this year in support of the VHA Medical Ethics Program office, physicians and other providers who care for Veterans. This, as well as other educational products, were selected as finalists in the showcase.

Goals of Care Conversation provides learners with meaningful opportunities to acquire and practice communication skills needed to conduct high-quality, goals-of-care conversations with patients who have a serious illness. The learner practices these skills in an immersive and realistic environment, with immediate feedback from a virtual mentor to help reinforce important skills. This virtual training program will help busy clinicians practice, including the patient and their care givers, in making quality-of-life decisions with empathy and caring.

The challenge was an international competition that included learning games from government, industry and academia. Each game was evaluated during two rounds of evaluation by a team of international game development and educational professionals. Games were evaluated based on a carefully crafted rubric that included ensuring the games met stated learning objectives while remaining interesting and engaging. The finalists were invited to display their games in Orlando during I/ITSEC in November.

I/ITSEC is the world's largest modeling, simulation and training conference. As an integral part of I/ITSEC, the SGS&C incubates and celebrates the use of games and game technology as a delivery medium for instructional material. The SGS&C is divided into the following categories:  business, government, student, mobile and innovations. After a rigorous, two-tiered evaluation, the team chooses the best game in each category. 

Aurelio Maldonado, EES project manager, and Leslie Dubow, EES associate director for Educational Gaming, led the team that developed the product. They also accepted the award on behalf of VHA.  

By Gerald Sonnenberg
EES Marketing and Communication

ORLANDO, Fla. – VHA staff train regularly to care for our Veteran patients in VA facilities. It is rare for staff to be involved in an emergency outside of VA, but it does happen. That situation happened recently when Phil Hargreaves, director of VHA’s National Simulation Network, was waiting to board a flight to Washington D.C. at the Orlando International Airport.

Hargreaves, a registered nurse, who also leads VHA’s Resuscitation Education Initiative (REdI), was nearby when he overheard a call for a doctor to a nearby gate. REdI is a national program to standardize, document, track and monitor the provision of Advanced Cardiac Life Support (ACLS) and Basic Life Support (BLS) training throughout VHA. 

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By Catherine Kawaihalau, BSN, RN, Urgent Care Lead Nurse and
Hallry Ho, MSN, RN, Nurse Educator
VA Pacific Islands Health Care System
Spark M. Matsunaga VA Medical Center

HONOLULU - The “Code Blue Committee” and nursing education at the VA Pacific Islands Health Care System (VAPIHCS), Spark M. Matsunaga VA Medical Center (VAMC), worked collaboratively to create relevant scenarios to enhance individuals and team performance in emergency medical crisis management. In October, the hard work came to fruition when the nurse educators conducted two sessions of mock code training with 24 community living center (CLC) nursing and ancillary staff using a high-fidelity simulation mannequin the trainees named Georgia.

“Georgia” was borrowed from the Ambulatory Care Center (ACC) on the Tripler Army Medical Center campus about half a mile away from the CLC. The staff was excited when Georgia arrived at the CLC. A familiarization of Georgia was given as staff huddled around and were amazed with all her “bells and whistles.” Once the simulation started, staff all took an active part and immersed themselves into the moment. The verbal and written feedback indicated they truly appreciated the hands-on experience and requested to have similar training more often.

“I love this training,” said one participant. “We should do this at least every six months,” said another.

This simulation experience validated their knowledge and skills, as well as identified areas that needed improvement as individuals and as a team working in emergency medical crisis management.

Moving forward, future mock code training will be virtually extended to remote community based outpatient clinic staff throughout the Pacific, which includes all the Hawaiian Islands, Guam and American Samoa. Unannounced mock codes will be conducted annually in ACC and CLC with more frequent planned sessions to further increase staff responsiveness.  

In the photo, (Left to right, top row) Hallry Ho, RN, and Richardo Woolcock, chaplain. (Middle row): Amanda Hiljus, RN; Jingle Tabayan, LPN; Ruth Javier, RN; and Judy Gilliland, RN. (Bottom row) Lorlyn Dela Cruz, RN, and Judy Gilliland, RN. (VA photo by Colette Kon)

By David Cochennic, Management Analyst and Lionel Dacpano, Project Manager

ORLANDO, Fla. – Ten members from the National Simulation Network’s (NSN) Resuscitation Education Initiative (REdI) team traveled from Orlando to Washington D.C. to provide the American Heart Association HeartSaver Cardio Pulmonary Resuscitation Artificial External Defibrillator and First Aid course to Veterans Affairs Central Office (VACO) non-clinical staff members.

The team was led by the NSN Director, Phil Hargreaves, and they came prepared to provide training to over 200 VACO staff. This VACO-required course was available over a three-day period and offered both full-day and blended courses. Some of the attendees included the Assistant Secretary of VA’s Office of Human Resources and Administration (HR&A), Peter Shelby and Deputy Assistant Secretary for Administration, HR&A, Roy Hurndon, who both attended the full-day HeartSaver course.

In the photo, Tracey Robilotto (center), REdI associate director, leans in to help a VA central office staff member with the proper placement of the pads for the Artificial External Defibrillator or AED. Assistant Secretary for HR&A Peter Shelby is also pictured (left) practicing the steps with a mannequin. (VA photo by Dave Cochennic)

By Robert Kononowech, M.S., MPH, and Douglas Paull, M.D., MPH, VA National Center for Patient Safety

ANN ARBOR, Mich. - Incorrect procedures (wrong site, wrong side, wrong patient, wrong procedure, wrong implant, etc.), though infrequent, have the potential to cause devastating consequences to patients, families, providers and health care organizations. The Joint Commission’s Universal Protocol remains the gold standard in the prevention of incorrect procedures (Norton, 2008).  

An integral part of the Universal Protocol is conducting a pre-procedure “timeout” immediately prior to the start of the procedure. The timeout allows staff to verify the patient’s identity, the procedure to be performed and the procedure site; it also affords staff the opportunity to certify the informed consent and review pertinent medical images. However, despite the importance of pre-procedure timeouts as a patient safety tool and a VHA policy requiring a timeout before any invasive procedure (VHA, 2013), compliance with timeouts outside the operating room (OR) has been an ongoing issue (Neily, et al., 2009). This is due, in part, to a lack of training and awareness of timeout procedure and policy.

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ORLANDO, Fla. – SimLEARN staff recently awarded new simulation certifications to qualified facilities. Facility certifications last for two years and are renewable. They are a distinctive accomplishment.

There are three tiers of certification: basic, intermediate and advanced. Congratulation to the facilities listed below on their certifications:

VA Palo Alto Health Care System - Palo Alto, California – Advanced

Louis Stokes Cleveland VA Medical Center - Cleveland, Ohio – Intermediate

South Texas Veterans Health Care System (Audie L. Murphy VA Hospital) San Antonio, Texas – Intermediate

Wilkes-Barre VA Medical Center -Wilkes-Barre, Pennsylvania – Intermediate

Carl Vinson VA Medical Center - Dublin, Georgia – Basic

James J. Peters VA Medical Center - Bronx, NY – Basic

Marion VA Medical Center - Marion, Illinois – Basic

VA Southern Nevada Healthcare System - Las Vegas, Nevada – Basic

VA Ann Arbor Healthcare System - Ann Arbor, Michigan – Basic

A facility can request certification after one year of existence while meeting the basic level criteria. A non-binding email of intent and certification application is required. New certification criteria will be announced in 2018. Please contact the team by sending an email to EESFacilitySimulationCertification@va.gov. For a full list of certified simulation centers, click here.

ORLANDO, Fla. - The SimLEARN Hospital Activations Team began testing new VA medical centers (VAMCs) in 2012 to work with local staff and rehearse patient flow, as well as test hospital systems for unanticipated events or situations. To this end, SimLEARN was asked to apply simulation technology to tackle one of the greatest challenges facing medical practitioners and hospital risk managers which is to identify previously unknown clinical issues as VA "stands up" hospitals.

A video about this innovative team is available on two formats: YouTube and Bright Cove.

By Spencer Donovan, Pharm.D.
and Alexander Goldman, Pharm.D.
Interprofessional Fellows in Advanced Clinical Simulation
Providence VA Medical Center

PROVIDENCE, R.I. - The Providence VA Medical Center (PVAMC) simulation center is responsible for the training and certification of many clinical staff members in the provision of Advanced Cardiac Life Support (ACLS). In the center’s hands-on ACLS sessions, numerous physicians and nurses expressed unfamiliarity with the crash cart and its contents, especially those clinicians that were relatively new to practice.

Most of the feedback the center received on the crash cart pertained to the medications included in the cart, as the carts in the facility are always sealed shut when they are not in use.

The ability to quickly obtain and use the correct medication or tool in the crash cart is vital to the successful response to emergent situations and patient outcomes in a resuscitation attempt. To address this need, a 10-minute presentation was developed by the simulation fellows and a University of Rhode Island nursing student to educate clinicians about the uses and locations of all items in the crash carts.

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