A Sanford Health pediatric surgeon is working with Microsoft Corp. and another technology company to develop software that tracks lifelike mannequins used in training.
In some professions, mistakes can easily be fixed without repercussions. In health care, they can harm, so doctors, nurses and other staffers regularly simulate various scenarios. That constant practice ensures quality patient care and customer service in real-life situations.
“You can essentially have 25 ‘deaths’ in a day but never really have a death. But you learned from those 25 deaths and what system problems you had,” said Scott Engum, M.D., a pediatric surgeon at Sanford Children’s Hospital Fargo in North Dakota.
The mannequins get a lot of use. In addition to Sanford Health care providers, medical school students, residents in training, nursing school students, paramedics and emergency medical technicians and others regularly rehearse with them. That creates scheduling challenges.
“We have a lot of different facilities that are training, teaching and evaluating,” Dr. Engum said. “How do you get the people, equipment, supplies and needed educational materials there to make it all happen?
There are few software solutions on the market. The challenge is to find a cost-effective option for a system to share and grow resources. He went to Microsoft, which operates a large research and development center in Fargo.
“We have a need. They have a solution,” he said.
That solution started with Microsoft Dynamics 365 customer relationship management and enterprise resource planning software. The tech firm Power Objects in Minneapolis then tailored it to create the scheduling tool Dr. Engum sought.
“You can put the Sanford simulation application on top of our pre-existing software solutions and apply it to all our enterprise facilities,” he said. “Moving mannequins around, moving people around, doing project management, communicating between team members, communicating with the customer.”
Creating tech partnerships
Microsoft and Power Objects put $30,000 toward development of a prototype and Sanford Health matched it. The pandemic paused testing and further development of the software, which can eventually be used by other health care systems, schools and simulation training environments.
Scott Ilvedson is the health care account executive at Microsoft who worked with Dr. Engum on the project.
“If this works as well as we think it can, Sanford could potentially take that IP (intellectual property) out to market and sell it to other health care organizations across the U.S.,” Ilvedson said. “Historically speaking, sim center software vendors only get you about 60% of where you need to be. Dr. Engum knew this and wanted to do something different. Building it on top of our Dynamics 365 foundation gives Sanford the ability to grow and adapt to its specific needs. Power Objects is engaged to help build and deploy it.
“Using Microsoft’s Business Applications software as the foundation has another benefit as it integrates seamlessly with the other Office 365 tools (Outlook, Excel, and Teams) that Sanford has already invested in,” he said. “The 365 ecosystem works very well together and keeps you from bolting on a number of third-party products which, of course, add complexity.”
Testing with SIM-ND
The prototype software is currently being tested in one of the four trucks operated by SIM-ND, a partnership of the University of North Dakota Simulation Center, Sanford Health and the state’s other health care systems. The vehicles are equipped with the high-tech patient simulators and travel the state to train emergency rescue and hospital staff on-site.
Once the pandemic-related workload eases, Dr. Engum hopes to expand testing to three other Fargo locations: F-M Ambulance Service, Sanford Medical Center Fargo and Sanford Broadway Medical Center.
Simulation doesn’t generate sufficient revenue to cover all expenses of training. So part of the challenge is helping leaders see the value of the training in improved patient care outcomes throughout the medical system in care and quality indicators, Dr. Engum said.
“This software now tracks all the metrics,” he said. “All you have to do now is tie it to patient quality and safety initiatives and follow improvements, such as decreased infection rates, increased teamwork scores and other metrics.”
Helping patients and students
Besides boosting operation and staffing efficiencies, the software also should help standardize instructor support, curriculum management, evaluations, surveys, reports and other information related to teaching at all levels: trade schools, undergraduate and graduate learners.
For nursing students, 25% of their education in North Dakota can be exchanged for time in simulated environments, Dr. Engum said. Other students in premed, radiology and other professions also would benefit from the improved simulator scheduling, he said.
“The beauty of it is we are at a point now where the mannequins are good enough that a person does not have to suspend the thought that the training isn’t real,” Dr. Engum said of the role simulators. “We are hopeful this will assist in attracting students not just to the Fargo-area universities, colleges and trade schools but will be a health care training resource for the region and state of North Dakota at large.”
Patients also would benefit because the simulators can be programmed to duplicate numerous ailments. That allows physicians, nurses and other clinical workers to continually hone their skills, even when a live patient with that condition isn’t available.
“There’s been many times when we’ve done simulations and the nursing staff would come to us two weeks later and said, ‘You wouldn’t believe it. The exact event you just simulated happened to me. And I was so thankful that I had the opportunity to have a thought process that was previous to that,’” Dr. Engum said.
Simulated environments also help staff work as a team, he said.
“No health care system can function just with a good doctor and a good nurse or a good pharmacist if they aren’t working together,” Dr. Engum said.
“I love the term collision. You think a car accident is a bad thing. In simulation, I think a car accident’s an excellent opportunity because two people had to stop, interact and ask what happened. And that’s kind of what simulation does. We try to create collisions. And by treating these collisions, we get staff more comfortable to speak up.”
Sanford Health values the ideas and problem-solving ability of its physicians, researchers, clinical workers and support staff. Any employee with an idea for a device, therapy, software, tool or other method that helps patients is encouraged to contact the commercialization team and join the dozens of people at Sanford Health who are already inventing.
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