In an industry such as ours in which things are rapidly changing, it is crucial that we dedicate as much time as possible to training. This is not news to anyone, but what’s important is that we ensure the message is being delivered and that our crews are receiving the appropriate training. Here at REVA, Inc. (Air Ambulance), we are committed to providing the highest level of care to all patients, so we are constantly evaluating areas upon which we can improve.
Currently, as a medical management team led by Medical Director Dr David Farcy, we quality assess every single patient chart thoroughly. Having a strong culture of quality assurance has allowed us to consistently identify opportunities for growth and improvement within the department. This has also allowed us to identify specific areas of opportunity where we can optimize delivery of care to patients.
“After doing peer review on ventilator malfunction, I noticed that operator error was the biggest area of concern. I felt that hands-on training addressing the alarms and different modes was critical,” commented Dr Farcy.
Having a strong culture of quality assurance has allowed us to consistently identify opportunities for growth and improvement within the department
We have Dr Farcy as a resource 24/7, 365 days a year and he is extremely involved with all medical decisions being made daily. After reviewing all cases associated with ventilator malfunction, it was decided as a medical management team to have a hands-on, scenario-based ventilator training day. The idea behind this style of learning is to allow everyone to engage in a group atmosphere. By working as a group, it allows everyone in the room to provide their input, feed off one another, and look at everything from a different point of view.
How did we go about the training? Time and communication are crucial, so the first thing we did was sit down and identify a date for this training and immediately send this communication to all medical staff. Providing crews with an ample amount of time to organize themselves will result in a higher turnout. We reserved a room at Fort Lauderdale Executive Airport and communicated that if they were unable to physically be present, we would be broadcasting live and uploading the recording online as well after. It was agreed that we would present four different scenarios to the staff, all of which were actual scenarios that had occurred during patient transports in the past year at REVA.
On the day of the training, we had the room set up with multiple ventilators spread through the room. In addition to that, we had Dr Farcy in the front of the room with both the ZOLL 731 and Hamilton-T1 ventilators. Dr Farcy started the lecture by communicating to everyone in the room that this would be a working session. He expressed that he wanted everyone to participate, ask questions at any time, and pause if something was not understood fully.
For each scenario (all names and identifiers removed), we started by reading aloud the medical intake report, including a brief description, vital signs, recent lab work, assessment by the crew at the patient’s bedside, past medical history, and any treatment done prior to arrival. In addition to that information, we were able to provide arterial blood gas results and current ventilator settings. As we read the case out loud to the group, Dr Farcy stood in front of the whiteboard and made notes as if he were taking a report on the patient. At this point, the discussion began.
Dr Farcy then chose one of the personnel in the room to come to the front and circle what was most concerning to them. As medical professionals, we are all able to identify what is abnormal in terms of lab work and vital signs, but the question becomes what is most alarming or concerning. Dr Farcy then opened it up to the room and asked if anyone wanted to circle anything else. It was then identified as a group what the next steps were to correct the abnormalities or current issue at hand. This led to great conversation amongst everyone in the room. After further discussion, this led to hands-on training with the ventilators.
The ventilators were turned on, and the settings for these patients were programmed in. Dr Farcy talked through all the steps with the ventilators, reviewing the functionality of the ventilators along with all the terminology associated with each setting. By having the ventilators in front of everyone, it allowed them to physically turn them on and work through troubleshooting potential situations.
The primary goal is to make everyone feel more comfortable with the equipment, so that when an issue may arise, they are able to easily adjust the ventilator and make necessary changes
The primary goal is to make everyone feel more comfortable with the equipment, so that when an issue may arise, they are able to easily adjust the ventilator and make necessary changes. To physically have personnel train with the device at hand is much more beneficial than just lecturing on the subject. Furthermore, performing this type of training as a group is extremely beneficial. By pulling actual cases we have done, it shows our crews that these are real-life scenarios that we have faced and may face again. Following the training, there was a lot of positive feedback from the staff, and a lot of the staff acknowledged that it was a more effective way of learning versus watching a video or reading an article.
Training is something that is at the forefront of our organization. Shannon Schell, CEO of REVA, Inc., commented: “At REVA, we believe that training and education are critical to ensure the highest level of patient care. Comprehensive training gives our employees the tools that they need to make decisions during all facets of the operation. The goal of the training program is to create an environment where all employees feel confident and empowered to make safety-related decisions that will drive the best results”. We are supported from the top of our organization to provide all necessary training to be able to deliver the highest level of care possible to each patient.