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Simulations help prepare Janesville hospital staff for opening day

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GINA R. HEINE
December 22, 2011
— Doctors and nurses at the new St. Mary’s Janesville Hospital last week practiced a mock delivery of twins by cesarean section.

According to the scenario, one of the babies was in respiratory distress and needed to be transferred to Madison. Doctors simulated the paperwork and prep needed before the transport.


The new hospital on Janesville’s east side opens Monday, Jan. 9, and staff members are training to be ready when the first patients walk or roll through the door.


Training has been ongoing since physicians, nurses and other staff started work in early October. Before the hospital and adjoining Dean Clinic-Janesville East open, staff members are receiving training in everything from the security system and medical equipment operation to supply storage.


“Everyone has been phenomenal as far as just jumping in and taking ownership of their new hospital and new departments and bringing their experiences that they’ve had from orientation in Madison and other places and saying, ‘We want to be the safest hospital, could we try this instead?’” said Deana Miller, director of surgical services.


Trainers have had three months to assemble people who have never worked with each other and ready them for whatever situation comes through the doors.


Developing a team

Hospital directors described staff members as experienced—none is fresh out of school.


In the family birthing center, experience ranges from three to 28 years, center director Belinda Hopper said.


“That’s one great big benefit,” she said. “They’ve been assisting with the actual creation of the policies and procedures we’ll be following, so they’ll know them inside and out.”


Her staff members spent two weeks in the St. Mary’s hospital in Madison paired with team members there to demonstrate their skills, she said.


“So it’s not just them saying they know what to do—they’ve actually demonstrated it to a member of the OB teams up there,” she said.


New staff across the hospital has been getting experience at the network of affiliated hospitals and clinics including in Madison, Baraboo and Sun Prairie.


Among her staff of 25, three have worked together at one hospital and two others worked together at another hospital, she said. Remaining staff members were strangers, and Hopper assigned teams to mix up those who had worked together.


Miller has been busy merging 30 new surgical staff members with the existing staff of about 23 who will move from the Riverview Surgery Center, which will be doing outpatient procedures until next month.


“It’s given us a really good opportunity to let the physicians meet the staff, the staff meet the physicians they’re going to be working with and build that relationship before they come over here in a new environment,” she said.


All of the nurses hired in the emergency department have prior experience, said Brenda Clark, director of the emergency department.


Emergency responders from across the county toured the hospital during a special open house. EMS departments soon will receive badges to access the hospital garages and details such as which radio frequency to use, she said.


All hospital staff members are going through a teambuilding program intended to teach them how to relay information, build trust and to stop a situation if they’re not comfortable, said Joan Neeno, marketing and public relations director.


Simulations

Staff have been running simulations to practice real-life scenarios.


“We use everything we have, outside of the real needles,” Hopper said.


Directors discussed common patient experiences and some “off the wall” scenarios before writing simulation scripts, Clark said.


Staff members have played the role of a patient—including having a clothed staff member in the stirrups in the birthing department—while others have acted as the patient’s family members, Hopper said.


“Did they feel welcome? Did they feel rushed? How was the feeling of being that patient here?” she said. “Then for the staff, how was the flow as far as teamwork … was our computer working right, did we have all the equipment that we need?”


Such exercises allow everyone to determine if the right equipment is in the proper place and if adjustments are needed, she said.


Aside from visible patient-care needs, they’ve focused on behind-the-scenes tasks such as making sure a patient’s electronic medical records move through the system and orders are executed throughout the hospital.


“We wanted to make sure that when the doctor dropped the order in, did the labs get to lab, did the X-ray order get the X-ray?” she said.


Vendors and sales representatives have been educating staff on equipment—everything from blood pressure machines to the security system. All equipment is tested by the biomedical department to ensure it’s functioning correctly, and employees have been working with vendors to ensure competency, Miller said.


Staff also are being training in St. Mary’s culture and values, Neeno said. Candidates completed an online test of their personal values, and some people weren’t hired because they didn’t align with St. Mary’s values, she said.


Values can’t be trained, she said, so the hospital was “trying to choose people that fit our corporate values, and our mindset was something we tested for.”


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Staff to receive one week of training before new Mercy clinic/ER open

Staff at the new Mercy Health System clinic and emergency department/urgent care on Janesville’s northeast side will receive one week of orientation before the facility opens in early January, Mercy Vice President Sue Ripsch said.


Construction started in September and is on schedule, and the emergency room/urgent care is set to open Monday, Jan. 9, followed by the clinic Monday, Jan. 16, she said.


The facility will be furnished and equipped in time for the staff to have a week of orientation.


The facility won’t have a completely new staff. Emergency/urgent care staff have been hired and are working at Mercy Hospital and Trauma Center now, Ripsch said. Nurses and physicians will rotate between the new ER North and Mercy Hospital and Trauma Center downtown.


While the new ER won’t have a Level 2 trauma designation, all nurses will be trained to that level, she said.


“We think the level of care will be very high,” she said.


During the week of training, staff will learn what procedures can be done at the new facility rather than the main ER, she said.


“They will function and do the same policies and procedures as we do here—none of that is new,” she said. “It is an extension of our ED here (at Mercy Hospital).”


Mercy has been working with area EMS departments on the types of patients that can go to the new ER instead of the hospital downtown. If a heart patient needs to go directly to the catheterization lab, the ambulance would go to the hospital, she said. The same is true for other major trauma cases.


The new ER/urgent care will include 24-hour X-ray imaging, a CT scanner, laboratory services and community and emergency medical services education space.


On the primary care clinic side, three physicians already in the Mercy system will move with their nursing staffs to the new building, Ripsch said. Not all affected patients have been notified, so she declined to say which physicians would move.


Mercy probably will add a fourth physician by next summer and a fifth later, she said.



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