In 2001, the Institute of Medicine (IOM) published "Crossing the Quality Chasm: A New Health System for the 21st Century. In response to the estimated 98,000 deaths occurring annually in U.S. Hospitals due to medical error, the IOM defined six aims for delivering quality care. The IOM states that healthcare should be: safe, effective, patient-centered, timely, efficient, and equitable. The IOM put the issue of patient safety front and center before healthcare policymakers.
2004 - 2007
The Human Factor (2004) shed light on the importance of teamwork and communication.3 Recommendations to reduce error included the use of the SBAR (situation, background, assessment, recommendation) tool and closed-loop communication tactics.
In 2006, the Agency for Healthcare Research and Quality (AHRQ) released Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS). These insights were designed to serve as the national standard for team training in healthcare.4 Shortly after, in 2007, the Quality and Safety Education for Nurses (QSEN) Institute created the QSEN Competencies. The competencies can be applied in a multitude of settings to develop nurses with the knowledge, skills, and attitudes necessary to continuously improve the quality of healthcare.5
Each of these initiatives made evident the fact that the healthcare community had begun to respond to threats on patient safety.
Realizing the need for high-fidelity physiological responses in a simulator that could be used in an in situ setting – i.e., a real clinical environment – Laerdal developed SimMan 3G . This next member of the SimMan family can display neurological symptoms as well as physiological symptoms and can easily be made mobile with wireless technology. SimMan 3G provides educators with the flexibility to train basic and advanced skills in a team-based setting.
The year following SimMan 3G’s release, Laerdal introduced SimMan Essential. SimMan Essential offers comprehensive clinical functionality to teach core skills in airway, breathing, cardiac, and circulation management. By offering an expanded simulator portfolio, Laerdal gave clients the power to choose a solution tailored to their needs. It was not long before SimMan Essential was seen as a common element in training within EMS, the Military, and Hospital Emergency Rooms.
In 2012, the Leapfrog Group introduced the Hospital Safety Score, the first letter grades assigned to over 2,500 hospitals rating how safe their care practices were.6 During the same year, the Centers for Medicare and Medicaid Services (CMS) launched the Accountable Care Organizations (ACO) Model. It sought to spend health care dollars more wisely while enforcing the delivery of quality care among its providers.7
These two movements for patient safety signified that the public and the government had a greater demand for transparency. They also held healthcare professionals and the organizations within which they work more accountable for medical errors made.
As patient safety initiatives in hospitals gained traction, the military also worked to improve the scope and realism of their training. In 2013, Laerdal introduced SimMan 3G Mystic – a simulator designed specifically for the U.S. Army. SimMan 3G Mystic is designed specifically to meet the needs of training for Tactical Combat Casualty Care (TCCC). SimMan 3G Mystic is only available to U.S. clients. Laerdal takes pride in knowing that we are enabling our military life savers to train to the best standards possible.
Following the release of SimMan 3G Mystic, Laerdal released SimMan 3G Trauma . It was developed with severe trauma training needs in mind – particularly those of the military and the pre-hospital setting. SimMan 3G Trauma provides clients with the ability to simulate amputated limbs, sternal intraosseous infusion (IO) access, and bleeding control. These features, among many others, help to shape a realistic trauma emergency scenario for learners.
In 2016, a Johns Hopkins study calculated that more than 250,000 deaths each year in the U.S. are due to medical error.8 These findings were groundbreaking as the death toll made medical errors the third leading cause of death after heart disease and cancer.9 The year prior, the National Council of State Boards of Nursing (NCSBN) published a study demonstrating that simulation can successfully substitute up to 50% of traditional clinical hours across the prelicensure nursing curriculum.10
Following these two studies, it became clear that organizations and the healthcare professionals within them were making moves to reverse the problem. Also, the general public began gaining awareness of the issues that might affect them and their health.
In 2016, Laerdal developed SimMan ALS , a mobile and durable solution to meet the needs of pre- and in-hospital emergency care providers. SimMan ALS can be used in conjunction with the Laerdal-SonoSim Ultrasound Solution, LiveShock, or ShockLink to meet a client’s specific training requirements.
A large benefit that simulation offers is giving learners the opportunity to rehearse real-world, specialized training – something that might otherwise be hard to practice. Recognizing the need for multidisciplinary team training for Endovascular Specialists, Cath Lab teams, and Pre-hospital care providers, Laerdal developed SimMan Vascular . Built on Laerdal’s SimMan 3G platform with Mentice’s VIST® endovascular simulation technology inside, SimMan Vascular is an integrated emergency patient and endovascular procedure simulator.
Similarly, Laerdal has taken note as educators begin placing more emphasis on diversity in healthcare. Most recent enhancements to SimMan 3G include a range of skin tones to reflect the diversity of real patients. As educators continue to address disparities in healthcare and to strive for health equity, it can help to introduce simulators that can enhance patient realism.