Simulated disaster provides a road map for rescue
Interprofessional exercise between MSU Denver and Denver Health students showcases the lifesaving impact of collaborative coordination.
About 80% of medical errors occur due to miscommunication issues. One area of high risk is the handoff between health care providers such as emergency medical technicians and nurses.
“When a disaster strikes, it’s critical to have a clear chain of command where everyone clearly understands their roles and responsibilities,” said Kris Caudill, a student in Metropolitan State University of Denver’s Fire and Emergency Response Administration program.
Caudill will step into the role of incident commander in a simulated carbon-monoxide leak on Nov. 16 at MSU Denver. It’s part of an applied interprofessional training triangulated among Denver Health’s EMS education program alongside the University’s Nursing and FERA programs. The goal is to reduce miscommunication and improve patient care, potentially helping to reduce the number of deaths that result from medical error.
Scott Heiss, an associate professor in FERA and retired division chief of training for Denver Fire’s Station 28, is coordinating the effort as a part of his Emergency Management Institute National Response course.
“Whether an engine company is called to a dumpster fire or a multilevel high-rise, every incident needs an incident commander — that’s where it all begins,” Heiss said.
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The challenge, he added, is that too often, responders encounter the interwoven nature of incident response for the first time while on the scene.
“This opportunity gives students a hands-on chance to work with other agencies and disciplines to see how to use the system they’ll encounter on the job correctly,” Heiss said. “It’s an invaluable experience for them.”
As a primary instructor for Denver Health’s EMT school through MSU Denver, Mark Whitright echoed this sentiment and noted confusion of terminology as a potential factor contributing to patient-handoff error.
“Is it a pram, a gurney or a stretcher? What exactly does ‘triage’ mean in this situation?” he asked. “The more we can highlight the importance of communication integration, the more we can give our patients the best care possible.”
After the scenario’s carbon-monoxide detection and staging of EMS responders, the simulated patients will be transferred to Nursing students in the newly opened Gina and Frank Day Health Institute Interprofessional Simulation and Skills Laboratory (Sim Labs).
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Mary Tucker, DNP, director of the Sim Labs, noted the pandemic as an example of why the interprofessional approach is critical to formulate a public-health response strategy.
“An exercise like this is essential to helping our students understand how health care professionals interact with one another and how students can learn from mistakes in a safe environment,” Tucker said.
A former Air Force medic, Caudill found her fit within the FERA program after running to help a friend whose house had caught fire. Witnessing the care and competence of the first responders proved to be a continuation of her call to service.
“I saw what the fire crew was doing, and that solidified it for me,” she said. “You see people on their worst days and try to make a difference.”
In the role of incident commander, she will use a framework called a “strategy prompter” — essentially a flowchart setting up the command post, then sectoring the duties into a clear, coordinated chain of command to establish priority areas.
It follows the response protocols established by the National Incident Management System, which Heiss details in his FERA class. Founded in 1980s-era Arizona wildland firefighting, NIMS grew to prominence following the terrorist attacks of Sept. 11, 2001, when then-President George W. Bush mandated that first responders establish a common verbiage in mass rescue-and-recovery efforts. The format is still widely used today, including for planning Denver events such as the 2008 Democratic National Convention and the National Western Stock Show.
Heiss said one of the keys to its effectiveness is retaining simplicity at scale: Even as a scenario grows, each individual responder is never talking to more than five others at any given time, streamlining the logistics against miscommunication.
That’s not to say mistakes won’t ever happen. But with coordination and scenario training, Caudill and these real-life lifesavers are working to ensure that they don’t occur when lives are on the line.
