Improving patient safety and quality of care

The Scott & White Clinical Simulation Mobile Unit Helps Test Important Hospital Systems and Train Medical Staff for Emergency Situations

This is the second of two articles in a two-part series about the things that go on behind the scenes at Scott & White that help to improve patient safety and quality of care.

dummyAn elderly man is visiting his grandson at McLane Children’s Hospital Scott & White, when he is overcome with chest pains and numbness in his left arm. Nurses at the children’s hospital must spring into action to get this man the help he needs, even though they aren’t used to caring for adults.

The good news is that this was all just a simulation exercise executed by the team from Scott & White’s Clinical Simulation Mobile Unit.

This team travels to Scott & White hospitals all over Texas, helping healthcare providers practice emergency situations and to increase patient safety and quality of care.

After completing the simulation at McLane Children’s Hospital Scott & White that day, the team was shocked to see the scenario play out for real.


“Forty-five minutes [after we finished the simulation] a guy was driving down the road having chest pains and was losing feeling in his arm,” said simulation technician Joe Garza. “He saw the sign for the children’s hospital and pulled in. He ran inside saying that he was having a heart attack. The same nurses that [participated in the simulation] took him back and did everything to him that they had just done to our Standardized Patient.”

Garza can’t imagine what would have happened if the simulation team hadn’t been there that morning.

“Would the nurses been as comfortable treating an adult?”

What is the Clinical Simulation Mobile Unit?

The idea for the mobile unit came out of a need to standardize the care patients receive throughout the Scott & White system.

“We wanted patients to go to any of our Scott & White hospitals and clinics to get the same quality of care as they get here at [Scott & White Hospital – Temple],” said Jose F. Pliego, MD, medical director of clinical simulation. “We wanted to make sure that the excellent quality standards in patient safety were being implemented in all of our distant facilities.”

In September of 2012, simulation educators and technicians loaded up a van, they call MobileSim, with several different high fidelity mannequins who can cry, scream, moan, bleed out and dilate and brought them to the Scott & White hospitals outside of Central Texas.

Many of these hospitals are rural facilities and might not see the volume or variety of patients that are seen at Scott & White Hospital – Temple. That’s where the mobile unit comes in. They give the hospital staff the chance to run through emergency situations in a safe environment where their mistakes won’t be fatal.

“We want to make sure that [each hospital team] knows how to take care of their patients with their own equipment and their own people,” Dr. Pliego said. “The only way for us to really assure that is to test the system. These simulated exercises give them the opportunity to learn based on their own limitations.”

What is the benefit of having this type of unit?

Along with standardizing the procedures and protocols in all Scott & White facilities, the unit also helps to ensure the safety of all who enter.

“Basically, we can set up to do any medical procedure or test any system,” said Della Austin, RN, MSN, director of Clinical Simulation/Standardized Patient Program. “We can even test to see if stretchers or hospital beds will fit in hospital elevators. We do a lot of that before new facilities receive patients.”

Dr. Pliego said these simulations help to give healthcare providers experiences to draw on when they are faced with those situations in real life.

“For example, if you’re a patient who has shoulder dystocia, where the baby’s head is stuck behind the mother’s pubic bone during delivery, you’re going to want a physician who has been in that situation before.”

What does the future look like for the mobile unit and clinical simulation?

“I think the role that clinical simulation plays for the future is going to increase,” Dr. Pliego said. “I think we’re going to be seeing it as a part of certification for nurses and physicians.”

By incorporating simulation, it will allow directors to assess performance, technical and communication skills and professionalism in real time, the medical director said.

Simulation Technician Joe Garza sees his job as important as anyone else in the healthcare system.

“We may not deal with real patients, but we’re helping to save lives.”

For more information about the Clinical Simulation Mobile Unit, please visit clinicalsimulationcenter.sw.org.

About the author

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Jessa McClure holds a degree in journalism and mass communication from the University of Mary Hardin-Baylor in Belton, TX, where she is currently an adviser for student publications. She has been a writer in the health care field since 2009.

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Improving patient safety and quality of care