Dear KCRSA members,

I am going to try to reach out monthy about issues that I think affect all of us in Simulation – with special attention to the Kansas City region and it’s needs.

Many of us have just returned from the annual International meeting (IMSH 2018) in LA.  This was my first trip ever to LA.  What a beautiful dynamic city with such great amenities for a meeting like this!  But let me warn you, when we return in a few years to this venue on the meeting cycle, don’t pick a hotel right on the edge of LA LIVE if you want to get to sleep before 2:00 am.

I attended the pre-course on M & S – Modeling and Simulation.  Although I am not an engineer and make no pretense about being able to work in differential equations, I think that what these specialists do is obviously so critical to what we are about in education in healthcare, that I am personally very interested in what they are saying.  I have always thought that after the invasion of simulation by psychologists, the next wave of input would be by systems engineers.  I joined the SIG group for systems engineering and I was there at the first meeting at IMSH in 2013 (if you look at the picture on the website of the inaugural meeting, that crown of white hair with my face hidden by a person at the table in front is me).  I said at the keynote at the opening and dedication of HEB at KU last year, that I was aware of only two methods that have proven to achieve sustained “zero error” rates for currently monitored conditions (e.g. “clabsi”).  The first is team instruction programs such as TeamSTEPPS and CUSP (the two currently promoted by AHQR).  The second is of course “Systems Engineering.”

Since 2013 the SIG group has grown, has established a website, has met at IMSH yearly and last year sponsored a number of courses, presentations and abstracts/posters.  This year the group has progressed to presenting the pre-course – a day and a half of short and plenary length presentations and highly organized panels (you would expect nothing less from a bunch of engineers) by the top names in the field. The four planning committee members gave us 50 speakers who widely represented the areas impacted from this approach.  Since I was the only Kansas City area representative there at this forum, I thought it might be helpful if we devoted a few issues of this “zlog” to what I heard there.

The opening plenary address was by Prof. Terry Young, Chair of Healthcare Systems at Brunel University in London.  He started his presentation by reminding us of Friedman’s graph where the rate of change in technology over time is compared to the adaptability of humankind to this technology.  You may or may not agree with Friedman’s hypothesis about human’s adaptability but, as Prof. Young pointed out, no one would disagree with the phenomenal increase in the rate of technological advance.  The impression I got from the course is that there is no other way to deal with this except by systems and models.  I hope to write more about this but let me today just give you Prof. Young’s own abstract summary of his presentation:

“Modeling and simulation are not commonly used in designing healthcare services – yet!  In this session we’ll explore three reasons why clinical staff, in particular, should model: the insights yielded by modeling provide clinicians with insights into how to obtain the goals they want in the context of the service being run, and the output from models provide clinical staff with a voice when it come to the design or improvement of services and an ability to articulate their preferences in meaningful terms to operational managers and strategic planners.  Too often, clinical staff feel the only option left open to them is to withdraw support from changes on the grounds of safety.  Finally, healthcare services rely heavily on information service and modeling provides a link for clinicians into the world of IT and communications.”

I hope you are as uncomfortable with the first reading of that as I was.  But as educators, we need to learn about healthcare and modeling if we are to teach simulation and modeling.  We are going to have to learn to hold hands with the engineers who model, just as we have learned how to hold hands with psychologists who do simulation.

Dave Zamierowski

P.S. Here is a picture of Emily presenting her award winning paper at IMSH.