Enhancing Escalation Skills in Medical Emergencies: The Role of Tabletop Simulations

Purpose: The purpose of implementing tabletop simulations was to develop a more effective training model that would incorporate microburst learning sessions to enhance preparedness of team members in the ambulatory care clinical setting. These sessions, centered on medical emergency processes, enabled clinical nurses and multidisciplinary staff members to integrate crucial escalation responses into their workflows. Furthermore, the simulation experiences engaged key personnel to promote a collaborative working environment and clarify roles and responsibilities.
Description: Prior to introducing emergency preparedness tabletop simulations, clinical nurses raised concerns that the current training provided was not applicable to clinical practices, as it did not account for procedural differences. The variations in medical emergencies across the clinical areas spurred the adoption of tabletop simulation as an educational experience, enabling clinic participants to practice their knowledge of escalation procedures. The delivery of education was held in actual clinical environments, which enabled staff to engage in realistic scenarios and apply their understanding of organizational policies and clinical escalation processes. Structured around pre-incident, incident, and recovery phases, the simulation experiences created a space for exploring different strategies and solutions. Clinical educators collaborated with the simulation department and life support services to establish quarterly tabletop simulation rotations at each clinical site.
Evaluation/outcome: Qualitative data was obtained via feedback from rounding huddles and post-activity surveys. The key themes identified from self-reported preparedness included effective communication, staff empowerment to take appropriate actions, and interdisciplinary collaboration during medical emergencies. Learning outcomes were measured by improvements in knowledge, confidence, and understanding of protocols. Behavioral changes were tracked through performance in both simulations and actual emergencies. Ultimately, the initiative resulted in enhanced patient safety, more accurate responses, and consistent adherence to escalation procedures.
Consistent completion of tabletop simulation sessions is necessary to foster continuous improvement in critical-thinking and communication skills, which are vital for effective interdisciplinary collaboration during escalations. The simulations sessions helped refine escalation processes and improve staff responsiveness to future emergency situations, providing a means of improving decision-making abilities. Tabletop simulation sessions were successful in providing an engaging and interactive approach to strengthen knowledge escalation in the unique clinical environment of ambulatory care services.