6121 Multidisciplinary in-house simulation with outreach support improves delivery of safe patient care

Objectives We work in a busy District General Hospital where we very frequently manage critically ill children. A recent case we encountered was escalated to serious incident investigation, where both skill-mix and multidisciplinary team functioning were identified as shortfalls. In response to this, we designed and led a training day. The aim was to develop knowledge and skills in managing critically ill children within the District General Hospital setting, provide hands-on experience in setting up and troubleshooting equipment used in resuscitation, and enhance in-house multidisciplinary team working. We planned to focus simulation scenarios around real life serious incidents, where cases presented with more than one pathology. We recognise that real life cases (as opposed to the algorithmic approach of emergency courses) are messy problems which require lateral thinking and management of more than one presenting complaint/more than one organ system at the same time. Methods We devised small group high-fidelity simulation scenarios based on three recently encountered serious incidents. This was run in conjunction with our Trust simulation team in a dedicated simulation suite. We recruited external faculty (Consultant from our retrieval service and Consultant from our network Paediatric intensive care unit) and internal faculty (Consultant Paediatrician and Consultant Anaesthetist) to debrief on scenarios and to deliver tutorials on anaesthetic agents, ventilation and inotropes per pathology. Results The course was attended by A+E and ward nurses, Paediatrics and Anaesthetics doctors from our hospital and other District General Hospitals within our regional network. It received excellent feedback including 'so good to have interdisciplinary collaboration and learning' and 'very practical and easy to follow, relevant to real life practice'. We have now integrated this course into our annual local Paediatrics teaching programme. Feedback from our most recent course this year demonstrated that all candidates felt that the programme had influenced their future practice and had improved their communication and team working skills. Conclusion We believe in-house simulation days are excellent for understanding and unpicking human factors that exist within the team, in addition to upskilling staff in a safe and unpressured environment. We would like to share our experience with the wider Paediatrics Community across our region and across the UK.