Acute medical unit clinical skills lab

Sarb Clare; Joe Wheeler

doi:10.7861/futurehosp.6-1-s140

Aims

City Hospital opened the first dedicated clinical skills lab within an acute medical unit (AMU) in November 2016. We believe this is the first in the UK with the aim of prompt accessibility in a high-acuity, fast-turnover area. The principle is to ‘learn in chunks of 15 minutes’ and bring back the concept of learning on the job. We were keen to create a culture of learning and education for nurses, doctors, students, allied health professionals (AHPs) and our patients which has led to an improvement in quality of care and job satisfaction as well as a decrease in expenditure.

Creation of the AMU clinical skills lab was to:

provide 24/7 accessibility to a wide range of teaching materials including simulator, and procedural kits
increase competency and confidence with expectation that all procedures would occur promptly leading to increased quality of care with less complications and thus reduced length of stay
all training to be delivered in-house with no need for doctors, nurses and AHPs to attend courses, reducing costs
by creating an environment of learning we would see a drop in sickness, and improved retention and recruitment in an area which is traditionally difficult to retain.

Methods

The lab is within the AMU and has been funded by revenue from courses that Dr Clare has been running since 2010 and cost approximately £15,000. Equipment includes a simulator and all procedural kits as well as a projector and Airway, Breathing, Circulation, Disability, Exposure resources. A dedicated USS machine also sits within the lab.

Many teaching programmes occur throughout the day ranging from mandatory training to procedural training (lumbar punctures (LPs), ascitic drains and central venous pressure lines) to simulated crash scenarios. In addition, undergraduate training for students rotating onto the AMU occurs.

Results

As there are numerous programmes occurring this is a snapshot of data.

Junior doctor teaching programme has shown an increased level of competence and confidence in the ability to carry out LPs / ascitic drains from data pre- and post-AMU clinical skills lab.
Junior doctors rate acute medicine at City Hospital as the best rotation within the trust and the specialist registrars rate it as number one within the west midlands.
Discharge rates are 60% versus national of 40% and length of stay of 0.6.
Mandatory training is at 96% versus 76%.
Nursing sickness levels are at the lowest and retention is at 100%.

Conclusion

Data collected from the various teaching programmes have overwhelmingly shown the benefits of a dedicated AMU clinical skills lab. Individuals and teams are being taught despite constant pressures, and being empowered with skills and knowledge which then prompt consolidation out on the AMU. This has not only raised morale, improved on-call experience, and empowered individuals and the team, but has ultimately improved the quality of care we give to our very unwell patients in the AMU. We have a large dedicated clinical skills lab for our new super-acute Midland Metropolitan Hospital within the centre of the AMU.