Staff at The Queen's Medical Center Trains on Real Emergencies, Artificial Patients

Laura Greer, RN, applies chest compressions when the "patient" codes; the OB team rushes to perform a C-section.

Late one Friday afternoon, two pregnant patients were being readied to spring delivery room emergencies on the nurses and physicians at Labor and Delivery at The Queen's Medical Center. The focus, however, was not so much on saving the patients-they were only mannequins, after all-as on learning valuable lessons in handling emergencies.

The mannequins were high tech electronic simulators. They behave like real patients with blinking eyes and dilating pupils, pliable skin and chests that rise and fall as they breathe. You can find pulses where you'd normally find them and can hear authentic sounding heart beats and even bowel sounds through a stethoscope. Vital signs appear on the operating room's actual monitoring equipment. A thick cable snakes from each simulator to a laptop computer, which controls the patient's vitals and makes her react to medical procedures.

Queen's Heart staff have been organized under this big picture concept over the past year. Two new programs, the Cardiac Transfer Center and Cardiac Curbside, were launched last year to facilitate cardiac care by making it easier for patients to access cardiac services. "Departments throughout Queen's have come together in cooperation with one goal-what's best for the patient," says Williams.

Playing God at the keyboard was Paul Preston, MD, a Kaiser Permanente anesthesiologist from the Bay Area, who quietly launched emergencies. It was Queen's physicians' and nurses' job to diagnose the problem and treat the patient (or perhaps her mannequin baby) before a fatality occurred. The scenarios were videotaped, and staff immediately retreated to a debriefing room to analyze what went right-and wrong.

Other complex, high-risk fields such as aviation and nuclear power have used simulation to train professionals for years, but medicine has been slow to change. Cited in a January 2006 U.S. News and World Report article, Dr. Preston is a pioneer in bringing simulation to medicine. Many past simulation attempts focused only on one group of a medical team; Dr. Preston's training includes everyone.

Instructor Paul Preston, MD, in action.

Dr. Preston's training takes into account not only medical procedures, but also communication issues and the psychology of human behavior during a crisis. The simulations are designed to teach doctors and nurses to react with calm and precision in emergencies.

"This is a very good hospital," said Dr. Preston of Queen's. "It's right up there with our top Bay Area hospitals." The 20th hospital he has worked with on simulation training, Dr. Preston will in turn take home ideas he learned at Queen's, demonstrating another level of positive communication among health care professionals.