Simulation based education in integrated older adult care - a new way of learning for a new way of working

Background: The Integrated Care Programme for Older Persons in Ireland (ICPOP) aims to change the way health and social care for older persons is planned and delivered, with the aim of improving patient experience, quality and outcomes.¹ A key component of ICPOP is the implementation of new ways of working across healthcare teams. Simulation based education (SBE) can help support the interprofessional educational needs of these newly established teams in a dedicated supported environment,² and has the potential to promote change in healthcare delivery. Alongside this, SBE can also be utilised for system probing, where patient safety issues can be identified and remedied through system changes and training.² Methods: An interprofessional simulated education session was designed and developed following consultation with ICPOP team members. It was delivered in a simulation laboratory with participants from several disciplines including doctors, nurses, physiotherapists, occupational therapists, and therapy assistants from ICPOP and the acute hospital Frailty at the Front Door (FFD) Team. A prebriefing session was facilitated for participants. The simulation session followed the journey of a frail older person who experienced a fall and had presented to the Emergency Department. Participants representing team members from the acute hospital setting formulated a care plan and simulated the onward referral to the integrated care team. Afterwards, a debriefing session was facilitated by a medical simulation professional. Involved were the participants of the simulation, patient and participant involvement group members, and stakeholders from hospital, community and national service providers who were observers during the session. Feedback on the sim was obtained through an online questionnaire. Results: 12 participants provided quantitative and qualitative online feedback. A content analysis was undertaken on collected qualitative data. Overall all twelve enjoyed participating in the simulation and reported that they would be eager to engage in future SBE. The simulation highlighted areas for quality improvement pertaining to existing communication structures. All participants stated they found the simulation relevant to their area of practice and expressed that their practice would change as a result of the simulation, with improved communication noted as a key learning outcome by many. Participants noted that relationships developed through SBE could potentially deliver more efficient patient care and better patient outcomes. Discussion: Through SBE we identified key areas for quality improvement for older adults moving between multidisciplinary services. Following this systems probe approach, ICPOP and FFD now share weekly meetings and are collaborating on a patient information leaflet. Future SBE sessions are planned to explore the continuum of older adult care, bringing together teams from primary care, rehabilitation and specialist inpatient services, with the aim of fostering collaboration and forging new partnerships. 1.ICPOP Steering Group. Making a start for integrated care in for older persons - A practical guide to the local implementation of Integrated Care Programmes for Older Persons. 2017. 2.Sollid SJ, Dieckman P, Aase K, Søreide E, Ringsted C, Østergaard D. Five topics health care simulation can address to improve patient safety: results from a consensus process. Journal of patient safety. 2019 Jun;15(2):111.