SBIR-STTR Award

Nationwide, Emergency Medical Services (EMS) play a crucial health care role in the well being of rural populations. There are substantial challenges within the rural EMS system, including: high costs for providing EMS care to sparsely populated regions, poor access to training and medical supervision, volunteer shortages, high response times and lower levels of training. EMS personnel recruitment and retention have been shown to be the most significant problems facing rural EMS. In 2008 the Institute of Medicine published the report - Medical Services at the Crossroads - suggesting that poor recruitment and retention of EMS professionals nationwide may have a detrimental effect on the health of communities. Lack of adequate medical services detracts from the attractive quality of life available in rural areas. Widely used in aviation and the military, simulation technology has emerged as an important new training tool in health care. The increased realism of simulation allows health care providers to train as they treat for the first time. In many ways still an immature technology, simulation when deployed in a mobile configuration offers the potential to address part of the serious training crisis of rural EMS in a collaborative and cost-effective manner. This Phase 1 research program will allow the development of a prototype mobile simulation platform by Hudson Simulation Services (HSS) to be fielded and used for training and research in the rural region of Northeastern New York. The prototype simulation package will include as its component parts : high fidelity patient simulators, training curriculum, debriefing equipment and a performance tracking system. The program will introduce advanced simulation training to the region and assist with the development of local emergency medical trainers. This focused simulation training effort can equip EMS providers with timely training that will raise both their competence and confidence levels in emergency response skills. Mobile simulation training has the potential to decrease the overall cost of providing medical services in remote areas by decreasing the high costs associated with turnover and make scarce health care dollars go further. This service allows older people with special health needs to stay in their communities rather than being forced to move to larger urban locations. A mobile simulation infrastructure would also have important economic development benefits by creating jobs for instructors in rural areas as well as keeping travel and lodging expenses in the area rather than going to distant training sites. Knowing that an essential safety net supports them as they work in remote locations and at sometimes dangerous tasks will add to the peace -of- mind of the citizens of Rural America. OBJECTIVES: The goal of this study is to gather qualitative data on the technical and economic feasibility of utilizing the type of rich training made possible by medical simulation for rural EMS personnel. The primary objective of the Phase I project is to research and develop a training approach and technology configuration making it possible to develop, deliver, manage, and track advanced medical simulation training for EMS in rural areas. The specific objectives of the program are to: 1.Introduce advanced medical simulation and training to the testbed region. 2.Provide foundational simulation science instruction to a cadre of instructors in the region. 3.Perform validation research on the effectiveness of simulation training to improve EMS staff recruitment and retention in the testbed region. 4.Field a prototype rural EMS mobile simulation package that includes as its component parts: patient simulators,training curriculum, debriefing equipment and techniques and performance tracking capability. Much of the technology used in the system is Commercial -Off- The -Shelf (COTS) and has not been field tested for this special application. We anticipate finding some limitations in the equipment performance under high volume field conditions. The overall Phase 1 objective which we believe can be readily achieved within the eight month period of performance will be completed by completing the following activities. The work plan has been divided into five major tasks: Task 1- Validation research on the effectiveness of simulation training in testbed region. Task 2 - Curriculum development for rural EMS simulation tailored to testbed region training priorities completed by June 30th, 2010. Task 3- Instructor training on simulation technology completed by June 30th, 2010. Task 4 - Development of a protype mobile simulation package by June 30th, 2010. Task 5- Field Operations from July 1 to December 31, 2010 resulting in the training of 800 personnel in high stakes simulation scenarios

Nationwide, Emergency Medical Services (EMS) plays a crucial health care role in the well-being of rural populations. There are substantial challenges within the rural EMS system including: high costs for providing EMS care to sparsely populated regions; fewer tax dollars to fund health programs and trouble with providing public services. In addition, rural regions have difficulties with increasing health care demands from aging residents, poor access to training and medical supervision, volunteer shortages, high response times and lower levels of training. There are many barriers to providing high quality training in rural areas. Rural EMS providers often have to travel long distances to receive training. Conferences, workshops, and specialty trainings tend to happen in urban centers, forcing rural personnel to take time away from their primary jobs and family, not to mention leaving their home community vulnerable in their absence. Widely used in aviation and the military simulation has shown promising results in healthcare. Medical simulation is an emerging training and feedback method in which learners practice tasks and processes in lifelike circumstances, at their own locations, using models or virtual reality, with feedback from observers, peers,and video cameras to assist improvement in skills. But for all its demonstrated potential in improving performance a number of barriers exist to the more widespread dissemination of simulation technology in health care including: 1. cost of simulators and related equipment 2. staff training in simulation technology and methodologies 3. resistance to change in training methods among faculty. It is recognized that the quality of simulation facilitators is one of the most valuable factors for successful simulation training. The primary objective of our Phase 1 project was to research and develop a feasible training approach and tools to make it possible to deliver, manage and measure the effectiveness of advanced medical simulation training for EMS in rural areas. Our results suggest that mobile simulation can be an effective means of improving EMS team and technical skills training in rural agencies. Our goals for our Phase II effort will be to demonstrate a medical simulation training capability that has a positive impact on recruitment and retention of Rural EMS providers and that can be deployed in various operational environments on a commercial scale. Our testbed region for the study will be a 9 county region in Upstate NY. The emphasis during Phase II will be on longer-term impacts. The following additional benefits are anticipated from the Phase II effort:1. Achieve turnover cost savings in rural EMS, 2.Improve patient quality and safety measures in Rural New York, 3.Improve teamwork and communication skills of trainees, 4.Advance the state-of-the-art in health care simulation technology. Mobile simulation training has the potential to decrease the overall cost of providing medical services in remote areas by decreasing the high costs associated with turnover and make scarce health care dollars go further.