This pre-course will be virtual-only

Course Director

• Barbara Masser, MD

Faculty 

• Barbara Masser, MD. USA
• Jonathan Edlow, MD. USA
• Jon Burstein, MD. USA
• Roberta Petrino, MD. Italy
• Ian Higginson, MD. UK

Participants

The course is designed for 30 participants. 

Target group: emergency physicians and nurses interested in emergency department quality improvement 

Course description 

Learning objectives

After this one day course, participants will learn:

1. The necessity of having a well-run quality program in their EDs and the importance of using quality metrics to measure ED performance, drive intended clinical behaviors, and ensure high-quality care delivery to patients in emergency medicine clinical practice through the creation of a blame-free culture.
2. The structured review technique, applying it to three specific clinical cases with the goal of determining the presence or absence of error and its most likely source (provider, systems, supplies, protocol deficiency, administrative).
3. The creation of a clinical pathway (through hands-on practice), and important concepts regarding the use of clinical pathways to improve patient safety.
4. How to define an error (versus “judgment”), differentiate errors in planning (mistakes) from errors in execution (slips and lapses), distinguish between errors and adverse events, rate an error using the AHRQ Adverse Event Severity Scale, discuss factors contributing to errors, and understand the relationship between error and standard of care

ETR

This course addresses Section 2.6 - 4 Health care evaluation and improvement from the European EM curriculum

Schedule

Wednesday 27 October

11.00-11.30 Why Quality Assurance is Essential to Every Emergency Department

This introductory session will be a discussion of the necessity of having a well-run quality program and the importance of using quality metrics to measure ED performance, ensure high-quality care delivery, and create a blame-free culture.

11:30-13:30 Workshop 1: Performing Case Review and Objectifying Error: How to perform a structured case review & objectifying error. 

After a brief instruction, learners will break into a group discussion, facilitated by all course faculty, and jointly “review” three specific clinical cases applying the technique of the introduced structured review. At the end of this exercise, participants will have determined the presence or absence of error and its most likely source (provider, systems, supplies, protocol deficiency, administrative).

13:30-14:00  Break

14:00-16:00 Workshop 2: Reducing Error through Pathways

First, we will discuss the development of multi-disciplinary clinical pathways to reduce error in the emergency department (introduction to the clinical problem, what was the scenario that led the department to feel the need to create a clinical pathway?). After the introduction, we will take the “error” identified in our earlier workshop for each specific case and discuss ways in which this could be prevented in the future. The group will engage in strategic brainstorming and discussion of potential clinical pathway development around these specific clinical issues, as well as multi-disciplinary considerations (dealing with consulting services, interaction with hospital administration).  

16:00-16:15  Break

16:15-17:15 Conclusion & QA Challenge Panel

During this session, participants will bring their biggest QA challenges to the table. The four international faculty members will propose potential solutions, discussing their experiences with QA management at their home departments. At the end of the session, we will summarize the techniques reviewed (structured case assessment, objectifying error, clinical protocol and pathway development).

Course Director

Christian Heringhaus (The Netherlands)

Faculty

1. Vanessa Valk (The Netherlands)
2. Ruth Sneep (United Kingdom)
3. Lieke van de Voort (The Netherlands)
4. Roy Welsing (The Netherlands)
5. Meys Cohen (The Netherlands)
6. Zohra Ebrahimi (The Netherlands)
7. Harald Hennig (Germany)
8. Erik Oskam (The Netherlands)

Participants

The course is designed for 16 participants (Emergency Physicians).
Target group: Emergency Physicians and residents. Doctors who will follow the pre-course must be adequately trained in advanced life support and airway management skills.

Course description & learning objectives

Procedural sedation and analgesia (PSA) is widely administered by emergency physicians, in order to perform painful or uncomfortable procedures in the Accident and Emergency department.
PSA is significant associated with complications and must be seen as a high-risk procedure. Due to the inherent risks, it is important that doctors are aware of and follow available national, international and local guidelines.
Furthermore it is crucial that adequate training should be followed to ensure the knowledge and skills to safely administer PSA and to treat possible complications.
With this course, we will give the participants an overview of existing national and international guidelines, show them how to prepare the patient and the environment to perform safe PSA on the Accident and Emergency department and how to avoid and treat the most common complications related to PSA.
After an introduction with some short presentations, we will mainly train with simulated patients in hands-on workshops.

Educational Material

Pocket cards with relevant information for PSA preparation and treatment of complications.

After the course participants will get a list of relevant literature.

Schedule Wednesday 27 October 

Course Directors

• Aine Mitchell, Ireland

Faculty

• James Wallace, UK
• Pieter Heeren, Belgium
• Arjun Thaur, UK
• Rosa McNamara, Ireland
• Ruth Sneep, the Netherlands
• James van Oppen, UK
• Bas de Groot, the Netherlands

Participants

The course is designed for 24 participants (Emergency clinicians, residents, nurses and paramedics more than welcome).

Course description  

The number of older patients in the Emergency Department is rising. Many of these older patients suffer from complex comorbidities, frailty and are at risk of adverse outcomes. Working with frail older patients can be difficult for those working in Emergency Medicine, however it is becoming more and more important.

This  ‘hands on’ pre-course has the goal to improve the knowledge and skills regarding Geriatric Emergency Medicine of the participants. We start with one lecture after which the rest of the day will be filled with working groups and scenario’s with small groups.

The participants will be provided with practical tips and clinical education points with which they can start working when they are back in their own hospital.

Using several themes the main issues of working with older patients in the ED will be discussed, such as frailty, the older trauma patient, sepsis, pain management, syncope, polypharmacy, cognitive impairment and end-of-life care.

Learning objectives

• To teach participants about general concepts of Geriatric Emergency Medicine such as frailty and its implications when working in the ED
• To give participants clinical education about older patients with:
  • Trauma
  • Sepsis
  • Deprescribing / polypharmacy
  • Pain management
  • Abdominal pain
  • Syncope
  • Delirium and cognitive impairment
• To give participants training on how to discuss end of life care in the ED

EDUCATIONAL MATERIAL

Prior to the course a information pack will be sent to the participants with background information to study, this way we can focus on practical work during the pre-course.

To be handed over onsite at the course:
A ‘take home info pack’ will be provided to give the delegates an appreciation of the impact what having a diagnosis of frailty can mean for the trajectory/outcomes of an older person presenting to the emergency department, with written information about the wider implications of frailty on outcomes. This will contain a number of carefully selected review articles as food for thought for interested candidates. Also handouts of the slides and the summary of the key learning points will be provided.

Schedule thursday 28 october

PLEASE NOTE THAT THIS PRE-COURSE IS OFFERED IN A HYBRID FORMAT. YOU CAN JOIN VIRTUALLY AS WELL.

Course Directors

• Guillem Bouilleau, France
• Pierluigi Ingrassia (Italy)
• Anne Laure Philippon (France)

Faculty

• Lukas Drabauer, Austria
• Guillem Bouilleau, France

Participants

The course is designed for 16 participants. 

Objectives

• To learn techniques and framework of debriefing in simulation and professional situations
• To practice debriefing with special feedback from peers and faculty

Course overview

During this hybrid workshop you will learn how to conduct a debriefing of a learning situation in emergency medicine (in the context of simulation-based training but also in a professional context). You will also learn about the content, framework and outcomes of such a debriefing.

The first part of the day will be devoted to the work you prepared before coming. Indeed, we will ask you to prepare the content of a debriefing starting from a situation that we will previously sent to you. We will ask you to videorecord yourself, in order to have some basis to discuss about debriefing.

The second and larger part of the day will be devoted to 8 short simulation sessions, with 8 debriefing made by binomials. All the debriefings will be followed by a debriefing or a feedback of the debriefing.

At the end of the day, you will be able to conduct debriefing on your own, and will have some resources to deepen your experience after the workshop.
The apprenticeship will be done throughout personal returns on debriefing, little conference and several practical simulation scenarios in which every participant will have the opportunity to conduct a debriefing.

Participants who are at home would participate in all the debates, conferences and simulation courses, and they could also drive a debriefing, in binomial with participants onsite. Participants onsite will make the same activities, and will also play the actors for the simulation sessions.

Schedule

Before the session: (maximum 30 minutes of work)
Each participant records a 5-minutes video of himself making a debriefing for a simulation session, that we will send to all of them. Then they send us their video, and had to prepare a mini-scenario, inspired from emergency medicine, within a specified framework (short scenario, for residents, with maximum 2 or 3 learning objectives)
Each participant also completes the pre-test workshop.

Wednesday 27 October (8h30-17h30)

8h30-9h: Beginning time, presentations
9h-10h30: Feedback on the participants’ videos, helping us to describe the framework and content of a qualitative debriefing

10h30-10h45: Coffee Break

10h45: 11h40: First simulation session: preparation, short briefing, 4 minutes scenario, 15 min debriefing and 15 minutes debrief of the debrief (faculty)
11h40-12h30: Second simulation session, following the same running

12:30-13:15: Lunch

13h15-14h: Debrief 3 then debrief of the debrief (faculty)
14h-14h45: Debrief 4 then debrief of the debrief by the peers
14h45-15h30: Debrief 5 then debrief of the debrief by the peers

15:30-16:00: Coffee Break

16h-16h30: Debrief 6 then feedback from faculty
16h30-17h: Debrief 7 then feedback from faculty
17h-17h30: Debrief 8 then feedback from the peers