For most city dwellers with good health insurance, a visit to the emergency room is usually just for emergencies. But for people who live in rural America where there is a shortage of healthcare providers, the ER is often the first place to go for care, especially for residents who are low-income or uninsured. As a result, it’s common for rural emergency rooms to see long wait times, increased patient walkouts and overworked staff – all factors that can contribute to poor quality care.
Fortunately, for nearly 340,000 residents in four rural counties in North Carolina, a team of nurse educators led by Donna Havens, a professor at the School of Nursing at the University of North Carolina at Chapel Hill, is working to change this by improving interprofessional collaborative practice (IPCP) at four different emergency rooms.
“Based on our prior research,” explains Donna, “we had identified through hard data that the interprofessional staff working in emergency rooms expressed the greatest need for more help with communication and collaboration to deliver better care.”
To teach these vital skills, Donna and her team used a number of tools, including Friday Night at the ER, after securing a grant from the U.S. Bureau of Health Workforce, Health Resources and Services Administration (HRSA) for the three-year project.
“We bought games for each hospital and several for our team to loan out to the hospitals, and taught them how to play it,” says Donna. “We initially facilitated the games ourselves, but part of our goal was to help them sustain the positive change themselves, so we helped them learn how to facilitate.”
In each case, hospital employees participated in a game session and structured debrief that focused on reflection, dialogue and actionable steps.
“Every time we hosted an interaction with Friday Night at the ER,” Donna explains, “it was met with excitement and curiosity, and the discussions that followed later went pretty deep. It’s to the point where they see the relevance of using it beyond the emergency department, which is perfect because the real issue in providing quality care is that it has to flow from the emergency room to the other units and departments.”
Donna’s project was an ideal use of our simulation game because it gave the ER professionals in rural North Carolina an opportunity to view their workplace from a different perspective and to collaborate in a way they might not have tried in the real world.
“I know that because of our project, which includes the use of Friday Night at the ER, we have opened new awareness between the ER and Critical Care staff, and it is helping to promote the flow of patients in a timely way,” Havens says. “We are seeing improved coordination as we use it.”