By Mary Catherine Gaston
Well before sunrise on a crisp spring morning in rural Indiana, a small hospital receives an alert that an ambulance is in route, carrying a pregnant woman whose pre-term baby will need to be delivered by and receive critical neonatal care from a skeleton night-shift crew. In a county with no practicing pediatrician, obstetrician or neonatal specialist, the outlook for mother and child does not seem promising.
On a sweltering summer afternoon in Las Vegas, the alarming of diagnostic device sends a combat veteran suffering from Post Traumatic Stress Disorder scrambling for perceived safety in the corner of a clinical exam room. A young medical resident attempts to coax the terrified patient out of his hiding place, unsure of exactly how to interact with the man or properly treat the mental and behavioral scars of combat experience.
In the colorful but cramped office of a school nurse in a small town in south Georgia, a medical school professor uses a device fashioned from foam flotation “noodles,” PVC pipe and rubber cement to teach first-year educators how to effectively apply pressure to a bleeding wound in order to keep an injured person alive until paramedics arrive on an accident scene.
All of these are real-life examples of medical simulations—training exercises designed to be realistic enough to prepare medical and paramedical professionals, law enforcement personnel, educators and community leaders to respond to situations they are likely to encounter. Though different in nature, all three scenarios have two characteristics in common: Each is carefully designed and facilitated by highly skilled medical simulation professionals. More importantly, the knowledge and experience afforded by each scenario have the significant potential to save one or more human lives.
“States all over this country are investing brain power, time and financial resources to find new, better ways to serve the health care needs of their rural populations, and many of those solutions are taking the form of medical simulation,” said David Bridges, interim director of Georgia’s Rural Center. “While Georgia is rich in medical assets, the health care situation in many rural places is just plain poor. Bridging the gap will bring true prosperity within reach, and so, it is a high priority for the Rural Center.”
Last month the center convened a symposium at Lake Blackshear near Cordele to examine the health and wellness challenges confronting rural Georgians and to begin to craft innovative solutions, possibly including training through simulation. The center envisions the conversation will lead to the establishment of the Georgia Medical Education and Technology (G-MET) Experience and hopes influencers from throughout the rural health care spectrum will join the effort.
Though Georgia boasts multiple schools, colleges and universities offering degrees in medicine, nursing and related fields, many of the state’s 120 rural counties have critically low or no access to medical professionals and services. Out of 159 counties, 75—nearly half—have no OBGYN, 63 have no pediatrician, and eight counties have no physician at all. Practices in some rural places face doctor-to-patient ratios so high that quality care is nearly impossible because demand so far outweighs supply.
It is a problem with which Paul Umbach, founder and president of Tripp Umbach of Pittsburg, Pennsylvania, is familiar. Specializing in economic and community development, Umbach’s international consulting firm has played a role in the majority of establishments of new medical schools and existing medical school expansions.
“The health and wellness challenges rural Georgians have become all too familiar with are not unlike those we see in other rural areas throughout the nation, even the world,” Umbach said. “So what could work for the people of rural Georgia could become a model for rural America—could become a model for the rural world.”
Bridges and Umbach, together with partners from Georgia’s Rural Health Innovation Center and the South Georgia Medical Education and Research Consortium, charged representatives of south Georgia’s medical and nursing schools, community health organizations and health care systems with working together to fill the gaps in medical training, technology use and patient care that currently stand as barriers to prosperity for small towns and rural communities.
While some states are investing millions of dollars in state-of-the-art brick-and-mortar simulation facilities and technologies, speakers from some of those states, including Jack Jaeger, director of Indiana’s Rural Health Innovation Collaborative, or RHIC, urged the group not to limit itself to one location or format.
Doug Patten, a medical doctor and associate dean of the Southwest Campus of the Medical College of Georgia, agreed, encouraging collaboration among all the entities represented.
“It is not about our institutions,” Patten said. “It’s about better health care for rural Georgians.”
As for next steps, Bridges says he looks to industry and education leaders to take carry the idea forward.
“We need a thorough inventory of existing rural health care assets, and then we can determine where the gaps are,” he said. “Every education and training tool we’ve learned about that is in use throughout this country is valuable and could be part of our eventual solution. The main thing is that we are doing something to provide on-going, intense, hands-on training so that we can deliver the best health outcomes possible.”