NYC Health + Hospitals presents VR-Technology as part of comprehensive maternal health simulation training
Co-developed with Health Scholars, a provider of innovative VR healthcare simulations, OB providers across the City's health care system will be able to hone in on skills to earlier detect and successfully address rare but life-threatening health conditions that can present during labor and delivery. The new VR technology will complement the training OB providers, including attendings, midwives, physician assistants, and residents, received from in-person training to experience simulated life-like scenarios through a VR headset, improving competencies and promoting knowledge retention at their convenience during shifts. The new VR OB training technology builds on the municipal health care system's commitment to combatting maternal mortality disparities present among people of color, often perpetuated by implicit bias.
"We must do right by all expecting families and close the significant pregnancy-related health disparities that Black and Brown moms face," said New York City Mayor Eric Adams. "By investing in technology to train health care providers on how to safely deliver babies in life-threatening scenarios, we are ensuring that all expecting parents and babies have access to the quality care they deserve."
"We know that Black women are affected disproportionately related to maternal mortality and morbidity and we must utilize every opportunity to close those equity gaps," said Deputy Mayor for Health and Human Services Anne Williams-Isom. "I am excited to see NYC Health + Hospitals leveraging technology in service and support their obstetricians and the New Yorkers they serve. These new tools are yet another part of how the city is working to provide safe, healthy births for every expectant person and family."
"I am proud to say that NYC Health + Hospitals is a leader in virtual reality simulation training," said NYC Health + Hospitals Chief Women's Health Officer Wendy Wilcox, MD, MPH, MBA, FACOG. "Thankfully, serious and life-threatening conditions during childbirth, labor, and the postpartum period are uncommon. However, ensuring that our providers have the skills necessary to deal with these critical situations is paramount."
"Being able to provide convenient, easily accessible, on-site, and realistic simulations is imperative when you want to both provide these important skills-building opportunities without disrupting any patient care," said NYC Health + Hospitals Director of Nursing Simulation Kimberly Campbell-Taylor, MSN-Ed, RN, CHSE. "Being able to offer a diverse suite of high-tech simulations that not only realistically portray the medical scenario, but also reflects what our workforce and patients look like is an important part of training our staff to provide the highest quality, expert care no matter the situation the arises in the delivery room."
The VR technology transports providers to a labor and delivery suite where they can virtually interact with their patient and team members using voice communications and real-time interactions. They are required to direct the clinical team to perform all appropriate managements according to their hospital's protocol, allowing them to realistically practice critical cognitive skills like communication, teamwork, critical thinking and decision-making during an emergency. The municipal health care system will acquire 22 VR headsets, two for each hospital, where OB providers will be able to check them out to complete their training when time permits during shifts. This training will be another arm added to the ongoing obstetrical simulation training and maternal home pre and post-natal care as part of a larger Maternal Mortality Reduction Program. The new VR technology will be available to all OB providers within NYC Health + Hospitals in the near future.
The introduction of the new VR simulation technology allows OB providers across the health care system to more easily access skills-trainings on their time, being able to sign-out the VR headset and joysticks during downtime in their shifts. Prior to the introduction of the VR technology, whole OB teams had to schedule time to travel to simulation labs across the system to complete individual scenarios.
Once the VR technology is signed out, the OB provider dons a headset and completes a short orientation on how to use their voice to interact with virtual team members and manage care. The provider is also given a brief of the patient, like they'd receive in real life through a patient's chart. Transported to a labor and delivery suite, providers can virtually interact with their patient and team members using voice communications and real-time interactions. They are required to direct the clinical team to perform all appropriate managements according to their hospital's protocol. The scenario itself takes 8 to 12 minutes to run through, which is comparable to the time allotted to safely triage the emergency during labor to avoid adverse outcomes. Once the OB provider completes the scenario, they're immediately given a grade to summarize how they reacted to the situation. They're provided a debrief that highlights what could have been done better.
Co-developers, Health Scholars, partnered with NYC Health + Hospitals due to the municipal health care system's comprehensive and high-tech approach to OB simulation trainings. Combining Health Scholars' expertise in VR technology and voice technology with NYC Health + Hospitals' expertise in OB trainings, both groups developed an immersive approach to competency trainings that will facilitate clinical skills building in health systems across the country. The simulations are also configurable so healthcare organizations can teach and validate competencies against national evidence-based guidelines from American Academy of Obstetrics and Gynecology (ACOG) and California Maternal Quality Care Collaborative (CMQCC).
"Moving OB simulation into VR provides educators an affordable, efficient, and easy way to deliver students and healthcare providers the practice required to provide safe and effective care to OB patients," says Health Scholars Medical Director Pam Martin, MD, FACS. "Our VR training enables any size organization to scale readiness and, in a time where healthcare professionals are stretched to the brink, it's time to rethink how we prepare our providers to deliver the very best care possible."
Significant racial and ethnic disparities in pregnancy-related mortality exist. According to the Centers for Disease Control and Prevention, Black patients have a pregnancy-related mortality ratio approximately three times as high as that of their white counterparts. The first scenario available to OB providers will simulate postpartum hemorrhage, which is the leading cause of maternal mortality. Additional scenarios, such as maternal code, shoulder dystocia, and fetal heart monitoring will be developed and added to the VR curriculum in the coming months.
The cast depicted in the VR scenario includes a pregnant patient of color, a partner, and a diverse care team. Previously, OB simulations carried out by NYC Health + Hospitals utilized specially-designed, high-tech, full-body mannequins-of-color.
In 2018, NYC Health + Hospitals maternal mortality rates were lower than New York State's rate of 20.9/100,000 live births.