First, make no mistakes

Downtown Tampa’s new medical simulation center uses high-tech training to reduce the margin of doctor error.

click to enlarge VIRTUALLY THERE: The trauma operating room uses sound effects and temperature changes to recreate conditions in which surgeons might find themselves. - Shanna Gillette
Shanna Gillette
VIRTUALLY THERE: The trauma operating room uses sound effects and temperature changes to recreate conditions in which surgeons might find themselves.

After months of hype, the USF Health Center for Advanced Medical Learning and Simulation (CAMLS) held its official grand opening in Tampa on the last Friday of March.

Hundreds of people crowded into the facility’s downtown location, including a number of lawmakers and other Bay area movers and shakers. As if it were a Manhattan nightclub, two young women vetted the guest list to determine who would be able to enter the 200-seat second-floor auditorium, where for the next 90-plus minutes a series of local and national speakers hailed the creation of the center, with USF President Judy Genshaft proclaiming that it has always been a project with a “global reach and global vision.” (Those who weren’t blessed with access could watch the speeches by Genshaft, Mayor Bob Buckhorn, Congresswoman Kathy Castor and others via high-definition screens mounted outside the auditorium.)

To much of the public, the details of what takes place at CAMLS have taken a back seat to its potential as an economic driver for the Tampa Bay area. During the Tampa mayoral campaign in the winter of 2011, the facility shared center stage with high-speed rail as a touted instrument for economic renaissance.

Officials say that tens of thousands of doctors, nurses, radiology technicians, anesthesiologists, residents, emergency medical personnel and others who require medical training are expected to travel to Tampa to visit the center. As with many economic forecasts, the numbers aren’t precise. In January of 2011, when dirt was first broken, a story on USF Health’s website reported “some 60,000 health care professionals are expected to visit Tampa each year.” That figure has been readjusted down to 30,000 annually (with as many as 10,000 of those professionals coming from the Bay area), but according to figures from USF, CAMLS will still have a $5.7 million impact on the Tampa Bay economy.

Listening to the medical professionals involved, you hear exuberant proclamations of “paradigm shifts.” But what does CAMLS actually do? The answer was best expressed on that opening morning by Dr. Steven Klasko, the CEO of USF Health and dean of the Morsani College of Medicine.

“We have to start to learn from our mistakes.”

In 1999, the Institute of Medicine of the National Academies released a report titled To Err Is Human: Building a Safer Health System, which concluded that tens of thousands of Americans die each year as a result of preventable mistakes in medical care. A follow-up report in 2005 stated that effective teamwork and the development of team training performance are necessary to improve patient safety. A separate 2008 report said the “incidence of adverse events in a hospital setting approximates 10%.”

Dr. Laura Haubner, medical director for CAMLS Virtual Patient Care Center, says that the initial study revealed that up to 70 percent of medical errors can be traced to lack of teamwork or intra-professional skills.

At its core, CAMLS is a simulation center. No one treats actual patients there; the center is designed to help train medical professionals to improve health outcomes when they do. In recent years, there has been an explosion of such facilities around the world, using technology to improve surgical skills and assess performance.

What distinguishes the Tampa site is its sheer size: 90,000 square feet.

By comparison, Florida Hospital’s Nicholson Center for Surgical Advancement, which opened in October in Celebration, is 54,000 square feet, while the Methodist Institute for Technology, Innovation and Education (MITIE), which opened in Houston in early 2011, is at 35,000 square feet. Stuart Hart, CAMLS medical director, calls Tampa’s center the largest freestanding health care training/education simulation center of its kind in the country.

He plays a genial host on a recent Wednesday afternoon, giving me a full tour of all three floors of the immaculately clean building.

Like a proud papa, he’s eager to extol the virtues of everything the center has, including the bathrooms, which include showers and digital lockers. Hart says visiting medical personnel will appreciate this. “One of the things that I used to do as a teacher doing this stuff is I would go to Denver and sit there in a cadaver lab and then get on a plane, and you stink.”

Good to know that won’t happen with those coming to CAMLS.

The first floor contains lots of surgical lab space in what is known as the Surgical and Interventional Training Center (SITC), which houses the 21 station surgical arena and two seven-station surgical skill labs with state-of-the-art high-tech systems — all told, making it the largest surgical arena in the country.

But the undeniable highlight is the trauma operating room, which can provide a range of different physical environments for surgeons, with sound effects and temperature changes available to recreate conditions (including extremely stressful ones) in which doctors might find themselves. The backdrop at times simulates a battlefield in Afghanistan, complete with gunshots and helicopters hovering about the operating field.

The second floor is where the Education Center resides, with the aforementioned auditorium, three 50-seat classrooms, an executive boardroom, a catering kitchen and dining space for 250 people. This will provide opportunities for healthcare professionals to have their work reviewed on video and critiqued.

The third floor hosts the Virtual Patient Care Center, which is also where the Tampa Bay Research and Innovation Center (TBRIC) is situated. A critical part of the whole CAMLS concept, TBRIC sets it apart from most simulation centers around the country and the world.

Officials say that the goal is to create a multi-collaborative team of engineers, businesspeople and healthcare providers to solve challenging medical problems. As Stuart Hart tells it, the three groups generally do their own thing, but rarely come together.

“We don’t want any silos,” he said. Instead, the offices feature open working spaces and collaborative tables.

Michael Fountain, director of the USF Center for Entrepreneurship, is now running TBRIC. Fountain says CMLS/TBRIC has the ability to take an idea all the way from prototyping, through to an evaluation and simulation. The medical device can then literally be walked down to the first floor. “It gives us the ability to work with corporate partners and industrial partners that nobody has been able to do in a comprehensive manner.”

Fountain’s distinguished CV includes founding or co-founding seven new ventures. He uses three words to describe what the facility is all about: transformative, translational and innovation.

In addition to providing what’s known as CME (Critical Medical Education), CMLS will also provide medical training courses with some of their biggest industry partners — companies like Stryker, Philips and Covidien, who will bring in doctors from all over the country to showcase their medical devices. The facility is also working with such heavyweights as the American College of Surgeons, the American College of Cardiology, the American College of Obstetricians and Gynecologists and other specialty societies to provide training for their members.

Hillsborough County Commissioner Mark Sharpe is a big proponent not only of CAMLS but of the whole cluster of health care facilities that are changing Tampa. Institutions like Moffitt Cancer Center and the Alzheimer’s Center and Research Institute at USF change the image of what the region has always been about.

“Rather than simply a place where you go to vacation, or if you want to go to Sun City to retire,” Sharpe says, “It’s going to be where you’re going to get your medical treatments, or you’re going to study medicine, and that’s because of what’s happening at USF Health and what’s happening at Moffitt Cancer.”

If the original plans for creating CAMLS had been approved, the facility would not be downtown, but located near the USF College of Health buildings near the mothership North Tampa campus. CAMLS CEO Deborah Sutherland says that five different locations were indentified at one time or another as the future home of the simulation center, including Tampa Heights.

But all those plans had a hotel attached, to house some of the 20,000 to 30,000 medical professionals expected to fly into Tampa to work at CAMLS. Because of the moribund economy, that added feature stalled over the past several years. When land became available downtown next to some of the biggest hotels in the city, the project finally had a home.

Although CAMLS hasn’t been open for a full month yet, everyone associated with it expects it to grow. Deborah Sutherland says in fact that Trammell Crow and Colliers Arnold are developing the lot across the street from CAMLS for a hotel and mixed use retail area, which could also house more of the office components of the current structure. But don’t call it “CAMLS II,” since that’s what officials are calling a possible project in the works in Panama.

In surgeon and noted author Atul Gawande’s 2007 book, Better: A Surgeon’s Notes on Performance, he writes, “monitoring and improving clinical performance would do more to save lives than advances in laboratory knowledge.” By that standard, CAMLS is on the way to making health care better for all of us.

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