SimVET’s operating room
Courtesy: SimVET
The $43 million VA facility is a sprawling facility with operating rooms, intensive care units and outpatient clinics, but no patients inside. At least not any real ones.
The 53,000-square-foot building, located just minutes from Florida’s Orlando International Airport, is known as the National Center for Simulation Verification, Evaluation and Testing (SimVET). It serves as the primary hub for teams of Veterans Administration frontline health care workers to travel to practice procedures and trial new technologies, all without unnecessary risk to patients.
For example, if a team of clinicians wanted to fine-tune the response to an opioid overdose or test a new artificial intelligence tool, they could simulate the process repeatedly on SimVET. VA officials told CNBC that by practicing in a controlled environment, health care workers can problem-solve and ensure new ideas are feasible and safe to implement.
SimVET opened in 2016 and is an example of how simulation in healthcare is becoming a reality increasingly common In recent years it has become more complicated. As health systems evaluate hundreds of new artificial intelligence tools that have recently become available, facilities like SimVET can help cut through the noise.
SimVET facility in Orlando, Florida
Courtesy: SimVET
The Veterans Health Administration serves 9 million veterans at 172 medical centers across the United States.
Dr. Scott Wiltz, medical director of the VA’s Simulation Learning, Assessment, Evaluation and Research Network, said the SimVET facility in Orlando is “by far” the largest simulation center within the VA and one of the largest in the country. SimLEARN.
Simulating high-risk scenarios is a fixture in industries such as the military and aviation, and pilots can spend hours practicing in flight simulators.
In health care, hospital systems and medical schools have long relied on professionals to help train doctors, and virtual reality headset is becoming an increasingly popular tool practice surgery. But SimVET goes one step further.
The goal is usually to “get as close to reality as possible,” Wiltz told CNBC.
“The operating room is a great example,” Wiltz said. “We have two fully staffed operating rooms with all the equipment you normally use: lights, booms, real anesthesia machines. We even have a mannequin that realistically responds to anesthesia.”
CNBC visited SimVET in March, and the mannequins are a virtual fixture of the facility. They come in different skin tones, hairstyles and facial features, and some are programmed to speak, move and develop complications. One “aged” mannequin in the facility has wrinkles and more visible veins, and another can “birth” a “baby” mannequin.
Wiltz said the numbers should be representative of the Veterans Administration’s veteran population as well as the broader population across the country. He said there are “well over” two dozen mannequins at the facility.
Mannequins in SimVET facilities
Courtesy: SimVET
In addition to its unusual patients, SimVET features many familiar-looking healthcare scenarios. The long corridors are lined with fluorescent lights, filled with exam rooms, and the operating room is filled with machines that look like they were lifted directly from a nearby hospital.
To the unsuspecting visitor, the facility looks a lot like a real medical center. The only minor blemish is the building’s many classrooms and educational spaces.
“The variety of spaces that we have, the sense of reality that it brings, it really gives you a full sense that you can actually take care of patients in that building,” Wiltz said. “We do. Yes, it’s just that our patients are mannequins and actors.”
A space for “safe failure”
SimVET Building in Orlando, Florida
Courtesy: SimVET
Wiltz said SimVET has about 60 full-time employees, who often work on multiple pilots and projects at the same time. Frontline staff within the national program office and VA will come to SimVET with simulation ideas, and sometimes the facility’s staff themselves will be inspired, he said.
SimVET is able to provide funding directly through the VA to provide services, so Wiltz said it often makes more sense for these groups to come to them instead of trying to pay someone outside the government.
Amanda Borchers, patient safety manager at the VA Medical Center in Lexington, Ky., was part of a surgical emergency team that visited SimVET last May. She said they wanted to improve their response to unexpected complications that could arise during surgery, so they turned to SimVET in winter 2023 for help and ideas.
Borchers said some of the higher-risk veterans in her population have respiratory, heart and circulatory problems that can cause sudden problems during surgery. Her team hopes to develop a new protocol to better address some of these challenges, such as how to quickly retrieve blood and bring it to the operating room.
SimVET leadership helped Borchers and her four other teammates program multiple simulations before arriving on site, and they also connected with many field experts from around the country.
The team had a busy week at the SimVET facility: their first day started sharply at 7 a.m. around the drawing board, then they spent several hours working through different procedures and discussing issues with experts and SimVET employees.
“You can fail, but you fail safely, and then you use it to make a change. And then you do it again. And then you do it again,” Borchers told CNBC. “The transformation and what we are able to do in an unexpected emergency is amazing.”
Borchers said she has participated in simulations before but had never experienced anything comparable to SimVET. She said the facility mimics the environment she works in every day, allowing her to practice “every detail” of her daily job.
“Exactly the same,” she said. “You can literally do surgery right away, right there.”
Intensive Care Unit at SimVET
Courtesy: SimVET
At the end of the week, Borchers and her team left SimVET with the framework for a new medical protocol, a facility-wide response to specific types of emergencies. For example, TV shows and movies often refer to “code blue,” in which medical personnel take immediate action after a patient goes into cardiac or respiratory arrest.
Borchers said the new code developed by the team will be called “Code SET” on overhead speakers, which stands for “Surgical Emergency Team.” Its purpose, she said, is to alert a dedicated team to provide support if unexpected complications arise during or immediately after surgery.
SimVET gave Borchers and her teammates the initial practice and assurance they needed to make their idea a reality, but they still needed buy-in from others at the Lexington Veterans Administration Medical Center. They present the code to executive leadership and then begin to determine which people and resources will respond to it.
Borchers said the medical center began running its own simulations and continues to fine-tune its internal code. Small pockets of hospital throughout the fall. They expanded testing in the spring and began using code to conduct facility-wide simulations.
The medical center is currently updating its paging system, and Borchers said the facility will simulate the code again once the new system is in place. If all goes according to plan, the SET code will be available for use on real patients within the next two to three months.
Borchers said her ultimate goal is to see Code SET used at Veterans Administration medical centers across the country, and staff from states such as Tennessee, Mississippi, Louisiana, Arkansas and Texas have already participated in the simulation training.
Wiltz said the code is becoming a national program for the Veterans Administration.
“Fortunately, it’s not coming from adverse events, it’s coming from people saying, ‘You know what, we’re doing a good job, but we think we can do better,'” Wiltz said.