  News Alert Update, Sheba Medical Center at
Tel Hashomer, Israel Who would believe that "little Israel" is training American soldiers? Yedioth America
On Monday, at the Hewlett Bay Park home of Mira and Ami Bar-Mashiah, more than 50 Israelis gathered to hear Dr. Amitai Ziv (Deputy Director of the Sheba Medical Center) speak about Sheba (Tel Hashomer) Medical Center. Ziv is also the Director of The Israel Center for Medical Simulation - M.S.R (pronounced MESER-which in Hebrew means "message" and is the acronym for "medical simulation center"). Dr. Ziv came to New York following an international conference on medical simulation in Miami. Together with his colleague Dr. Haim Berkenstadt, Dr Ziv gave several lectures on recent innovations in the Israeli model in medical simulation. The two physicians addressed an audience of 500 doctors and nurses -- specialists in the simulation field -- who attended the conference from all over the world. MSR's story is the perfect example of missed opportunity for Israeli hasbara. The gathering in the Bar-Mashiah home was arranged as a result of their personal encounter with some wounded soldiers and victims of terror acts who were cared for in Sheba. Mira (who serves on the board of American Friends of Sheba Medical Center at Tel Hashomer) and Ami "could not find enough good words" for the treatment patients received in the rehabilitation center of the hospital. The American Friends of Sheba Medical Center at Tel Hashomer, based in New
York, was a dormant organization until a year and a half ago. Since then, a new
Board has been established. Jill Indyk serves as the US Liaison. The evening at
the Ba-r Mashiah home raised $125,000 for MSR. Like many other public institutions in Israel, MSR needs donations in order
to continue developing revolution in the field of medical education at Sheba and
throughout the world.
Recent report on patient safety (To Err is Human-US National Institute of Health report, 1999) has indicated that health care is far less safe than it should be. Death due to medical errors in the US amount to 50-100,000 patients annually. "If we translate these number into aviation it means that the equivalent of a Boeing 747 jumbo jet crashes into the sea every day"- claims Dr Ziv. As a result Dr. Ziv had the vision of establishing a simulation center where physicians and nurses can practice. Ziv is a pediatrician who came to medicine from the Israeli air force where he served as a pilot and as an instructor. He explained that in the area of safety, moving from aviation to medicine "was a big shock" for him. In the Israeli Air Force every little detail is examined and every action is evaluated and anticipated in depth - and lessons are learned as a result. In the medical field physicians and nurses are actually practicing on the patients themselves. It is even more severe when there is a need to tell a patient bad news: concerning the death of a loved one, or how to handle an aggressive patient.
Dr Ziv specialized in children's medicine at Hadassah hospital in Jerusalem and in the 1990's was recruited by ECFMG - the Educational Commission for Foreign Medical Graduates in Philadelphia. The organization assesses the readiness of international medical graduates to enter residency or fellowship programs in the U.S. The assessment scenario is enacted by simulated patients played by professional actors. In 1998 due to the success of the program it was decided that every foreign physician who is seeking work in the U.S. has to go through entrance exams in the simulation center which was developed by Dr Ziv and his colleagues. To date, 60,000 physicians have been tested in the Pennsylvania center. Early in 1990 Ziv traveled to Israel with 10 actors in order to build an array of tests for various medical situations. Throughout this project he tested with his crew of graduates from Haifa and Beer-Sheba medical schools and originated a pilot test for the graduates of Hadassah. Ziv was busy with the project till 1996 and had the opportunity to travel in many different countries and become familiar with their needs and work. Ziv felt very privileged to have been approached by Professors Shani and Rotstein from Sheba Medical Center and asked to lecture about his project. In October 2000 he was recruited to become the Deputy Director of Sheba Medical Center, responsible for Risk Management and Quality Control, and the founder of MSR.
The Center commenced operation in 2001 and today is considered the international leader in the field. An 8000 square foot virtual hospital was built on Sheba's campus to house the center and enable doctors and other staff members to practice. The center includes six individual examination rooms, operating rooms, emergency rooms and intensive care rooms and a debriefing room. Thirty-five cameras are located in the rooms and about 100 Israeli actors work in the center, acting as all kinds of patients: ob/gyn, elderly, abused, adolescent, pharmaceutical, and just difficult. Students from Blich high school in Ramat-Gan (where Ziv's daughter is a student) were recruited for the "delivery room" project- where they trained the medical staff how to handle a variety of issues and problems including how to tell a mother about stillborn. MSR also trains paramedics how to treat victims in public areas in the event of nuclear, chemical and biological warfare attacks. In recent years, sophisticated simulation mannequins were purchased from the US, England, and Norway. Each mannequin cost around 200-300,000 dollars. The computer- driven mannequins respond to treatment: "you can connect a mannequin to an electric shock in order to revive her but if you do not supply enough oxygen her situation will deteriorate" explains Ziv. Part of the financing for the mannequin was received from donations - from Jewish donors in NY who understood the importance of the center. The importance of the center was accelerated by the Palestinians terror acts, the Gulf War and the constant fear of chemical missile attacks on Israel. Ziv tells us that during operation Choma and Magen "we trained all the Israeli army medical teams. We trained 6000 physicians and paramedics in real life (or battle) emergency situation. They trained with the mannequins in real field conditions --under fire, smoke and shooting." Courses were established for trauma management to support many of the hospitals in Israel whose ER teams are not yet skilled in this area. A new formation for emergency rooms is being developed and 25 teams from other hospitals have already been trained at MSR. The center is also involved in other important projects including a "license test" for paramedics and anesthesiologists.
Innovation in the selection process for new applicants to medical school has
been established by MSR. "Instead of the applicant providing their cognitive
test results, and telling about themselves, they are asked to care for a mannequin
in stress." Ziv continues and explains that beyond the professional knowledge
it is very important to learn about the applicant's communication and compassionate
skills. People who are not empathic and lack good communication skills are not
suitable for the profession of medicine. Ziv has also been asked to brief The Greater New York Hospitals Association (the organization representing the 120 NY metropolitan area hospitals) who have expressed an interest in the project and also how to learn from it and use it as a model in the wake of 9/11. Right now Dr Ziv's main goal is to develop the second floor of the center so
that he can incorporate a growing curriculum in the field of medical simulation.
In order to pursue that goal he will need donations in the range of 2-5 million
dollars. Dr. Ziv is hoping that the "American friends" will help. For more information, please contact: Lauri Novick, Executive Director, Friends of Sheba - Tel
Hashomer: New York
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