Blue Bell man honored as Fellow by American Academy of Nursing
EAST NORRITON » Being selected a Fellow into the American Academy of Nursing places Michael Kost in an elite group of honorees.
“It’s prestigious because out of the 3.8 million nurses in the United States there’s only 2,700 people in the country that have that designation,” noted the Director of Healthcare Simulation for Einstein Healthcare Network.
Kost leads the integration of simulation instructional technologies using evidence-based practice principles that aligns research and clinical expertise for all simulation activities.
For more than three decades he has also served as the Program Director of the Frank J. Tornetta School of Anesthesia at Einstein Medical Center Montgomery/LaSalle University School of
Nursing where he oversees all aspects of classroom and clinical instruction provided to nurse anesthesia students enrolled in the program.
“We get to work with the other Fellows in the American Academy of Nursing and advise on policy, research, academia, clinical practice,” added Kost, who is also a renowned author who will join the other inductees at the Academy’s annual Transforming Health,
Driving Policy Conference, taking place virtually October 29 through 31.
“If you went in for a procedure that didn’t have an anesthesia provider there, nurses would give you the sedation that were not anesthesia-trained,” he explained, “so what I did was I wrote three textbooks on the topic over the last three decades and also (trained) over 30,000 nurses and traveled to probably 300 cities and lectured on the topic to improve their education so they understand how the drugs work, how to give the drugs, how to take care of the patient under sedation.”
A press release described the impact of Kost’s work on procedural sedation and analgesia over the past 30 years:
“In addition to serving as Program Director of the Frank J. Tornetta School of Anesthesia at Einstein Medical Center Montgomery/La Salle University School of Nursing and as the Director of the Einstein Healthcare Network Simulation program, Dr. Kost through his scholarly contributions … has advocated for the safe administration of sedation by non-anesthesia providers for over three decades. Dr. Kost developed a nationally recognized evidence-based core curriculum and a competency-based credentialing program for non-anesthesia nurses administering conscious/moderate sedation. These resources transformed non-anesthesia provider nursing care nationally and internationally.”
Since many of the educational efforts were implemented, “the safety has improved and the morbidity and mortality has gone down over the last 30 years, so I think that’s one of the reasons I got recognized by the Academy, as well as my role for 30 years as the program director of Dr. Tornetta’s School of Anesthesia at Einstein Medical Center Montgomery, which used to be at Montgomery Hospital,” said Kost, a Roxborough native now living in Blue Bell.
In 1951 Tornetta, a Norristown native, started the nurse anesthesia program at Montgomery Hospital.
“He was a physician 50 years ahead of his time,” Kost noted. “He received his PhD degree from New York
University and his M.D. from Hahnemann Medical College. He was the Chief of Anesthesia at Montgomery for over four decades and served in the role of consultant to many hospitals in Montgomery County upon his arrival in 1949. He was a well-respected clinician, researcher and role model to many. I was one of his students, from 1983 to 1985 and in 1991 he made me the director of it,” Kost added. “My life’s greatest work has been to honor the legacy that Dr. Tornetta created. It’s been my only job ever, between Montgomery Hospital and Einstein, when they merged the two healthcare systems, so I’ve been a Norristown product since 1983.”
Kost compared the evolution of simulation in the medical field to aviation and the nuclear power industry, “which have been 30 or 40 years ahead of healthcare with regards to simulation. A nuclear power plant will simulate an accident, in the airline industry you’ll fly in a simulated cockpit before you’re allowed to fly a regular plane. So healthcare started getting into simulation about 20 years ago and 10 years ago people started getting serious about it and a lot of places built million-dollar sim centers. Large simulation centers presented time constraint issues in the ability to allocate large groups of healthcare providers to train interprofessionally in simulation, therefore at Einstein we have now brought the simulation from the simulation center directly to the patient care areas so providers can train together.”
With the need for healthcare providers to travel to simulation centers, it was not a practical solution for training
“You’ve got eight or 10 people who work together and now you’re going to say they need to go to the sim center for a couple of hours. So healthcare simulation evolved,” Kost said. “Our simulation center utilizes Gaumard Scientific simulators (HAL adult simulator, Victoria birthing simulator, Pediatric HAL, Super Tory) which affords our healthcare network to utilize state of the art technology when providing simulation educational sessions to our staff. Simulators can range in price from $8,000 to in excess of $60,000. The simulators can blink, cry, talk. We have an entire fleet of Gaumard simulators, all the way from birth simulator all the way up to an adult simulator. We take these all throughout the Einstein Healthcare Network. So, instead of having to take an operating room team to a simulation lab to practice, we take the simulation to them,” Kost explained. “We’ve been practicing using these simulators that are very lifelike over the last 10 years. We simulate scenarios ranging
from very routine procedures to high acuity, low occurrence (HALO) emergent events. We also practice for a number of worst case scenarios, something that a healthcare provider may see once in their career. All of our work is based on quality improvement, with the help of metrics the medical team learns ow to improve the process. All sessions are digitally recorded. We measure team response times, scenario treatment delays, quality and depth of the medical intervention etc. The whole purpose of doing a simulation is to make us better. It’s kind of like golf, you’re always trying to outperform yourself. We’re always trying to do better the next time.”
When a nurse manager in need of simulation training for a staff contacts the school, the unique education process is set in motion.
“We would meet with them, establish learning objectives, we’ll go and set everything up, show up that morning and most of the staff does not expect that we’re there, we’ll go in very quietly and set up the room and then all of a sudden we’ll call a mock code, ‘somebody’s in cardiac arrest’ and we digitally record it and watch everything that happens during that event,” Kost noted. “After the simulation we complete an educational debriefing process which includes a period of reflection, analysis, adherence to evidence based medical algorithms or protocols and summarization of the simulation identifying methods to improve care in the event of a real life crisis.”
The goal is always to improve upon the previous performance, Kost said. “The program has been very successful. We are extremely grateful to the Albert Einstein Society for a $40,000 grant that they provided this year for a mobile simulation vehicle that has allowed us the opportunity to expand our reach to include all of Einstein Healthcare Network in our simulation efforts, both acute care sites as well as offsite office practices,” he allowed. “The beauty of it is that now you won’t have to travel to us. A variety of support personnel are now going to go practice … we do it right in the ICU, right in the OR and it’s been very successful and much more practical than simulation centers.”