Simulating before Opening to Assess New Facilities

Using simulation, our objective was to define optimal staff roles, refine scope of practice, and identify LSTs before opening a new satellite hospital pedeatric ED

Case Study Details

Identified 37 LST focused around Equipment and Resources
Identified 46 errors in clinical proficiencies

  • Laboratory simulations were used to define roles and scope of practice
  • After each simulation, teams were debriefed using video recordings
  • Simulations were scored for team behaviors by video reviewers using the Mayo High Performance Team Scale
  • Subsequent in situ simulations focused on identifying LSTs and monitoring for unintended consequences from changes made
  • ₤74,250 per annum
  • ₤46,800 Staff Training
  • ₤17,450 Protected Training Time
  • ₤10,000 Consumables/Simulator

3 months

  • prior to opening

81 Health care providers participated

  • Nurses
  • Paramedics
  • Physicians

New Facility, no baseline data for performance

  • done to identify Latent Safety Threats
  • The 37 LST would have had patient safey implications
  • The 46 clinical proficiency errors would have had patient safety implications

Decision Maker Talking Points

  • Identified 37 LST focused around Equipment and Resources
  • Identified 46 errors in clinical proficiencies
  • Harm would have come to patients if this had not been done
  • potentially damaging new hospital and ED reputation
  • Identified 37 LST focused around Equipment and Resources
  • Identified 46 errors in clinical proficiencies
  • potentially damaging new hospital and ED reputation
  • Identified 37 LST focused around Equipment and Resources
  • Identified 46 errors in clinical proficiencies
  • potentially damaging new hospital and ED reputation
  • need to train medical students with evidence based best practices
  • need to have medical students training in an IPE environment to best prepare for current needs in Hospitals
  • have students prepared to operate in high risk, time pressured critical environments
  • better preparing the medical students given limitations on clinical hours
  • practicing in a simulated environment instead of on actual patients
  • need to train nursing students with evidence based best practices
  • need to have nursing students training in an IPE environment to best prepare for current needs in Hospitals
  • better preparing the nursing students given limitations access to clinical placements
  • practicing in a simulated environment instead of on actual patients
  • Teams need to be assessed in simulation and not on patients
  • better informed about staff to properly structure team education as needed
  • ability to retain staffing by showing value for patient satisfaction
  • ability to better adjust behavior as teams train together
  • making the case will involve a fully engaged staff of passionate educators
  • make clear that faculty educators must be trained to conduct deliberate practice and feedback
  • support a part of the institutions patient safey initiative to align with mission focus
  • focus on capturing the appropriate ROI metrics for you environment