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Pharmaceutical Poisoning: Potential Scenarios01:26

Pharmaceutical Poisoning: Potential Scenarios

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Updated: Jun 12, 2026

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

Published on: January 15, 2017

Using simulation to identify and resolve threats to patient safety.

William R Hamman1, Beth M Beaudin-Seiler, Jeffrey M Beaubien

  • 1Western Michigan University, Kalamazoo, MI, USA. william.hamman@wmich.edu

The American Journal of Managed Care
|June 12, 2010
PubMed
Summary

In situ simulation identified environmental threats to patient safety, such as flawed procedures, by training healthcare teams in their real work settings. This approach revealed system-level issues impacting daily performance and patient care.

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Area of Science:

  • Healthcare simulation
  • Patient safety research
  • Systems engineering in medicine

Background:

  • Simulation-based team training, widely used in aviation, offers a model for enhancing patient safety in healthcare.
  • Identifying latent threats within the healthcare environment is crucial for improving patient outcomes.

Purpose of the Study:

  • To demonstrate the effectiveness of in situ simulation in uncovering environmental hazards that compromise patient safety.
  • To highlight how real-world simulations can reveal systemic issues impacting healthcare delivery.

Main Methods:

  • A case study employing in situ simulation at a Midwestern hospital.
  • The simulation involved a simulated cardiac catheterization scenario for a patient with chest pain and hypotension.
  • Utilized a patient manikin, high-definition video recording, and real-time annotation software, with a Master Scenario Event List to guide the event.

Main Results:

  • Identified three critical latent environmental threats: patient transport procedures, handoff process management, and cardiac catheterization workflow organization.
  • These threats stemmed from poorly developed or absent procedures, affecting all healthcare teams daily.
  • Participants and supervisors identified these threats during post-simulation debriefing as common, dangerous, and requiring remediation.

Conclusions:

  • Conducting simulations in the actual care environment with intact healthcare teams practicing real workflows is effective.
  • This method successfully identifies latent environmental threats to patient safety that artificial lab settings cannot reveal.
  • In situ simulation provides a powerful tool for uncovering and addressing systemic risks in healthcare.