A Simulation-Based Failure Mode Analysis of SARS-CoV-2 Infection Control and Prevention in Emergency Departments

Area of Science:

• Healthcare Management
• Infectious Disease Epidemiology
• Patient Safety

Background:

• The COVID-19 pandemic exposed global challenges in infection control and personal protective equipment supply.
• Sustainable infection prevention and control measures are critical for managing pandemics.
• Occupational hazards and nosocomial spread of SARS-CoV-2 require proactive mitigation strategies.

Purpose of the Study:

• To develop an action plan for mitigating occupational hazards and nosocomial spread of SARS-CoV-2.
• To analyze failure modes in healthcare settings during the COVID-19 pandemic using in situ simulations.
• To assess healthcare worker and emergency department preparedness for emerging infectious diseases.

Main Methods:

• A multicenter, cross-sectional, observational study utilizing in situ simulations was conducted in 7 Latvian hospitals.
• Healthcare Failure Modes and Effects Analysis (HFMEA) was employed to systematically identify and analyze potential process failures.
• Structured debriefings followed simulated COVID-19 patient presentations to evaluate performance gaps and systemic issues.

Main Results:

• Sixty-seven healthcare workers participated across 7 hospitals.
• Thirty-two failure modes were identified and risk-assessed; 84.4% were medium/high risk or single-point weaknesses.
• Failure modes were categorized as organizational (40.7%), individual (40.7%), and environmental (18.5%).

Conclusions:

• Simulation-based failure mode analysis effectively identified risks in healthcare preparedness for the COVID-19 pandemic in Latvia.
• The HFMEA approach provides a framework for assessing and maintaining readiness for future emerging infectious disease outbreaks.
• Proactive identification and mitigation of failure modes are essential for enhancing healthcare system resilience.