"Talk-Through Walk-Through"-A Simulation Approach Adapted During Preparation for COVID-19

Area of Science:

• Healthcare Systems Engineering
• Patient Safety
• Clinical Process Improvement

Background:

• Complex patient care systems require robust development and testing.
• The COVID-19 pandemic necessitated rapid adaptation of care processes.
• Existing methods may not adequately address time and resource constraints.

Purpose of the Study:

• To adapt and apply the talk-through walk-through simulation format for developing and testing patient care processes.
• To enhance the safe management of COVID-19 patients.
• To evaluate the efficiency of the talk-through walk-through approach in resource-limited settings.

Main Methods:

• Adapted the talk-through walk-through simulation format from task analysis literature.
• Paired a 'talk-through' phase (identifying process issues, building shared mental models) with a 'walk-through' phase (testing solutions, uncovering challenges).
• Applied the method to develop and test processes for COVID-19 patient management.

Main Results:

• The talk-through walk-through enabled rapid identification and resolution of major process issues.
• The approach successfully uncovered unanticipated system and process challenges during testing.
• Process development and testing were achieved within a single session.

Conclusions:

• Talk-through walk-through is an effective simulation format for the rapid development and improvement of complex patient care systems.
• This method is particularly valuable for multi-disciplinary, multi-location care settings with time scarcity, such as during the COVID-19 pandemic.
• The approach facilitates the creation of shared mental models and robust process testing.