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Setup and Execution of the Rapid Cycle Deliberate Practice Death Notification Curriculum

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Refining mass casualty plans with simulation-based iterative learning.

Rosel Tallach¹, Barry Schyma², Michael Robinson³

¹Royal London Hospital, London, UK; Raigmore Hospital, Inverness, UK.

British Journal of Anaesthesia

|November 10, 2021

Summary

This summary is machine-generated.

Hospital mass casualty incident plans improved through iterative simulation-based learning. Simulation exercises enhance staff understanding of roles and reporting, leading to better system safety and response effectiveness.

Keywords:

iterative improvement low fidelity mass casualty plans normalisation process theory simulation staff engagement

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Area of Science:

Emergency Medicine
Healthcare Management
Patient Safety

Background:

Mass casualty incident (MCI) plans aim to optimize hospital response.
A gap often exists between MCI planning and effective response delivery.
Simulation-based iterative learning can bridge this planning-delivery gap.

Purpose of the Study:

To improve mass casualty incident (MCI) plans using simulation-based iterative learning.
To identify and rectify latent errors and system safety issues in hospital MCI preparedness.
To enhance staff understanding of roles and reporting during simulated MCIs.

Main Methods:

Utilized Normalisation Process Theory for iterative learning from MCI simulations.
Conducted five small-scale 'focused response' simulations feeding into two large-scale whole-hospital simulations.
Analyzed debrief notes for plan improvement and used online surveys to track staff learning and outcomes.

Main Results:

Seven simulations involving over 700 staff identified latent errors and safety issues.
Post-simulation, participants showed increased likelihood of returning surveys (OR=2.7), knowing reporting locations (OR=4.3), and understanding roles (OR=3.7).
Simulations did not disrupt usual emergency care.

Conclusions:

Simulation exercises are effective for iterative improvement of mass casualty incident plans.
Hospital-wide staff engagement in simulations enhances preparedness.
Continuous learning through simulations improves system safety and response clarity.