A novel approach to operating room readiness for airborne precautions using simulation-based clinical systems testing

Area of Science:

• Medical Simulation
• Patient Safety
• Healthcare Systems Engineering

Background:

• The COVID-19 pandemic presented significant challenges to operating room environments.
• Institutions needed to adapt systems and develop safe medical protocols rapidly.

Purpose of the Study:

• To employ simulation-based clinical system testing with rapid cycle deliberate practice.
• To identify latent safety threats in new operating room COVID-19 protocols.
• To gather frontline staff recommendations for mitigating identified threats.

Main Methods:

• Combined training/education with systems function testing in the operating room.
• Participants progressed from assistant to primary airway manager roles during simulations.
• Latent safety threats were identified through observation, and solutions were developed during debriefing.

Main Results:

• Identified 17 unforeseen latent safety threats, enabling protocol corrections before patient impact.
• Post-simulation surveys showed high program reception and perceived value.
• 57% of respondents used the developed protocols in actual COVID-19 patient care within four months.

Conclusions:

• Demonstrated a flexible methodology integrating simulation for training and systems testing.
• Effectively detected and mitigated latent safety threats in new workflows.
• The approach is applicable beyond COVID-19 for staff training and risk mitigation in various clinical settings.