Leading change in practice: how "longitudinal prebriefing" nurtures and sustains in situ simulation programs

Area of Science:

• Healthcare Improvement
• Patient Safety
• Organizational Change Management

Background:

• In situ simulation (ISS) programs offer patient safety benefits but face implementation and sustainability challenges.
• Prebriefing alone is insufficient for embedding and sustaining ISS programs long-term.
• A structured framework for ISS program change leadership is currently lacking.

Purpose of the Study:

• To present a novel framework for the sustainable implementation of in situ simulation programs.
• To describe a step-by-step change leadership process for ISS program success.

Main Methods:

• Analysis of three successful in situ simulation program implementations across diverse hospital systems.
• Adaptation of Kotter's change management theory into eight key leadership steps.
• Development of the "longitudinal prebrief" framework.

Main Results:

• Identified eight critical change leadership steps for sustainable ISS program implementation.
• These steps include stakeholder engagement, vision creation and communication, participant enablement, and success reinforcement.
• The framework, termed "longitudinal prebrief," guides sustained ISS program integration.

Conclusions:

• Sustainable in situ simulation program implementation necessitates comprehensive change leadership beyond initial prebriefing.
• The "longitudinal prebrief" framework provides a practical guide for healthcare organizations to establish and maintain ISS programs.
• This framework facilitates colleague engagement and embeds simulation into the organizational culture and operations for lasting patient safety improvements.