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Hazard Assessment and Remediation Tool for Simulation-Based Healthcare Facility Design Testing
Marlena Smith-Millman1, Lorraine Daniels2, Katie Gallagher2
1Immerisve Design Systems, Boston Children's Hospital, MA, USA.
HERD
|August 7, 2023
Summary
A new tool, the Hazard Assessment and Remediation Tool (HART), reliably identifies built environment hazards in healthcare simulations. This structured observational method aids in optimizing facility safety through objective hazard measurement.
Area of Science:
- Healthcare facility design
- Patient safety research
- Human factors engineering
Background:
- Simulation-based testing is crucial for optimizing healthcare environment safety.
- Current methods rely on subjective debriefing or expert observation.
- Objective tools are needed for consistent hazard identification.
Purpose of the Study:
- To develop an objective, structured observational tool for identifying and measuring built environment hazards.
- To apply this tool to audiovisual recordings of simulations by trained raters.
- To enhance the safety of healthcare environments through improved facility design.
Main Methods:
- Defined six hazard categories (e.g., slip/trip risk, impaired access, infection risk) through simulation video review and debriefing.
- Refined categories and developed operational definitions via iterative coding.
- Optimized hazard detection using structured coding protocols and specific camera angles.
Main Results:
- Developed the Hazard Assessment and Remediation Tool (HART).
- Achieved strong overall inter-rater reliability (Gwet's AC1: 0.89 paired, 0.85 individual).
- Demonstrated high reliability for most hazard categories (>0.8), with some exceptions requiring further refinement.
Conclusions:
- HART provides a reliable framework for quantifying built environment hazards in simulations.
- The tool shows high reliability for paired and single trained raters reviewing video.
- Future work will assess HART's ability to inform facility design and its transferability to other settings.
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