"Room of Horrors": A Proof-of-Concept Simulation Model for Error Reduction Training in the Emergency Department

Area of Science:

• Medical Simulation
• Patient Safety
• Pediatric Emergency Medicine

Background:

• Patient safety is a critical concern in healthcare settings.
• Identifying and mitigating patient safety threats requires continuous vigilance and effective training.

Purpose of the Study:

• To assess the effectiveness of a "room of horrors" (RoH) simulation in identifying patient safety threats within a pediatric emergency department (PED).
• To evaluate healthcare workers' (HCWs) perceptions of the RoH simulation experience.

Main Methods:

• Developed an RoH simulation with 25 potential safety hazards based on real incidents and "never events."
• Teams of physicians and nurses participated in a 10-minute hazard identification exercise followed by a debriefing.
• Participant perceptions were measured using a 5-point Likert scale questionnaire.

Main Results:

• Twenty sessions with 45 participants identified an average of 23 out of 25 safety threats.
• Mean detection rates were 86% for electronic medical record errors, 95% for physical space errors, and 97% for communication errors.
• The simulation received high ratings for positive experience (4.88/5) and impact on daily activities (4.68/5).

Conclusions:

• The RoH simulation effectively evaluated training retention and multidisciplinary teams' ability to identify major safety threats in a PED.
• Participants found the simulation valuable and engaging.
• Future research should explore methods to reinforce learned skills and enhance alertness to new safety threats.