Developing in situ large-scale simulation strategies for enhanced patient safety

Area of Science:

• Healthcare Operations
• Patient Safety
• Systems Engineering

Background:

• Transitioning to a new emergency department (ED) facility presents significant patient safety challenges.
• Ensuring operational readiness and staff preparedness is crucial for a successful ED relocation.
• Existing safety protocols may not adequately address the complexities of a new healthcare environment.

Purpose of the Study:

• To utilize simulation-based clinical systems testing to identify latent safety threats (LSTs) in a new ED.
• To ensure operational readiness and enhance staff confidence before and during the ED transition.
• To develop actionable plans for mitigating identified safety risks and improving the transition process.

Main Methods:

• A three-stage framework (development, implementation, evaluation) was employed for the study.
• A large-scale, "day in the life" in situ simulation was conducted to test system integration.
• Data from 125 participants, 50 standardized patients, observers, and facilitators were collected across 63 scenarios.

Main Results:

• A total of 113 latent safety threats (LSTs) were identified during the simulation.
• A detailed action plan was developed based on the identified LSTs.
• Participants reported increased confidence in providing safe patient care in the new ED facility.

Conclusions:

• Simulation-based clinical systems testing is an effective method for identifying LSTs during healthcare facility transitions.
• This approach enhances staff preparedness and contributes to operational readiness for new EDs.
• The methodology offers generalizable insights for other healthcare facilities undergoing similar transitions.