Outreach simulation for system improvement: a novel advocacy and reporting process

Healthcare simulation programmes measuring their value risk wasting resources in attempts to prove they impact patient outcomes. Simulation is one of many strategies used to enhance healthcare systems, and proving specific correlation with simulation will prove impossible in many circumstances. To maintain accountability but ensure feasibility, we argue simulation services need measurement processes that are robust, achievable, and synergistic with their mission. In 2023, the STORK service in Queensland, Australia, began measuring the impact of simulation on systems rather than patients to define the extent to which their educational programmes could impact system improvement.

Translational simulation methodologies and quality improvement measures were embedded in an established educational course. We used simulation activities to diagnose environmental and system-level problems in participants' workplaces throughout Queensland. Courses included dedicated time to discuss site-specific actionable solutions with participants and identified local champions to implement quality improvement changes. By designing a novel electronic reporting process (Optimus PRIME Course Summary), we documented issues and solutions identified in regional healthcare facilities and ensured they reached key stakeholders. We audited our ability to improve these systems through follow-up data collection via phone and emails with local educators across the state.

From 40 courses delivered across 37 facilities, 242 issues were identified, primarily related to drug safety and equipment management. At follow-up, 45.5% of the issues were resolved, with 44.6% still being addressed. Recommended resources were successfully implemented in 64% of sites.

This process demonstrates that focusing on system-level changes can significantly enhance healthcare systems. The reporting framework provided a robust, achievable, and synergistic method to measure simulation impact and influence change. Additionally, we share key lessons learned from the process to guide other simulation services in improving their own measurement strategies.