Simulation can be used to develop and serially test and enhance a process improvement. Repeating simulations with multiple groups of participants will demonstrate themes of information or resource needs. Simulations can expose workarounds that providers may not even recognize as workarounds because they are so common, providing evidence of processes that need improvement. Simulations can also be used to adapt a process that is a “best practice” in one organization, or under one set of circumstances, so that it fits a local context, resources, and culture.
Simulation-Based Preparation for Emergencies in Outpatient Settings
An article focusing on pediatrics notes, “The best way to ensure readiness for an emergency is to practice regularly in the office setting, with as many office staff members as possible participating. Simulated exercises, or mock codes, provide a good opportunity for staff members to practice the steps of an emergency.”23
Simulations can be used to support patient and family engagement. Patients, their families and support people, and community organizations can help inform the design and content of simulations relevant to their experiences. With appropriate preparation, they can actively participate in simulations and add valuable perspectives and insights during debriefings.25,26
Lessons learned from simulations can and should be shared beyond the direct participants. In one organization, simulation was used during the COVID-19 pandemic to test the effectiveness of processes designed to protect providers. Lessons learned were shared with multiple units so that solutions could be spread more quickly, and processes that were not practical or effective were discarded more quickly.
Simulation to advance antiracist culture
Simulations were developed in response to racist behavior by patients toward a clinical team member24: One participant commented, “This simulation opened my eyes to strategies I can use to better support my friends and colleagues in times of need.”
Information about hazards identified during simulation should be collected and addressed with the same seriousness and using the same data collection processes as information about unsafe conditions or near-miss events involving real patients. Organizations should ensure that lessons learned from simulation are tracked, trended, and reported at the same meetings as quality and safety indicators.
Debriefing All Surgical Cases
Rose and Rose found that debriefing 54,003 consecutive cases revealed 4,523 defects. Addressing these reported defects was associated with a significant reduction in 30-day unadjusted surgical mortality, improved operating room efficiency, and a better safety climate.27
