Oral Themed Presentation
Background: : Reource simulations have shown potential for being a powerful tool for riskmanagement and learning 1, 2). The Pediatric Centre for Advanced Simulation and Training (pCAMST) was commissioned by the chief medical officers to run simulations with all the care units at the Karolinska University Hospital in preparation for the move of all departments to a newly constructed hospital building.
Research Question: : To evaluate resource simulations as a method for individual and organisational learning
RQ1: Where the resource simulations well designed?
-Did the scenarios capture relevant clinical situations and safety critical patient flows?
-Where the simulations percieved as meaningsful??
-What was identified through the simulations?
RQ 2: Did the simulations contribute to that the participants felt more prepared and less anxious about the move?
Methodology: : We used a collaborative process for designing the simulations for each unit. Managers and staff from each unit identified key processes and procedures as well as common risk situations that the staff were anxious about and wanted to test in the new environment. Each day started with a pre-brief introducing the instructors, the unit and the pedagogic model used in simulation. We then ran 3-5 scenarios, either testing normal work-practices including surgical or radiological procedures or scenarios where a previously stable patient deteriorated, and the situation escalated into an emergency.
Data for the study were collected through a pre- post survey, field notes from participant observations and through analysis of logs of the findings from the simulations.
Results: : We ran 450 simulations over 89 days. Over 900 staff and managers participated in the simulations. Over 2900 issues were discovered. 726 respondents completed the pre- and post survey, a response rate of 73.6%. Most of the participants reported that the simulations captured relevant clinical situations, that they learned about how their work practices would work in the new hospital setting and reported that they felt that the pedagogical approach and the instructors facilitation was valuable. When asked if the participants thought that the simulations contributed to that the participants felt more prepared and less anxious about the move a significant improvement (Wilcoxon signed-rank test p= 0.00001) was seen in all professions except managers.
Discussion/Conclusions: : The participants felt that the simulation revealed a lot of solvable issues and where valuable in preparing for the move.
Simulated scenarios generate a lot of knowledge about latent patient safety threats, unsolved issues with technology and are a powerful tool for reconciling work as imagined (or planned) with how work actually will be done.