Quality improvement utilizing in-situ simulation for a dual-hospital pediatric code response team

In situ simulation and its effects on patient outcomes: a systematic review

“…While conducting this review, articles reporting on these surrogate endpoints were abundant. This finding is congruent with other systematic reviews published in the last several years 9 12 17 18. Recently, however, an increasing number of studies have been published that directly demonstrate the positive impact of in situ simulation training on patient morbidity and mortality.…”

“…In situ simulation-based training may be an important training modality to improve care delivery in high-pressure situations that demand the coordination of many healthcare providers, actions and resources 6. While it has been demonstrated that knowledge and technical skills are vital to providing competent emergency care, non-technical skills referred to as crisis resource management have also been shown to affect overall outcome, and are improved through in situ simulation training 7–10…”

Documentation framework for healthcare simulation quality improvement activities

“…The simulation methodology utilised for the testing of health systems and processes provides a unique lens through which staff at all levels can observe, assess, and evaluate [ 1 , 5 – 7 ]. The advantage of simulation as a quality improvement methodology is that one cannot accurately predict system performance without testing prior to ‘going live’.…”

“…Each method demonstrated strengths and weaknesses in finding active or latent system failures [ 1 – 4 ]. With the building of our new healthcare facility, it was decided that live (physical) testing of the environment using a medical simulation methodology was the best approach to bridge the gap from architectural plans, to real-world efficient and effective patient care, and for orientation and training of teams to their new environment [ 4 – 7 ]. Although the hospital had yet to open, testing the systems under immersive simulated conditions at the point of care delivery effectively replicated real-world workflows and systems [ 1 , 6 ].…”

“…The Plan-Do-Study-Act (PDSA) methodology provides a structure for cyclical or iterative testing of changes to a system or process, to improve quality and effectiveness [ 11 , 16 – 18 ], and therefore ideally suited the iterative nature of our activity. There was little in the literature about using the PDSA framework for quality improvement within medical simulation [ 6 , 7 , 19 , 20 ], and there was no evidence of a standard template for running medical simulation scenarios specifically to test clinical and non-clinical processes. As a result, the MEST developed the SQIOT.…”