SAFEE: A Debriefing Tool to Identify Latent Conditions in Simulation-based Hospital Design Testing

Colman, Nora; Dalpiaz, Ashley; Walter, Sarah; Chambers, Misty; Hebbar, Kiran

doi:10.1186/s41077-020-00132-2

Cited by 11 publications

(15 citation statements)

References 22 publications

(41 reference statements)

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“…Multiple design elements were evaluated as the facilitator prompted clinicians to interact with design elements under evaluation. 23 , 24 This ensured that a wide range of latent conditions were identified. For example, clinicians were instructed to exchange the ETT for a smaller size after the first intubation attempt.…”

Section: Methodsmentioning

confidence: 99%

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Simulation-based User-centered Design: An Approach to Device Development during COVID-19

Colman

Saldaña

Craig

et al. 2021

Pediatric Quality &Amp; Safety

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Section: Methodsmentioning

confidence: 99%

“…Facilitators probed users to explore how the device impacted performance and safety, eliciting the impact of each latent condition identified. 23 …”

Section: Methodsmentioning

confidence: 99%

Simulation-based User-centered Design: An Approach to Device Development during COVID-19

Colman

Saldaña

Craig

et al. 2021

Pediatric Quality &Amp; Safety

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“…For example, an ambulance, a small aircraft, a dentist’s chair, a catheterization lab – all of these settings present physical characteristics that are relevant for task management, but which are difficult to re-create [ 29 ]. In-situ SBA is recognized as appropriate to probe systems and the workflow, safety risks may thereby be identified, and corrections can be made without harming patients or hospital staff in real situations [ 30 – 33 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring health service preparation for the COVID-19 crisis utilizing simulation-based activities in a Norwegian hospital: a qualitative case study

Stømer

Dieckmann

Laudal

et al. 2022

BMC Health Serv Res

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Introduction The first wave of the COVID-19 pandemic caused stress in healthcare organizations worldwide. Hospitals and healthcare institutions had to reorganize their services to meet the demands of the crisis. In this case study, we focus on the role of simulation as part of the pandemic preparations in a large hospital in Norway. The aim of this study is to explore hospital leaders' and simulation facilitators' expectations of, and experiences of utilizing simulation-based activities in the preparations for the COVID-19 pandemic. Methods This is a qualitative case study utilizing semi-structured in-depth interviews with hospital leaders and simulation facilitators in one large hospital in Norway. The data were sorted under three predefined research topics and further analyzed by inductive, thematic analysis according to Braun and Clarke within these pre-defined topics. Results Eleven members of the hospital leadership and simulation facilitators were included in the study. We identified four themes explaining why COVID-19 related simulation-based activities were initiated, and perceived consequences of the activities; 1) a multifaceted method like simulation fitted a multifaceted crisis, 2) a well-established culture for simulation in the hospital was crucial for scaling up simulation-based activities during the crisis, 3) potential risks were outweighed by the advantages of utilizing simulation-based activities, and finally 4) hospital leaders and simulation facilitators retrospectively assessed the use of simulation-based activities as appropriate to prepare for a pandemic crisis. Conclusions The hospital leadership’s decision to utilize simulation-based activities in preparing for the COVID-19 crisis may be explained by many factors. First, it seems that many years of experience with systematic use of simulation-based activities within the hospital can explain the trust in simulation as a valuable tool that were easy to reach. Second, both hospital leaders and simulation facilitators saw simulation as a unique tool for the optimization of the COVID-19 response due to the wide applicability of the method. According to hospital leaders and simulation facilitators, simulation-based activities revealed critical gaps in training and competence levels, treatment protocols, patient logistics, and environmental shortcomings that were acted upon, suggesting that institutional learning took place.

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“…The utilization of SbCST with its accompanying tools allows a systematic, standardized, multidisciplinary evaluation of clinical workflow processes without putting actual patients at risk. [13][14][15] Although the SbCST approach has been applied to multiple areas of medicine, it has not yet found wide application in the field of trauma. Pediatric trauma, a field prone to high-acuity but low-frequency clinical management scenarios, may benefit from an SbCST approach.…”

Section: Introductionmentioning

confidence: 99%

Financial and Safety Impact of Simulation-based Clinical Systems Testing on Pediatric Trauma Center Transitions

Williams

Fitzpatrick

Chandler

et al. 2022

Pediatric Quality &Amp; Safety

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Introduction: Simulation offers multiple tools that apply to medical settings, but little is known about the application of simulation to pediatric trauma workflow changes. Our institution recently underwent significant clinical changes in becoming an independent pediatric trauma center. We used a simulation-based clinical systems testing (SbCST) approach to manage change-associated risks. The purpose of this study was to describe our SbCST process, evaluate its impact on patient safety, and estimate financial costs and benefits. Methods: SbCST consisted of the following steps: (1) change-based needs assessment, in which stakeholders developed relevant simulation scenarios; (2) scenario implementation; and (3) postsimulation failure mode and effects analysis (FMEA) to identify latent safety threats (LSTs). LSTs were prioritized for mitigation based on the expected probability and severity of adverse event occurrences. We calculated the costs associated with the simulation process. We conservatively estimated SbCST cost savings using 3 approaches: (1) FMEA-based avoidance of adverse events; (2) avoidance of trauma readmissions; and (3) avoidance of medical liability lawsuits. Results: We implemented 2 simulation scenarios prechange. FMEA revealed 49 LSTs, of which 9 were highest priority (catastrophic severity and high likelihood of occurrence). These were prioritized and mitigated using the hospital’s quality/safety framework. Cost-benefit analysis based on FMEA event avoidance demonstrated net cost savings to the institution ranging from $52,000−227,000 over the 3-month postchange period. Readmission-based and liability-based estimates also produced favorable results. Conclusions: The SbCST approach identified multiple high-impact safety risks and financially benefited the institution in managing significant pediatric trauma clinical process changes.

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SAFEE: A Debriefing Tool to Identify Latent Conditions in Simulation-based Hospital Design Testing

Cited by 11 publications

References 22 publications

Simulation-based User-centered Design: An Approach to Device Development during COVID-19

Simulation-based User-centered Design: An Approach to Device Development during COVID-19

Exploring health service preparation for the COVID-19 crisis utilizing simulation-based activities in a Norwegian hospital: a qualitative case study

Financial and Safety Impact of Simulation-based Clinical Systems Testing on Pediatric Trauma Center Transitions

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