دورية أكاديمية
Making a move: Using simulation to identify latent safety threats before the care of injured patients in a new physical space.
| العنوان: | Making a move: Using simulation to identify latent safety threats before the care of injured patients in a new physical space. |
|---|---|
| المؤلفون: | Kotagal M; From the Division of Pediatric General and Thoracic Surgery (M.K., R.A.F., M.D.), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Surgery (M.K., R.A.F.), University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Emergency Medicine (M.K., S.D.B., G.L.G., B.T.K.), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Center for Simulation and Research (B.M., G.L.K., S.M., S.D.B., G.L.G., B.T.K.), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics (G.L.G., B.T.K.), University of Cincinnati College of Medicine, Cincinnati, Ohio; and James M. Anderson Center for Health System Excellence (M.K., R.A.F.), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio., Falcone RA Jr, Daugherty M, Merkt B, Klein GL, McDonough S, Boyd SD, Geis GL, Kerrey BT |
| المصدر: | The journal of trauma and acute care surgery [J Trauma Acute Care Surg] 2023 Sep 01; Vol. 95 (3), pp. 426-431. Date of Electronic Publication: 2022 Dec 30. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott, Williams & Wilkins Country of Publication: United States NLM ID: 101570622 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2163-0763 (Electronic) Linking ISSN: 21630755 NLM ISO Abbreviation: J Trauma Acute Care Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Hagerstown, MD : Lippincott, Williams & Wilkins |
| مواضيع طبية MeSH: | Patient Safety* , Emergency Medical Services*, Humans ; Child ; Emergency Service, Hospital ; Patient Care Team ; Trauma Centers |
| مستخلص: | Background: In today's rapidly changing health care environment, hospitals are expanding into newly built spaces. Preserving patient safety by identifying latent safety threats (LSTs) in advance of opening a new physical space is key to continued excellent care. At our level 1 pediatric trauma center, the hospital undertook a 5-year project to build a critical care tower, including a new emergency department with five trauma bays. To allow for identification and mitigation of LSTs before opening, we performed simulation-based clinical systems testing. Methods: Eight simulation scenarios were developed, based on actual patient presentations, incorporating a variety of injury patterns. Scenarios included workflow and movement from the helipad and squad entrance as well as to radiology, the operating room, and the pediatric intensive care unit. A multiple resuscitation scenario was also designed to test the use of all five bays simultaneously. Multidisciplinary high-fidelity simulations were conducted in the new tower. Key trauma and emergency department stakeholders facilitated all sessions, using a structured framework for systems integration debriefing framework and failure mode and effect analysis to identify and prioritize LSTs, respectively. Results: Eight sessions were conducted for 2 months. A total of 201 staff participated, including trauma surgeons, respiratory therapists, nurses, emergency physicians, x-ray technicians, pharmacists, emergency medical services, and operating room staff. In total, 118 LSTs (average of 14.8/session) were identified. Latent safety threats were categorized. An action plan for mitigation was developed after applying failure mode and effects analysis prioritization scores (based on severity, probability, and ease of detection). Conclusion: Systems-focused trauma simulations identified a large number of LSTs before the opening of a new critical care building. Identification of LSTs is feasible and facilitates mitigation before actual patient care begins, improving patient safety. Level of Evidence: Therapeutic/Care Management; Level IV. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.) |
| References: | Alfredsdottir H, Bjornsdottir K. Nursing and patient safety in the operating room. J Adv Nurs . 2008;61(1):29–37. Francoeur C, Shea S, Ruddy M, Fontela P, Bhanji F, Razack S, et al. It takes a village to move a hospital: simulation improves intensive care team preparedness for a move to a new site. Hosp Pediatr . 2018;8(3):148–156. Davison M, Kinnear FB, Fulbrook P. Evaluation of a multiple-encounter in situ simulation for orientation of staff to a new paediatric emergency service: a single-group pretest/post-test study. BMJ Simul Technol Enhanc Learn . 2017;3(4):149–153. Kobayashi L, Shapiro MJ, Sucov A, Woolard R, Boss RM 3rd, Dunbar J, et al. Portable advanced medical simulation for new emergency department testing and orientation. Acad Emerg Med . 2006;13(6):691–695. Thompson H, Legorreta K, Maher MA, Lavin MM. Planning, designing, building, and moving a large volume maternity service to a new labor and birth unit. MCN Am J Matern Child Nurs . 2016;41(6):322–331. Rule ARL, Snider J, Marshall C, Kramer K, Geis GL, Tegtmeyer K, et al. Using simulation to develop care models for rapid response and code teams at a satellite facility. Hosp Pediatr . 2017;7(12):748–759. Wheeler DS, Geis G, Mack EH, LeMaster T, Patterson MD. High-reliability emergency response teams in the hospital: improving quality and safety using in situ simulation training. BMJ Qual Saf . 2013;22(6):507–514. Patterson MD, Geis GL, Falcone RA, LeMaster T, Wears RL. In situ simulation: detection of safety threats and teamwork training in a high risk emergency department. BMJ Qual Saf . 2013;22(6):468–477. Geis GL, Pio B, Pendergrass TL, Moyer MR, Patterson MD. Simulation to assess the safety of new healthcare teams and new facilities. Simul Healthc . 2011;6(3):125–133. Dube MM, Reid J, Kaba A, et al. PEARLS for systems integration: a modified PEARLS framework for debriefing systems-focused simulations. Simul Healthc . 2019;14(5):333–342. Holmes J, Chipman M, Barbour T, DiLisio C, Morejon O, Graydon-Baker E, et al. A simulation systems testing program using HFMEA methodology can effectively identify and mitigate latent safety threats for a new on-site helipad. Jt Comm J Qual Patient Saf . 2022;48(1):12–24. Weick K, Sutcliffe K. Managing the Unexpected: Sustained Performance in a Complex World . Hoboken, NJ: John Wiley and Sons; 2015. Johnson K, Geis G, Oehler J, Meinzen-Derr J, Bauer J, Myer C, et al. Simulation to implement a novel system of care for pediatric critical airway obstruction. Arch Otolaryngol Head Neck Surg . 2012;138(10):907–911. |
| تواريخ الأحداث: | Date Created: 20221230 Date Completed: 20230824 Latest Revision: 20230828 |
| رمز التحديث: | 20230830 |
| DOI: | 10.1097/TA.0000000000003865 |
| PMID: | 36583615 |
| قاعدة البيانات: | MEDLINE |
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