TY  - JOUR
PY  - 2022//
TI  - Making a move: Using simulation to identify latent safety threats prior to the care of injured patients in a new physical space
JO  - Journal of trauma and acute care surgery
A1  - Kotagal, Meera
A1  - Falcone, Richard A. Jr
A1  - Daugherty, Margot
A1  - Merkt, Brant
A1  - Klein, Gina L.
A1  - McDonough, Shawn
A1  - Boyd, Stephanie D.
A1  - Geis, Gary L.
A1  - Kerrey, Benjamin T.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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. <br><br>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 (FMEA) to identify and prioritize LSTs, respectively. <br><br>RESULTS: Eight sessions were conducted over two months. 201 staff participated, including trauma surgeons, respiratory therapists, nurses, emergency physicians, x-ray technicians, pharmacists, emergency medical services, and OR staff. In total, 118 LSTs (average of 14.8/session) were identified. LSTs were categorized. An action plan for mitigation was developed after applying FMEA prioritization scores (based on severity, probability, and ease of detection). <br><br>CONCLUSIONS: 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: Level IV, Care Management.<p />  <p>Language: en</p>
LA  - en
SN  - 2163-0755
UR  - http://dx.doi.org/10.1097/TA.0000000000003865
ID  - ref1
ER  -