In the age of rapidly evolving healthcare technologies and practices, patient safety and system integration remain top priorities for medical organizations worldwide. These topics have recently taken center stage in the Health Environments Research & Design Journal (HERD), which published an article detailing how healthcare teams can utilize simulation as a quality improvement tool to enhance the safety and cohesiveness of their services. This article, with the DOI 10.1177/1937586719846586, elucidates goals, recommendations, and practical How-To strategies for developing and conducting patient safety and system integration (PSSI) simulations based on expert consensus using the Delphi technique (Dubé, Shultz, Barnes, Pascal, & Kaba, 2020).
The need for constant quality improvement in the delivery of healthcare has led researchers and practitioners alike to seek methods that could preemptively identify potential system issues. The study carried out by Mirette M. Dubé and colleagues offered a comprehensive approach to use simulation for this purpose. Simulations are powerful tools that have been utilized to mimic real-world scenarios and processes within a controlled environment, making them an invaluable asset for healthcare teams aiming to reduce errors and integrate systems effectively.
To garner the expertise required for these recommendations, the authors employed the Delphi technique, a structured communication method used primarily when there are no adequate quantitative data available. This method engages a group of subject matter experts through a series of questionnaires to form a consensus on judgments concerning complex issues or processes (Hsu & Sandford, 2007). Through iterative rounds, individual feedback was transformed into collective wisdom.
The research article set forth several key recommendations that center around project management, stakeholder engagement, sponsorship, scenario design, and both prebriefing and debriefing practices. Additionally, the article provides guidance on choosing appropriate evaluation metrics, to not only foster patient safety but to also ensure effective dissemination of findings that can lead to actionable outcomes.
Project management within the context of PSSI simulations involves meticulous planning and coordination of resources, time, and personnel. Important considerations include clear objectives, timeline management, and budget oversight. A well-defined project structure can significantly enhance the success of PSSI simulations.
Stakeholder engagement is critical to ensure that the diverse perspectives and expertise within a healthcare organization are represented. The involvement of different departments and roles ensures that the simulation addresses all relevant aspects of patient care and organizational operation.
The researchers emphasized the importance of sponsorship – securing champions within the organization who can leverage influence to garner necessary resources, such as space or funding, and facilitate the integration of simulation findings into organizational practices.
In terms of scenario design, the article advised that simulation exercises should be reflective of realistic clinical situations that healthcare providers may encounter. This realism ensures that the outcomes and lessons learned are directly applicable to real-world challenges.
Prebriefing sessions prepare participants for the simulation, while debriefing sessions afterward provide opportunities for reflection and an examination of the events, decisions, and outcomes. These debriefing sessions are where much of the learning occurs, as they provide a platform for discussion and feedback.
Evaluation metrics should be robust and enable the measurement of both the effectiveness of the training and the subsequent implementation of changes to practice. Metrics can range from participant feedback and clinical performance indicators to patient outcomes and organizational impact.
The article by Dubé et al. demonstrates the crucial role that simulation exercises can play in aligning healthcare practices with safety principles. The authors outline a clear and structured method for utilizing simulations to advance patient safety and integrate systems throughout healthcare organizations.
Keywords
1. Patient Safety Simulations
2. Healthcare Quality Improvement
3. Delphi Technique in Healthcare
4. System Integration in Healthcare
5. Healthcare Simulation Strategies
References
1. Dubé, M. M., Shultz, J. J., Barnes, S., Pascal, B., & Kaba, A. (2020). Goals, Recommendations, and the How-To Strategies for Developing and Facilitating Patient Safety and System Integration Simulations. HERD: Health Environments Research & Design Journal, 13(1), 94–105. https://doi.org/10.1177/1937586719846586
2. Hsu, C-C., & Sandford, B. A. (2007). The Delphi technique: making sense of consensus. Practical Assessment, Research, and Evaluation, 12(10), 1-8.
3. Rosen, M. A., Hunt, E. A., Pronovost, P. J., et al. (2012). In situ simulation in continuing education for the health care professions: A systematic review. Journal of Continuing Education in the Health Professions, 32(4), 243-254.
4. Motola, I., Devine, L. A., Chung, H. S., Sullivan, J. E., & Issenberg, S. B. (2013). Simulation in healthcare education: A best evidence practical guide. AMEE Guide No. 82. Medical Teacher, 35(10), e1511–e1530.
5. Lateef, F. (2010). Simulation-based learning: Just like the real thing. Journal of Emergencies, Trauma, and Shock, 3(4), 348.