Abstract
Healthcare organizations strive to deliver safe, high-quality, efficient care. These complex systems frequently harbor gaps, which if unmitigated, could result in harm. Systems-focused simulation (SFS) projects, which include systems-focused debriefing (SFD), if well designed and executed, can proactively and comprehensively identify gaps and test and improve systems, enabling institutions to improve safety and quality before patients and staff are placed at risk.The previously published systems-focused debriefing framework, Promoting Excellence and Reflective Learning in Simulation (PEARLS) for Systems Integration (PSI), describes a systematic approach to SFD. It includes an essential “pre-work” phase, encompassing evidence-informed steps that lead up to a SFD. Despite inclusion in the PSI framework, a detailed description of the pre-work phase, and how each component facilitates change management, was limited.The goal of this paper is to elucidate the PSI “Pre-work” phase, everything leading up to the systems-focused simulation and debriefing. It describes how the integration of project and change management principles ensures that a comprehensive collection of safety and quality issues are reliably identified and captured.
Highlights
IntroductionInefficiencies, and latent safety threats lurk in modern healthcare organizations
Systems issues, inefficiencies, and latent safety threats lurk in modern healthcare organizations
Systems-focused simulation (SFS) and systems-focused debriefing (SFD) facilitate the identification of safety threats, inefficiencies, and opportunities for quality improvement at all levels of the system, without placing patients at risk
Summary
Inefficiencies, and latent safety threats lurk in modern healthcare organizations. Previous publications have described the use of simulation and debriefing to identify safety threats and inefficiencies during design [1, 2] prior to opening [3] and after opening [4] new clinical units and/or implementing new processes [5]. Patient safety science promotes proactive identification of systems issues to mitigate harm, before patients are placed at risk. Systems-focused simulation (SFS) coupled with systems-focused debriefing (SFD) is an emerging quality improvement tool [6]. SFS and SFD facilitate the identification of safety threats, inefficiencies, and opportunities for quality improvement at all levels of the system, without placing patients at risk. SFS and SFD can aid in highlighting (2021) 6:16 and reinforcing system resilience and organizational learning from simulation
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