Abstract
Healthcare resources have been strained to previously unforeseeable limits as a result of the COVID-19 pandemic of 2020. This has prompted the emergence of critical just-in-time COVID-19 education, including rapid simulation preparedness, evaluation and training across all healthcare sectors. Simulation has been proven to be pivotal for both healthcare provider learning and systems integration in the context of testing and integrating new processes, workflows, and rapid changes to practice (e.g., new cognitive aids, checklists, protocols) and changes to the delivery of clinical care. The individual, team, and systems learnings generated from proactive simulation training is occurring at unprecedented volume and speed in our healthcare system. Establishing a clear process to collect and report simulation outcomes has never been more important for staff and patient safety to reduce preventable harm. Our provincial simulation program in the province of Alberta, Canada (population = 4.37 million; geographic area = 661,848 km2), has rapidly responded to this need by leading the intake, design, development, planning, and co-facilitation of over 400 acute care simulations across our province in both urban and rural Emergency Departments, Intensive Care Units, Operating Rooms, Labor and Delivery Units, Urgent Care Centers, Diagnostic Imaging and In-patient Units over a 5-week period to an estimated 30,000 learners of real frontline team members. Unfortunately, the speed at which the COVID-19 pandemic has emerged in Canada may prevent healthcare sectors in both urban and rural settings to have an opportunity for healthcare teams to participate in just-in-time in situ simulation-based learning prior to a potential surge of COVID-19 patients. Our coordinated approach and infrastructure have enabled organizational learnings and the ability to theme and categorize a mass volume of simulation outcome data, primarily from acute care settings to help all sectors further anticipate and plan. The goal of this paper is to share the unique features and advantages of using a centralized provincial simulation response team, preparedness using learning and systems integration methods, and to share the highest risk and highest frequency outcomes from analyzing a mass volume of COVID-19 simulation data across the largest health authority in Canada.
Highlights
With the emergence of the Coronavirus disease (COVID)-19 pandemic of 2020, healthcare resources have been strained to unforeseeable capacities, promoting the need for rapid, effective, and efficient preparedness
These exercises allowed for proactive pandemic surge planning assessment of facility, departments, programs, and services related to COVID-19 patient flow. educate Simulate Innovate Motivate (eSIM) and human factors (HF) were utilized for designing decision algorithms, observation of new work processes and work environments, and identifying further improvement opportunities
This paper adds to the emerging literature on using simulation for pandemic planning and preparedness [8, 9] as it describes a highly coordinated COVID-19 pandemic simulation response using a centralized team, robust valid curriculum, and data outcomes team to analyze and rapidly share an unprecedented volume of simulation data for a large-scale simulation for systems integration (SIS) project across the largest single health authority in Canada
Summary
With the emergence of the COVID-19 pandemic of 2020, healthcare resources have been strained to unforeseeable capacities, promoting the need for rapid, effective, and efficient preparedness. Over just 5 weeks, this response team enabled a harmonized intake process, design, and development of a robust COVID-19 simulation curriculum, mobilized a data collection/outcome reporting team, and a response plan to facilitate over 400 acute care simulation session requests across Alberta’s broad geographical zones. This coordinated approach and infrastructure enabled an integrated provincial multi-site simulation response, allowing the ability to rapidly theme and categorize a mass number of simulation findings (over 2,500 systems issues) from over 30,000 learners (HCP) on the frontline. Simulation-based learning has historically focused on individual and team training of practicing HCPs [19,20,21,22,23,24,25], it has evolved to include just-in-time in situ training within the actual clinical environment [26,27,28] including simulation for systems integration (SIS), targeting the testing and integration of systems and processes (e.g., workflows, care pathways) that are uniquely important to disaster preparedness [29,30,31,32]
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