The Effect of Simulation-Based Training Prior to Moving to a New Department on the Quality and Safety of Patient Care

Background: The PICU at Edmond and Lily Safra Hospital moved to its new 22-bed facility in February 2017. The transition included several profound changes in the department`s operating philosophy that affect daily work, such as closed patient rooms, the possibility of parents staying next to their child and replacement of all monitoring and warning systems while significantly increasing the area of the department. In the face of these extensive changes and the high risk to hospitalized patients during this transition period, a preparatory training program was prepared prior to the actual transition.

Method: Analysis of the challenges involved in the transition raised several key points: the need to test systems and work procedures, assimilate the changes in the new work routine, familiarize with new equipment and obtain the ability to provide adequate emergent critical care in the new work environment. In order to meet these challenges, an In-Situ simulation-based training program was created in the new department.

Results: Prior to the opening of the new department, the entire team underwent simulation-based training, which included 258 hours of training and testing of systems. Each simulation examined a different component of the daily work regime and management of extreme situations. Pitfalls were identified and re-examined in subsequent training.

Throughout the simulation-based training, more than 173 potential pitfalls were identified at different levels of severity, including 38 severe pitfalls that could endanger patient care.

Conclusions: Assessments and early simulation-based training in the new work environment allow early detection and correction of significant pitfalls and risks prior to moving to a new work environment. In addition, simulation reduces the level of anxiety and fear from transition, while increasing the responsiveness and readiness of the staff with a significant impact on the quality and safety of patient care.