Abstract

The diverse landscape of healthcare exemplifies complex subsystems interconnecting to form a unique organization. System integration (SI) is the ability to improve the quality of care and patient outcomes through re-engineering of care delivery processes in the healthcare environment. With the acceptance of simulation as a tool for education has also come the evolution of SI simulation and testing. The lens of the SI simulation shifts from the traditional team training focus to a quality improvement tool that support optimization of health care delivery. System integration (SI) simulations can be done at the unit level, across multiple departments and sites, in various settings or even on a provincial scope.

Since 2010, the eSIM Provincial Simulation Program (eSIM) has conducted SI simulations to test new environments and policies, identify latent safety threats and transform new builds to meet the unforeseen needs of the healthcare team. Working with frontline clinical teams and healthcare leaders, eSIM has developed a standardized approach to SI simulations ensuring empowerment of growth and reporting and influence of quality.

Emphasis on this workshop will be highlighting the approaches developed by the eSIM team used in implementing SI simulations. Key concepts of the workshop will include: project management approaches, evaluation scope and objectives, metrics, scenario design/testing, implementation and operationalizing outcomes.

Objectives:

1. Describe the rationale for implementing SI simulations as part of a continuous cycle of quality improvement.
2. Key Differences in SIS vs. insitu simulations.
3. Understand the key features and how-to strategies for developing and facilitating SI simulations.
4. Application of SIS approaches to a healthcare process, protocol or space.

The instructional design:

1. Introduction
2. Didactic: SI approaches for simulation including key features, strategies in design and implementation.
3. Small Group Activity: Using worksheets and faculty support, groups develop approaches in SI simulation. Scenarios: site pediatric code blue process, new build admission hold unit outside emergency, testing of anaphylaxis kits and testing new massive transfusion protocol.
4. Large Group Reflection

References:

Coleman, N., Doughty, C., Arnold, J., Stone, K., Reid, J., Dalpiaz, A., Hebbar, K., (2019) Simulation-based clinical systems testing for healthcare spaces: from intake through implementation, Advances in Simulation, 4 (19).

Dube, M., Reid, J., Cheng, A., Eppich, W., Grant, V., Stone, K., Kaba, A. (2019) PEARLS for System Integration A Modified PEARLS Framework for Debriefing System-Focused Simulations, Society for Simulation in Healthcare.

Dube, M., Schultz, J., Barnes, S., Pascal, B., Kaba, A. (2019) Goals, Recommendations and the How-To Strategies for Developing and Facilitating Patient Safety and System Integration Simulations, Health Environmental Research, 12 (1). 10.1177/19375867.

Health Quality Council of Alberta. Simulation-Based Mock-up Evaluation Framework .Calgary, Alberta, Canada: Health Quality Council of Alberta; March 2016.

Shultz J, Borkenhagen D, Rose E, Gribbons B, Rusak-Gillrie H, Fleck S, Muniak A, Filer J. Simulation-based mock-up evaluation of a universal operating room, Health Environments Research & Design Journal (OnlineFirst) pp. 1-13. Copyright © 2019 (SAGE Publishing).