International Journal of Healthcare Simulation

Background:

Hospitals are dynamic healthcare environments, adapting to challenges including increasing demand through the design and construction of new clinical areas. In-situ simulation has been used effectively in clinical settings to assess the strength and suitability of these clinical environments prior to their use [1]. Additionally, simulation has been more recently used in critical care settings to evaluate adaptations required in response to new challenges, including the COVID-19 pandemic [2]. We ran a one day in-situ simulation-based session called Simulation for Stress Testing and Operational Readiness in Critical Care (SSTORCC) to evaluate the operational readiness of a new twenty-four bedded critical care unit built at our hospital prior to its official opening to patients and staff. The aim was to assess the operational readiness of the new critical care unit and evaluate its safety for patients, with the objective being to identify problems that would affect this. The attendees were key members of the team and stakeholders so that issues that arose from the session were addressed in a timely fashion.

Methods:

This in-situ simulation session followed a patient’s journey from admittance to the new critical care unit and incorporated all aspects of patient care, including accessing the unit, the ergonomics of the bed space, and equipment availability. We simulated several emergency situations including emergency intubation and cardiac arrest, and a transfer from the unit to another area of the hospital.

Results:

The session identified key areas of development and modifications required prior to the move of patients and staff to the new critical care unit. These included ensuring access to the unit for relevant staff at the hospital, clear labelling on each equipment trolley, assembly of emergency drug boxes for each of the four areas of the unit, and raising awareness about the location and opening of the new unit to the wider hospital.

Conclusion:

In-situ simulation is a constructive tool to use in stress testing a new critical care unit and allows for efficient recognition of areas which require immediate action prior to being considered ready for operational use.

References

1. Frommelt J, Noeller T. In situ Simulation to Evaluate the Readiness of a New Clinical Space. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022.

2. Fregene TE, Nadarajah P, Buckley JF, Bigham S, Nangalia V. Use of in situ simulation to evaluate the operational readiness of a high-consequence infectious disease intensive care unit. Anaesthesia. 2020;75(6):733–738.