Background/context Homerton University Hospital has an active simulation centre and in situ simulation programme. We have regular theatre multidisciplinary audit meetings and utilise this time when routine operating work does not take place to hold a multidisciplinary in situ simulation. Two sessions have already taken place and a third is planned. We have learnt many lessons from this undertaking and would like to share the good practice and perceived benefits.
Methodology On the day a full complement of theatre staff and resources were available. To maximise the number of participating staff three simultaneous scenarios were run and repeated twice. These scenarios were designed to recreate the themes of past incident reports, focusing on human factors.1 The evaluation was conducted via questionnaire, focusing mainly on qualitative data. This year we are aiming to merge theatres and ward based in situ, using the patient journey from ward to theatres as the basis for scenarios.
Results In both 2014 and 2015 showed we had ~60 staff members attend (excluding faculty) and greater than 95% found the session applicable and useful to their clinical practice. The feedback was extremely positive and we identified latent errors and gaps in knowledge that we were able address. We learnt much from organising such an ambitious event. Early planning to ensure the enough facilitators were available and designing scenarios specific to the participating staff were challenges we identified. We also discovered that there was a lack of facilitators amongst theatre nursing staff and surgeons, which we have addressed by encouraging attendance at our local train the trainers courses. We are currently investigating alternative methods to generate quantitative data from our feedback.2
Potential Impact Our aim is to promote teamwork and leadership throughout the hospital and reduce the number of theatre patient safety incidents.
Fortune PM, Davis M, Hanson J, Philips B. Advanced Life Support Group. Human factors in The Health Care Setting. Wiley-Blackwell, 2013
Observational Teamwork Assessment for Surgery (OTAS), Imperial College London http://www.imperial.ac.uk/patient-safety-translational-research-centre/our-work/teams-skills-and-safety/observational-teamwork-assessment-for-surgery-otas/
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