Article Text

91 Using in situ simulation to test preparedness for major trauma in a new build emergency department
  1. Sarah Nightingale
  1. Royal Wolverhampton NHS Trust, UK


Background In November 2015 a district general trauma unit opened a new emergency department. This presented an opportunity to use simulation to assess the preparedness of the department for opening. In situ simulation identifies latent safety threats and improves how well prepared staff feel when moving to a new department.1 In situ simulation prior to opening a new department can identify issues that can be corrected before opening.2 Using simulation to test the location of equipment and stock when opening a new department can improve efficiency.3

Methodology A trauma simulation scenario was planned in order to assess multiple areas of the new department including ambulance triage, the resuscitation area, access to the blood bank, CT scanner and the route to intensive care. An experienced clinical team was used in order to focus the simulation learning objectives on any potential latent safety threats in the new department, rather than assessing the participants. The simulation took place before the new department opened to allow any problems to be rectified.

Results Feedback was given by the participants and the scenario was also observed by the hospital lead for human factors. Multiple issues were identified. Examples of these included feeling isolated in the resuscitation area, a lack of certain trauma equipment, delay in getting O negative blood to the department and poor positioning of monitors in resuscitation bays. Solutions were found for all major problems and these were initiated, if not fully implemented, prior to the new department opening.

Conclusion and recommendations In situ simulation was useful in testing preparedness of the new department to manage a major trauma patient and several changes were made as a result. The experience also sparked enthusiasm amongst the staff involved to use in situ simulation for regular training.


  1. Kobayashi L, Shapiro MJ, Sucov A, Woolard R, Boss RM, Dunbar J, Sciamacco R, Karpik K, Jay G. Portable Advanced Medical Simulation for New Emergency Department Testing and Orientation. Academic Emergency Medicine: Official [Online]. Journal of the Society for Academic Emergency Medicine 2006;13(6):691–5. Available from: (Accessed 08/12/15).

  2. Geis GL, Pio B, Pendergrass TL, Moyer MR, Patterson MD. Simulation to Assess the Safety of New Healthcare Teams and New Facilities. Simulation in Healthcare: Journal of the Society for Simulation in Healthcare 2011;6(3):125–133. Available from: (Accessed 08/12/15).

  3. Riby S, Gay C, Smith C, Townend W. From novel simulation to integrated simulation – a successful collaboration with the hull emergency department 2015. In: BMJ Simulation & Technology Enhanced Learning Conference Proceedings of the Association of Simulation Practice in Healthcare (ASPiH) Annual Conference. 3rd to 5th November 2015, Brighton, UK, [Online] 1 (Suppl 2), A6–A7. [Abstract only] Available from: [Accessed 08/12/15].

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