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0039 Training the team – using in-situ simulation in stand-alone units to improve safety culture
  1. Celia Bygrave,
  2. Amanda Milligan,
  3. Julie Turner
  1. Worthing Hospital, Worthing, West Sussex, UK


Background Within our Trust we have a Day Surgery Unit located approximately 6 miles from the main hospital. The use of this building and the services provided has changed during recent years, and there has been concern over future plans. Despite no recent safety incidents, anecdotally morale has fallen, staff feel increasingly isolated and there have been questions over the future capabilities of the service.

Methods We have developed a simulation based training programme to enable the entire theatre team to undertake targeted training. We have used a mobile SimMan system to run scenarios within theatre using all local equipment, staff and facilities. It has also allowed us to test the system and functioning of a remote site operating department and identify possible sources for error and potential improvements.

We are measuring our progress using the Safety Attitude Questionnaire (SAQ).1 This has already been used to evaluate improvement in attitudes to safety culture and team working following intervention.2,3

Potential impact It is hoped that the use of focussed sessions specific to the needs of the individuals working in remote locations, we will improve confidence with rarely encountered emergencies as well as further developing non-technical skills. If successful we intend to expand this further to other areas of the Trust (such as ECT).

Following the first session we highlighted a number of potential latent errors, including a lack of understanding regarding the process for declaring emergencies and the layout of the emergency trolley. Individual feedback has been positive, and staff feel motivated to continue participating in the sessions.

We are confident that our findings will have an influence over the future provision of safe and effective care for our patients, as well as maintain skills and confidence in the workplace for the team and improve the safety culture.3


  1. Sexton JB, Helmreich RL, Neilands TB, Rowan K, Vella K, Boyden J, Roberts PR, Thomas EJ. The safety attitudes questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Health Serv Res 2006;6:44

  2. Wolf FA, Way LW, Stewart L. The efficacy of medical team training: improved team performance and decreased operating room delays: a detailed analysis of 4863 cases. Ann Surg 2010;252:477–485

  3. Hill MR, Roberts MJ, Alderson ML, Gale TCE. Safety Culture and the 5 steps to safer surgery: an intervention study. Br J Anaes 2015:1–5

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