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Responsive In-situ Simulation in Kids (RISK) project: a novel approach to learning from clinical incident reporting
  1. Kate Knox,
  2. Nicola Baldwin,
  3. Claire Cadman,
  4. Olivia Davies,
  5. Leanne Goh,
  6. Rebecca Mortimer,
  7. Carol Stiles,
  8. Yasmin Baki,
  9. Sarah Eisen
  1. Department of Paediatrics, University College London Hospitals NHS Foundation Trust, London, UK
  1. Correspondence to Dr Kate Knox, Department of Paediatrics, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK; keknox{at}

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The number of reported clinical incidents continues to rise in the UK, with 1.9 million incidents reported to the National Reporting and Learning System from July 2016 to June 2017, an increase of 6.9%.1 Despite this, there has not been a clear demonstrable improvement in patient safety. This is in part due to a failure to disseminate effective safety interventions into routine practice as well as the lack of a consistent tool to measure improvements in patient safety problems.2

Incident reporting in itself does not lead to improved patient safety without reflection, investigation and re-organisation,3 requiring us to find ways in which we can best respond to clinical incidents in a responsive and timely fashion to prevent recurrence.

Regular in situ simulation has been shown to result in sustained improvements in the management of acutely unwell paediatric patients.4 In situ simulation is also a practical method of identifying latent safety threats, allowing implementation of system changes that contribute to improved patient care.5


We developed an in situ simulation programme—known as RISK (Responsive In-situ Simulation in Kids)—within the paediatric department of University College London Hospital, a large London teaching …

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  • Contributors Each of the authors has contributed to the design of the project described and/or the acquisition of the data. KK prepared the manuscript, and YB and SE reviewed the manuscript prior to submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data sharing statement Data collection remains ongoing for our project as outlined in the manuscript. This is currently only accessible by the project team.

  • Correction notice This paper has been amended since it was published Online First. The seventh author’s surname was spelled incorrectly. The correct spelling is "Stiles".

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