Healthcare is one of the most high-acuity, highly scrutinized industries in today’s world in terms of what is at stake.对于那些管理风​​险的人来说，这意味着需要持续保持警惕和持续改进。尽管医疗保健中可能不可避免地会有一定程度的风险，但存在新工具来识别和预测何时何地发生在微观范围内。而且，有可能减少风险对患者预后以及财务问题的负面影响。

The patient safety movement that started two decades ago has led to growing interest in using simulation to reduce risk and improve patient safety. Simulation-based training – as a teaching strategy and not just referring to the technology itself – is often praised for its ability to replicate the reality of the patient journey. Likewise,模拟可以用作测量，评估，预防和最小化医院风险的一种手段。

在下面，我们介绍了五种特定的模拟方式可以有所作为。每个人都提供了一个原因，因此值得考虑减轻组织中风险的一种手段。

Latent safety threats (LSTs), or the errors in design, organization, training, or maintenance of the healthcare facility, can contribute to negative patient outcomes. These are known as等待发生的事故并可能在常规风险评估中被忽略。

与模拟中心相反，在实际护理环境中发生的原位模拟或模拟可以帮助识别LST在对患者或提供者造成伤害之前。通常，原位模拟涉及一个跨学科团队（就像真正的患者情况一样），并提供正常工作流程的背景。

By allowing a simulation scenario to unfold in the real clinical environment, participants are challenged with the same distractions, resource limitations, obstacles, and system flaws that they work with daily.²This is precisely howin situ simulation可以带来潜在的风险趁早。

Hospital systems are inherently subject to human error. Patient cases can be complex, dynamic, and stressful and, even for the most experienced healthcare professionals this can lead to mistakes. Additionally, throughout the continuum of care, a patient is not only treated by one single provider. Research shows that approximately医疗错误造成的死亡中有70％与交接期间的沟通故障有关。³模拟可用于提高人际交往能力和团队合作技能，从而降低这种风险。⁴

模拟的患者案例为提供者提供了使用患者安全工具（例如TeamStepps）练习的机会^®，机组人员资源管理或其自己的新内部协议。由于可以标准化这些模拟，因此可以培训跨学科团队的所有成员，以与组织的标准进行团队合作和沟通。这意味着可能从未共同努力的提供者能够准确有效地交流，从而最大程度地减少了错误和误解的机会。

不良事件（包括前哨事件）需要全面审查和调查，以揭示原因，并防止同一事件再次发生的可能性。可以通过模拟使根本原因分析和行动计划向前发展。⁵

Simulation scenarios can be designed to repeat the adverse event that took place, using data extracted from the electronic medical records (ERM). And, as the scenario is repeatable, it can be run multiple times to test variables that might affect the outcome. Typically, the root causes identified through simulation tend to focus more on systems-based error rather than errors caused by individuals.⁷然后，此信息可以改善纠正措施的实施，并降低复发的风险。

Similar to the ability to replicate an event that already occured, simulation affords an organization the chance to ask ‘what if?’ As predictive analysis is conducted and clinical target areas are prioritized, simulation can provide the ability to test and re-test any combination of theories and solutions. Using a customized scenario, the room design, and hand-selected participants, it is possible to create a controlled environment.

另外，正确仿真学习管理平台将允许提取相关数据。根据先前运行的模拟，风险管理者可以访问有关提供者绩效，趋势和最高风险领域的数据。这可以帮助减少患者伤害，提供者伤害或再入院率。

HCAHPS（医院消费者对医疗保健提供者和系统的评估）结果对医院的整体成功很重要。低分数或高分会影响医院的可销售性及其报销率。就像模拟培训可以提高提供者相互有效交流的能力一样，它还可以与患者发展提供者的人际交往能力。

Using a standardized patient, who can mimic emotional and psychological displays, can reinforce the importance of listening, observing, and communicating. And, this training can be further enhanced with the use of a full-bodied simulator that can receive medical interventions.

Developing a simulation focused on soft-skills can help providers adopt new communication styles, practice providing explanations in laymen terms, and rehearse keeping agitated patients calm. Each of these contribute to increased patient trust and, therefore, more disclosure about their symptoms. Ultimately, this can lead to more accurate diagnoses, better medication adherence, and even higher scoring on the HCAHPS.