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5 Reasons Why You Should Consider Simulation to Mitigate Risk

Healthcare is one of the most high-acuity, highly scrutinized industries in today’s world in terms of what is at stake.For those who manage risk, this implies the need for constant vigilance and continuous improvement. While some degree of risk may be inevitable in healthcare, new tools exist to identify and predict when and where it will occur—on a micro scale. And, it’s possible to reduce the negative impact that risk can have on patient outcomes as well as financial matters.

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。

Other high-risk industries such as aerospace, transportation, and power-generation have become steadily safer with the aid of simulation.1In hospitals, in addition to providing standardized, repeatable clinical training, we’ve learned from our clients’ experience that when a simulation culture is adopted, they see the following improvements:

  • Reduced sentinel events
  • Reduced litigation expenses
  • Improved patient satisfaction scores
  • Improved insurance rates
  • 改善患者的结果

Below, we dive into five specific ways simulation can make a difference. Each provides a reason why it is worth considering as a means of mitigating risk in your organization.

1.确定潜在风险

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 asaccidents waiting to happenand may be overlooked in routine risk assessments.

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。

2. Accounting for Human Factors

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 approximately70% of deaths caused by medical errors are related to communication breakdowns during handoffs.3Simulation can be used to improve interpersonal communication skills and teamwork skills, reducing this risk.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®, Crew Resource Management, or their own new internal protocols. As these simulations can be standardized, all members of an interdisciplinary team can be trained to conduct teamwork and communication to the organization’s standard. This means that providers who may have never worked together will be able to communicate accurately and efficiently, minimizing the chances of mistakes and misunderstandings.

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How Simulation Can Reduce Patient Risk

An Introduction for Risk Managers and Quality Improvement Specialists

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3. Conducting a Root Cause Analysis

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

具体而言,对事件的模拟可以帮助回答以下三个问题:6
  • 发生了什么?
  • 为什么会发生?
  • What can be done to prevent it from happening again?

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.7This information can then improve the implementation of corrective measures and decrease the risk of recurrence.

4. Predictive Modeling

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will allow for the extraction of pertinent data. Based on previously run simulations, risk managers can access data about provider performance, trends, and areas of the highest risk. This can aid in the reduction of patient harm, provider harm, or the rate of readmission.

5. Improving Care Quality and Patient Satisfaction

HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) results are important to a hospital’s overall success. A low or high score can impact a hospital’s marketability as well as its reimbursement rates. Just as simulation training can improve the ability of providers to communicate effectively with one another,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.

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Resources

  1. 医疗研究和质量机构。(2018)。医疗保健模拟以提高安全性。取自https://www.ahrq.gov/research/findings/factsheets/errors-safety/simulproj15/index.html
  2. Lamberta, M. & Aghera, A. (2020). Latent safety threat identification via medical simulation. Stat Pearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK549909/
  3. University of Illinois at Chicago. (2016). Preventing medical communication errors: Study examines multidisciplinary rounding in hospitals. ScienceDaily. Retrieved February 8, 2021 from www.sciencedaily.com/releases/2016/12/161220095204.htm
  4. Lamberta, M. & Aghera, A. (2020. See reference #2.
  5. Slakey,D.P.,Simms,E.R.,Rennie,K.V.,Garstka,M.E.,Korndorffer,J.R。Jr.(2014)。使用仿真来改善不良手术结果的根本原因分析。国际卫生保健质量杂志,第26(2)页,第1页。144-150)。取自https://doi.org/10.1093/intqhc/mzu011
  6. Ewen, B.M & Bucher, G. (n.d.) Root cause analysis: Responding to a sentinel event. Lippincott Nursing Center. Retrieved from https://www.nursingcenter.com/ce_articleprint?an=00004045-201309000-00006
  7. 同上。
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