As a result of 9/11, hospitals redesigned departments and protocols to better respond to terrorist events.²Now, future hospitals will likely be designed to better respond to pandemic events.

In a pandemic, experts agree that built-in flexibility is needed in the structure and layout of hospitals.³随着199名患者的增加，设施竭尽所能。现在，组织正在寻找更具战略性行动的方法。这可能包括将床计数扩展到标准模型之外的方法，或者如何通过单独的空气过滤系统隔离医院的不同区域。而且，虽然医院通常不会比平均患者数量更多的供应量，但他们现在开始保留更多的供应量。

组织可能会开始评估其当前蓝图，并注视着每个单元中的床位，存储，个人防护设备（PPE）的量，机械呼吸机的数量以及每个临时或永久性前房的位置。检查医疗空间和识别缺陷的最有用的方法之一是使用in situ simulation– which is a form of team-based simulations run in the real clinical environment.除了测试房间的逻辑流外，原位模拟还被证明可以提高团队合作，沟通技巧和患者安全成果.⁴

As one of the few interventions shown to benefit patients with COVID-19 is mechanical ventilation, there has been an increased focus on the skills required to manage a ventilator. Typically, these skills are exclusive to the respiratory therapist or intensivist and, at almost 50% of hospitals, there is not an intensivist who regularly performs rounds.⁵

In addition to the skills required to manage the ventilator itself, hospitals discovered that they did not have a sufficient number of personnel authorized to intubate and extubate their patients. Without adequate staff permitted to intubate patients prior to putting them on a ventilator, unnecessary delays were identified. And, the high risk for aerosolization of respiratory secretions during extubation required additional precautions to be put in place.

尽管对急性呼吸窘迫综合征（ARDS）的大规模培训可能不是其原始培训议程的一部分，但医院必须迅速调整其计划，以确保跨学科的提供者有信心治疗Covid-19患者。This ability to quickly and seamlessly change course was an important determinant for how well a hospital responded to the pandemic.

Simulation training helps reinforce clinical understanding, and provides the opportunity for hands-on practice before a provider treats a real patient. When a hospital is working to train a large group of practitioners on one specific task, simulation can make that training impactful for participants. And, when this training is being conducted on short notice, using pre-programmed simulation scenarios can save time.

Nationally, Blacks, Hispanics and other minority populations are disproportionally affected by COVID-19.⁶And, unfortunately,冠状病毒只会加剧现有和著名的健康差异.

Compared with white patients, members of racial and ethnic minorities are less likely to receive preventative health services and often receive lower-quality care.⁷这与社会经济和人口统计学因素结合，导致了少数民族的灾难性医疗保健结果。提供者不仅必须适应这些因素，而且还必须训练以不断发展其文化能力。Using simulation to train for diverse patient populations – and, specifically, using a simulator in a darker skin tone – can create an eye-opening learning experience for practitioners.

While COVID-19 has brought greater awareness to health disparities among racial and ethnic minorities, it has also encouraged healthcare providers to strengthen their interpersonal and communication skills withall患者和彼此。来自不同学科的护理提供者以前所未有的方式汇集在一起​​，并有望作为一支高度功能的团队表演。

Under normal circumstances, patient families are as involved as possible in vulnerable patient cases. COVID-19 has disrupted this as hospitals have not been allowing family members or visitors at the bedside.This means that critical patients and patients near death have been relying solely on healthcare providers for emotional support – and that providers need to exhibit their strongest interpersonal skills.

基于跨学科的团队模拟培训通常以一种可以提高临床准确性的学习方法而闻名。但是，这种培训通常还可以帮助学习者改善他们的方式与患者互动on a personal level. Communication skills, rapport building, emotional support, and increased patient trust are all vital to positive patient outcomes and patient satisfaction. And, this type of training provides an opportunity for healthcare providers to practice the use of a Crew Resource Management (CRM) or TeamSTEPPS tool for improved team communications with each other, too.