由于9/11，医院重新设计了部门和协议，以更好地应对恐怖主义事件。²现在，未来的医院可能会被设计为更好地应对大流行事件。

在大流行中，专家们认为，医院的结构和布局需要内置的灵活性。³Facilities did what they could with what they had as COVID-19 patients increased. Now, organizations are looking at ways to act more strategically. This might include ways to expand bed count beyond the standard model or how to isolate different areas of the hospitals with separate air filtration systems. And, whereas hospitals typically would not stockpile more supplies than they require for the average number of patients, they are now beginning to keep larger amounts of supplies on hand.

An organization will likely begin by evaluating their current blueprint with an eye toward bed space in each unit, storage, the amount of personal protective equipment (PPE), the number of mechanical ventilators, and the location of each temporary or permanent anteroom. One of the most useful ways to examine the healthcare space and identify flaws is to usein situ simulation- 这是在真正的临床环境中运行的基于团队的模拟形式。In addition to testing the logical flow of the room, in situ simulation has been proven to improve teamwork, communication skills, and patient safety outcomes.⁴

由于证明有益于COVID-19患者的少数干预措施之一是机械通气，因此人们对管理呼吸机所需的技能的重点增加了。通常，这些技能是呼吸治疗师或强化主义者独有的，在近50％的医院中，没有一个经常进行巡回赛的强化主义者。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.

Though mass training for acute respiratory distress syndrome (ARDS) may not have been a part of their original training agenda, hospitals had to quickly adjust their plans to ensure interdisciplinary providers were confident in treating patients with COVID-19.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-19.⁶而且，不幸的是，the coronavirus has only exacerbated existing and well-knownhealth disparities.

与白人患者相比，种族和少数民族的成员不太可能接受预防性卫生服务，并且经常获得较低质量的护理。⁷This, in conjunction with socioeconomic and demographic factors, has led to catastrophic healthcare outcomes for minorities. Providers must not only be attuned to these factors, but they must also train to continually develop their cultural competence.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.

尽管Covid-19使种族和少数民族的健康差异提高了人们对健康差异的认识，但它还鼓励医疗保健提供者通过使用人际交往和沟通技巧全部patients as well as with each other. Care providers from different disciplines were brought together in an unprecedented way and were expected to perform as a highly-functioning team.

在正常情况下，患者家庭在脆弱的患者病例中尽可能地参与其中。Covid-19破坏了这一点，因为医院不允许床边的家人或访客。这意味着关键的患者和死亡附近的患者一直仅依靠医疗保健提供者来获得情感支持，并且提供者需要表现出最强的人际交往能力。

Interdisciplinary team-based simulation training is often renowned as a learning method that can improve clinical accuracy. But, often times this training also helps learners improve how theyinteract with a patient在个人层面上。沟通技巧，融洽的建设，情感支持和增加的患者信任对于积极的患者结果和患者满意至关重要。而且，这种类型的培训为医疗保健提供者提供了一个机会，可以练习使用机组人员资源管理（CRM）或TeamStepps工具，以改善团队沟通。