就危险而言，医疗保健是当今世界上最高的，高度审查的行业之一。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.

二十年前开始的患者安全运动导致人们对使用模拟降低风险并改善患者安全的兴趣日益增加。基于仿真的培训 - 作为一种教学策略，而不仅仅是指技术本身 - 经常因复制患者旅程的现实能力而受到赞誉。同样地，simulation can be used as a means to measure, assess, prevent, and minimize risk to hospitals.

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.

潜在的安全威胁（LST）或医疗机构的设计，组织，培训或维护中的错误可能导致患者的负面结果。这些被称为accidents waiting to happenand may be overlooked in routine risk assessments.

In situ simulation, or simulation that occurs within the actual care setting as opposed to in a simulation center, can help to identify LSTs before they cause harm to a patient or provider. Often, in situ simulation involves an interdisciplinary team (just as a real patient case would) and provides the context of the normal workflow.

通过允许在真正的临床环境中展开模拟方案，参与者面临与他们每天一起使用的分心，资源限制，障碍和系统缺陷的挑战。²这正是原位模拟can bring to light potential risksbefore it is too late.

医院系统本质上会遭受人为错误。患者案例可能是复杂，动态和压力的，即使对于最有经验的医疗保健专业人员，这也可能导致错误。此外，在整个护理过程中，患者不仅由一个单一提供商治疗。研究表明，大约70% 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

Simulated patient cases offer providers a chance to practice using patient safety tools, such as TeamSTEPPS^®, 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.

Adverse events, including sentinel events, require comprehensive review and investigation to uncover the cause as well as to prevent the likelihood that the same event will occur again. The root cause analysis and action plan moving forward can be made stronger through simulation.⁵

可以使用从电子病历（ERM）提取的数据来设计模拟方案来重复发生的不良事件。而且，由于场景是可重复的，因此可以多次运行以测试可能影响结果的变量。通常，通过仿真确定的根本原因倾向于更多地关注基于系统的错误，而不是由个人引起的错误。⁷This information can then improve the implementation of corrective measures and decrease the risk of recurrence.

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.

In addition, the rightsimulation learning management platformwill 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.

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,it can also develop a provider’s interpersonal skills with patients.

使用标准化的患者可以模仿情绪和心理表现，可以增强聆听，观察和交流的重要性。而且，通过使用可以接受医疗干预措施的饱满模拟器，可以进一步增强这种培训。

开发着针对软技能的模拟可以帮助提供者采用新的沟通方式，以外行术语提供解释，并排练使激动的患者保持镇定。这些中的每一个都有助于增加患者的信任，因此更多地披露了他们的症状。最终，这可以导致更准确的诊断，更好的药物依从性，甚至在HCAHP上得分更高。