Calm Before the Storm: Utilizing In Situ Simulation to Evaluate for Preparedness of an Alternative Care Site during COVID-19 Pandemic (1090-003827) (Research Abstract Professor Rounds: Group 3)
Start time: Thursday, January 28, 2021, 11:30 AM End time: Thursday, January 28, 2021, 12:30 PM Session Type: Research Abstracts (Completed Studies)
The novel coronavirus, SARS-CoV-2, was first identified in Wuhan, China in late 2019. It was soon identified as the cause of a large number of cases of acute respiratory illness leading to severe acute respiratory distress syndrome. As the disease spread rapidly, the health care systems became overwhelmed. This pandemic has increased demands of the healthcare system including the need to rapidly expand hospital capacity. Many regions have utilized alternative care sites (ACS) to mitigate these issues. Establishing an ACS along with management protocols has many unique challenges, since these sites aim to offer hospital level of care in an austere, dynamic environment. In this paper, we describe a simulation based evaluation of a newly established ACS. The primary goal of this session was to perform systems testing to identify areas in need of improvement and suggest changes prior to patient arrival.
Four simulation cases were developed for the preparedness evaluation session. These cases were designed to depict common situations as well as low frequency, high acuity situations that would likely be encountered in the ACS. The cases included: acute hypoxic respiratory failure, cardiac arrest, and patient fall in the bathroom, and provider syncope. Participants were identified prior to the scenarios and given assigned clinical roles within their typical scope of practice. A high fidelity simulator was used as well as a standardized patient. Observers were given debriefing forms listing the objectives, critical actions and specific areas to focus their attention. The data was collected for review. The observer group was multidisciplinary including physicians, nursing, pharmacy, infection prevention and emergency medical services personnel.
Many logistical, operational and patient safety issues were identified during the simulation. Data was collected from the debriefing forms and compiled into a Simulation Event Report and distributed to key personnel. Proposed solutions and protocol changes were made in response to the identified issues.
Simulation was successfully utilized for systems testing, supporting efforts to maximize patient care and provider safety in a rapidly developed ACS. The simulation event report identified operational deficiencies and safety concerns directly resulting in equipment modifications and protocol changes.