• Conall Francoeur, Sarah Shea, Margaret Ruddy, Patricia Fontela, Farhan Bhanji, Saleem Razack, Ronald Gottesman, and Tanya Di Genova.
• Division of Pediatric Critical Care, Department of Pediatrics, The Montreal Children's Hospital, and McGill University, Montreal, Quebec, Canada.
• Hosp Pediatr. 2018 Mar 1; 8 (3): 148-156.

ObjectivesTo evaluate in-situ simulation to prepare a PICU to move to a new, redesigned unit.MethodsThe study setting is an academic PICU. This is a cross-sectional study using in-situ simulations of common PICU admissions. Postsimulation, participants completed a survey comparing the perception of preparedness pre- and postsimulation (via a 10-point Likert scale). Participants were resurveyed 6 months postmove to assess whether effects persisted. Qualitative data were obtained via thematic review of the survey comment section and from postsimulation debriefing.ResultsResponse rates were initially 100% and 67% at the 6-month follow-up. In the initial phase, all questions had statistically significant improvements in post- versus presimulation scores. Participants felt better prepared (presimulation: 6.20, postsimulation: 7.90, P < .001) and more confident about caring for real patients (presimulation: 5.49, postsimulation: 7.41, P < .001). They felt more comfortable working in the new unit (presimulation: 5.65, postsimulation: 7.50, P < .001) and better able to deliver safe care (presimulation: 5.85, postsimulation: 7.60, P < .001). Six months postmove, participants still believed that simulation was helpful (7.43, SD: 2.20) and still reported improved team confidence (7.36, SD: 2.11). Only 1 of 28 participants preferred less simulation. Exercises were described as helpful in identifying process and latent patient safety issues.ConclusionsOur pediatric intensive care team found simulations to be beneficial in preparation for providing care to critically ill children in a complex new setting. Simulations uncovered latent process, personnel, and patient-safety issues that were addressed before actual patient care.Copyright © 2018 by the American Academy of Pediatrics.

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