BMJ quality & safety
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BMJ quality & safety · Jun 2013
In situ simulation: detection of safety threats and teamwork training in a high risk emergency department.
Implement and demonstrate feasibility of in situ simulations to identify latent safety threats (LSTs) at a higher rate than lab-based training, and reinforce teamwork training in a paediatric emergency department (ED). ⋯ In situ simulation is a practical method for the detection of LSTs and to reinforce team training behaviours. Embedding in situ simulation as a routine expectation positively affected operations and the safety climate in a high risk clinical setting.
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BMJ quality & safety · Jun 2013
Unannounced in situ simulations: integrating training and clinical practice.
Simulation-based training for healthcare providers is well established as a viable, efficacious training tool, particularly for the training of non-technical team-working skills. These skills are known to be critical to effective teamwork, and important in the prevention of error and adverse events in hospitals. However, simulation suites are costly to develop and releasing staff to attend training is often difficult. ⋯ We also describe the important benefit of risk assessment for a clinical environment. During our simulations we have identified a number of issues that, had they occurred during a real resuscitation attempt, may have led to patient harm or patient death. For these reasons we feel in situ simulation should be considered by every hospital as part of a patient safety initiative.
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BMJ quality & safety · Jun 2013
Comparative StudyContextual information influences diagnosis accuracy and decision making in simulated emergency medicine emergencies.
It is well documented that adaptations in cognitive processes with increasing skill levels support decision making in multiple domains. We examined skill-based differences in cognitive processes in emergency medicine physicians, and whether performance was significantly influenced by the removal of contextual information related to a patient's medical history. ⋯ Our findings have implications for scenario design and the manipulation of contextual information during simulation training.
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BMJ quality & safety · Jun 2013
High-reliability emergency response teams in the hospital: improving quality and safety using in situ simulation training.
In situ simulation training is a team-based training technique conducted on actual patient care units using equipment and resources from that unit, and involving actual members of the healthcare team. We describe our experience with in situ simulation training in a major children's medical centre. ⋯ In situ simulations can identify latent safety threats, identify knowledge gaps, and reinforce teamwork behaviours when used as part of an organisation-wide safety programme.
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BMJ quality & safety · Jun 2013
Systematic simulation-based team training in a Swedish intensive care unit: a diverse response among critical care professions.
Teamwork-that is, collaboration and communication-is an important factor for safe healthcare, but professions perceive the quality of teamwork differently. ⋯ All team members benefited from the SBTT in an authentic composed team, but this was expressed differently for the respective professions.