By: Allison F. Perry
When I first became involved in simulation through the development of the Patient Safety Congress Learning & Simulation Center, which I described in Part I of this two-part series, the direct connection with, and strong purpose for, collaboration between safety and quality departments in health care organizations were quite obvious to me. I found myself embedded in a world that seemed on a fast track toward rapid improvement. Imagine my surprise as I began to uncover the silos and disconnect that still exist in many organizations, even in organizations that lead in simulation and patient safety.
The use of simulation was part of the fabric of patient safety prior to the famed 1999 Institute of Medicine To Err Is Human report. Advances in simulation have driven health care safety, and the field of anesthesiology and the Anesthesiology Patient Safety Foundation (https://www.apsf.org) had led efforts in both simulation and patient safety since the 1980s. Early innovators, like David Gaba (2004), encouraged the adoption of simulation as a technique that would span beyond traditional skills training for the individual learner into broader, ongoing systemic learning for teams and organizations for the purposes of patient safety. Yet, collaborative efforts continue to lag across health care.
To more fully infuse simulation into the culture of an organization, especially one where patient safety and simulation departments are not directly linked, there needs to be an effort on the part of simulation and patient safety leaders to seek out their counterparts and engage in dialogue. Collaboration is key. But collaboration can be difficult, can’t it? Especially when there is competition for critical resources: time and funding.
The exciting reality is that by collaborating on simulation programming, there is opportunity to meet your goals, your colleagues, and the larger institution. Assuming you, the reader, are a health care simulationist, following are a variety of methods you might adopt to foster networks of communication and collaboration among your patient safety colleagues.
Educators: Encourage the curiosity of your students to extend beyond the narrow borders of traditional simulation applications. How might you use simulation-based techniques to further emphasize the importance of an early and lasting commitment to safety and quality methods and ideals? Challenge your students to explore team-based issues, communication techniques (among team members, patients, and families). It may be common for students to practice clinical skills on a manikin, but how many of your students have had the opportunity to practice having difficult conversations with a patient or family member when an error has occurred? The Institute for Healthcare Improvement (IHI) offers numerous educational opportunities, both virtual and in person, that would be ideal for students and faculty who are looking to stretch their boundaries of expertise.
Students (new and lifelong): As you continue to explore the field of health care, consider the opportunities you have before you to contribute, in significant ways, to improving the safety of patients and the workforce. Challenge yourself to identify opportunities for using simulation to improve not just your clinical skills, but also the environment in which you perform these skills, the teams with which you work, and ultimately the larger system that delivers care across the continuum.
For those of you who are in clinical settings, seek out one or two people from another department who are also invested in patient safety work. Invite them to coffee or ask for just a short amount of their time. Inquire about their priorities, the projects they’re working on. Meet with your organization’s patient and family advisory council. What burning issues can you help them address? How might the voice of the patient improve your efforts? You can explore current hot topics in patient safety by visiting IHI’s patient safety content. When you talk with anyone in your organization, share what is meaningful and important to you and your work in simulation. Collaboration will open the door to projects and initiatives that are ripe for infusing simulation.
Stretch your wings and expand the boundaries within your institution. Explore the many ways simulation-based learning may be applied to patient safety efforts. Similarly, be open to the knowledge and learning that come out of the field of patient safety. Continual advances in safety science offer opportunities for improved simulation methods and techniques as well. Know that YOU can play an important role in both the diffusion of simulation in patient safety as well as future innovations in simulation.
I have been surprised by the disconnect between patient safety and simulation, despite the recognized impact that simulation has played in advancing the safe delivery of health care. This recognition has fueled my passion for developing programs and collaborative learning opportunities to improve dialogue between and among fields and, ultimately, coordinated efforts. Perhaps you also share a passion for using simulation to improve patient safety. Will you join me in creating and fostering communication and collaboration between the worlds of patient safety and simulation?
Gaba D.M. (2004). The future vision of simulation in health care. Quality and Safety in Health Care, 13(Suppl 1), i2-i10. doi: 10.1136/qshc.2004.009878
Institute of Medicine. (1999). To err is human. Washington, DC: National Academies Press.