Safety Program – Simulations and Mock Scenarios in Operating Rooms
Various forms of health care technology are being utilized today to enhance the skills of health care professionals, as well as improve quality outcomes. Considering the complex and high-risk nature of the operative setting, integrating simulations or mock scenarios has become a growing trend in fostering high-reliability interdisciplinary teamwork. The following paper focuses on the development and implementation of a simulation-based safety program within the operative setting of a health care facility in an effort to reduce adverse or never events. Although the safety risks related to implementing simulation and mock scenarios within the operative setting are identified, evidence is provided that suggests simulation of mock scenarios and tracking of long-term outcomes promotes the delivery of safe, quality care thereby reducing overall risks within the operative setting. Steps for creating the safety program are discussed.
Area of Interest and Safety Risks
The frequency, incidence and nature of adverse events within the operative setting appear to be increasing in recent years. According to Neily et al. (2009), approximately “five to ten incorrect surgical procedures occur every day in the United States” (p. 1028). While this figure may not seem considerable by some working within the health care field, one should ask themselves ‘What is an appropriate number for the occurrence of adverse events within an operative setting?’ and ‘How would you respond to a family member or friend who was involved in such an event?’
Not only have concerns been posed related to the occurrence of incorrect surgical procedures (e.g., wrong procedure, wrong site surgery and/or wrong patient) being performed, but also for the occurrence of other never events within the operative setting such as retained surgical items. According to the Agency for Healthcare Research and Quality (AHRQ), Centers for Medicare and Medicaid Services (CMS) and the National Quality Forum (NQF), never events include adverse events that are clearly identifiable and measurable, resulting in death or significant disability, and generally preventable (AHRQ, 2012). Hence, developing and implementing a safety program that focuses on the standardization of workflows and response to high-risk situations may be warranted to reduce and prevent the occurrence of adverse events within the operative setting.
Based on recent evidence, simulations within the operative setting and/or creating mock scenarios may be a solution to the problem (Davis, Riley, Gurses, Miller & Hansen, 2008; Paige et al., 2008; Paragi Gururaja, Yang, Paige & Chauvin, 2008; Patterson, M., Blike, G. & Nadkarni, V., 2008; Seagull, Moses & Park, 2008). Essentially, the focus of this safety program would be 1) to establish simulations or a simulation lab within the operative setting as a training tool for practicing mock scenarios in an effort to reduce and prevent...