(104) In Situ Simulation at a Small Specialty Hospital: Experience With a Novel Managed Services Program

Introduction: Simulation-based training in health care facilities has been of significant benefit ranging from increasing staff knowledge and skill sets to identifying latent safety threats. Widespread use of simulation may be restricted by high cost of equipment acquisition, space, and personnel constraints for smaller healthcare facilities. Here we describe an innovative alternative process to bring in-situ simulation to smaller medical centers which overcomes the aforementioned obstacles. A managed services program provided in-situ simulation-based staff training at significant cost savings at our small facility. We also set out to assess attitudes in staff without prior experience with simulation-based learning.

Methods: Staff perceptions and attitudes toward in-situ simulation, learning objectives, increase in satisfaction and knowledge were tracked throughout high-fidelity simulation engagements by conduct of pre- and post-surveys of staff participating in the simulations.

Results: Eight simulation engagements occurred from August 2021 to end 2023. A total of 438 staff encounters occurred during 128 simulation sessions with 158 unique participants over 3 years. 501 pre- and post-surveys (response rate:57%) were analyzed. Year 1 over two engagements, respondents who found simulation to be meaningful increased from 35% to 100%; respondents who wanted more simulations increased from 57% to 96%. Year 2, surveys over three engagements showed increase in staff perception of skills and knowledge (52% to 87%), and perception of greater empowerment (55% to 91%) in ability to escalating the level of care. Year 3, 94 sim participants revealed a universal appreciation (100%) of simulations providing an opportunity for teams to work together and that scenarios reinforced their ability to recognize clinical deterioration (100%).

Conclusions: We launched in-situ simulation at our smaller healthcare facility using a novel managed services program. Our initial financial outlay and infrastructure costs have been much lower than with an outright purchase of high-fidelity simulators or construction of a simulation lab. Staff perceptions toward simulation-based learning improved markedly over the course of three years. The survey results serve as a striking affirmation of the success of our innovative simulation program.