Recently, the first ‘In-Situ Simulation’ was held in the Emergency Department as part of a Code Trauma Scenario.

Code Trauma is an activation sequence that provides a staff and service response to a potentially major trauma patient in the Emergency Department, that meets the Code Trauma criteria including abnormal vital signs, specific injuries and/or special circumstances.

Simulation is part of a hospital-wide initiative run by the newly formed In-Situ Simulation Clinical Community alongside support from the High Reliability Organisation (HRO) Team at Northern Health. Simulation has been acknowledged as an important part of training in healthcare, with Northern Health having a dedicated simulation centre at the Northern Centre for Health Education and Research.

How In-Situ Simulation differs to regular simulation, is that it occurs in patient care units with scenarios involving healthcare professionals in their actual working environment. It is a tool that allows hospitals to target areas of known risk before they affect a patient, test systems to identify areas of needed system improvement and encourages translation of previous quality recommendations into practice and re-assessment.

The scenario involved a patient (simulation manikin) presenting with a closed head injury and closed left femoral fracture. The quality objectives of the scenario were to examine the response to Code Trauma and any barriers to implementation, as well as the process and barriers for early CT imaging of a trauma patient.

Dr Nancy Sadka, Emergency Physician and lead for In-Situ Simulation at Northern Health says, “If you tried to set up simulation in the simulation lab, people will do things differently to what they would normally do in their workplace. The best way to test the system is in that same environment.”

“Many times, we have areas of risk that we have already identified. These areas of risk have had analysis and recommendations, but if we don’t test to see if those recommendations are being translated into practice, then we don’t know if we’ve had any impact and if anything will change in the future,” Dr Sadka continues.

The simulation was attended by staff from multidisciplinary areas and will help to improve system quality through education and ensure our systems support the right clinical decision-making for the patient.

“We’ve done this first simulation now, we’ve made a simulation team from multidisciplinary areas, with the view to develop this program, aiming now for two monthly, then monthly, and then the sky is the limit!” Dr Sadka says.

“We would like to be doing this weekly if we could because we really feel it will make a difference to the quality of our patient care as well as improve our processes.”