In May 2019, Northern Health started the ‘Simulation Project’, as part of quality and safety initiatives and our trusted care transformation.

Dr Nancy Sadka, Emergency Physician, explains the project started with the aim of using in-situ multidisciplinary simulation as part of quality improvement processes.

“In-situ simulation means the simulation is performed in the clinical space, during clinical times. The purpose of the simulation isn’t necessarily education, but quality improvement. We are testing systems, like our code responses, diagnosing areas of risk and translating recommendations into practise, which is really important,” she said.

When the pandemic began, the simulation team shifted their focus to finding opportunities for improvement in the pandemic response.

“The demand grew so much that we ended up doing 13 simulations in just two months, compared to the initial plan to do one a month. Now, we are sitting at 27 completed simulations since last year,” Dr Sadka explained.

Over time, staff participation in simulations grew, with the initial sessions involving six team members, to now having around 20 team members. With the support of Dr Bill Shearer and the HRO transformation team, the simulation team has involved various hospital units – from critical care specialist and general medical, general surgical, obstetric and paediatric, and has grown to include many aspects of the hospital.

“We are not just looking at the number of simulations we’ve done, but also at the actual outcomes, the recommendations that have been made and the policy changes. When we do a simulation, we make recommendations, then we communicate these to the people that can change the policies, and then we re-simulate within six months to test and see if the recommendations have been implemented. That is how we ensure we are not just changing a piece of paper, but changing what happens,” she said.

Nancy adds that simulations are there not to test the staff, or their clinical capabilities – the only thing tested is the system.

Besides the tangible outcomes, Nancy is proud of the cultural change that simulations have brought. Now, simulation is not just for education, but is a system test which allows teams to come up with solutions and identify problems.

Nancy and the team have also been approached to help with MET team training and simulation videos, Code Brown response, pandemic response, education and are also part of the testing team for the new building.

“We’ve had a great response from staff who are asking for more and more exercises of this type, because staff feel that their voices get heard. These activities are also crucial for team building. Don’t forget that teams that practise together, perform well together.”

“There is a lot of scope for us to do more in 2021, as well as continue the quality project,” Dr Sadka said.

Dr Bill Shearer, Executive Director Transformation, Quality and Safety added, “Simulation, particularly in-situ simulation, epitomises HRO thinking. It allows us to increase the safety of our care by testing our systems and processes with the experts in providing that care, without risk to patients or staff.”