As Stage 2 of the Northern Hospital Expansion Project approaches completion, Dr Nancy Sadka, and the hospital in-situ simulation team have been busy testing the facility and training and providing orientation to staff prior to the go–live date.

The operational simulation project, a quality and safety initiative and part of our trusted care transformation, began on 1 February and will run for six weeks, and has already conducted over ten simulations. Nancy says they plan to conduct one a day over the coming weeks.

The project involves a multidisciplinary team and will include simulations of Code Blue, Code Grey, Code Pink, and evacuation of theatre. There will also be a Code Black simulation and a Code Red simulation jointly conducted with the Police and Fire Department.

Says Nancy, “It’s the perfect opportunity to train and simulate a practice in this space that doesn’t have patients in it yet.”

She explains, “It is really key for many reasons. Obviously first from a safety aspect and the opportunity to identify latent risks and address them. It allows us to proactively prevent risk events from happening and address those areas.”

It is also important as Nancy points out from a staff training point of view – evacuating theater and fire drills are examples of this.

As Nancy says, “One of the things about moving to a new space, is the concerns you have when you arrive, to a new and unfamiliar space.”

A key component, hence, of the operational simulation project, is what Nancy describes as the experiential orientation, it provides staff.

“Staff will learn about this space and become familiar with this space through practice and through facing the same scenarios they will face when they are working with patients – but in a safe way because there are no patients involved.”

A case in point are the High Dependency Units in the new building.

As Nancy explains, “For instance the doors open differently, the emergency buzzer is in a different place – and these are all really important for day to day work.”

On the day, we caught up with Nancy and the team had just concluded a simulation of a scenario that happens once or twice a year here (see main image).

As she explains, it was a simulation of a patient who was in cardiac arrest presenting in their car to the front of the new building and a family member running in for help. As part of the simulation, the reception staff activated a Code Blue and Emergency Department (ED) staff had to retrieve the patient from the car whilst performing advanced life support and CPR. The ED team then had to figure out how to move the patient onto a trolley and back to ED.

As Nancy explains, it allowed staff to test the space, have a response to an emergency in it and then be able to reflect on it. It raised questions as to, “What equipment and staff might we need?”, “Do we need to do anything differently in our response?” and “what were the barriers and dangers?”

Says Nancy, “It is really important for our staff to go into that space, be familiar with it and comfortable in it. It’s their voice that gets heard.”

“It’s about us asking staff from reception to sit at the reception desk and to have to call a code and to tell us what are the areas they are concerned about. It’s about ED staff figuring out the best way to bring a patient back to ED from the wards.”

Says Ms Bianca Grey from the communications team at reception, who was involved in the simulations, “It was a fascinating experience to see how the different code teams responded.”

Dr Joe Rotella from the ED team was also part of the multidisciplinary team involved in the operational simulation project.

Says Joe, “The best aspect of simulation at Northern Health is that these procedures that might not happen every day, have been tested vigorously. As a clinician, we have an opportunity to contribute to its development and its improvement and refinement of processes.”

Feature image shows a simulation at the entrance of the new building.