It Takes a Village to Move a Hospital: Simulation Improves Intensive Care Team Preparedness for a Move to a New Site

Abstract

OBJECTIVES: To evaluate in-situ simulation to prepare a PICU to move to a new, redesigned unit. METHODS: The study setting is an academic PICU. This is a cross-sectional study using in-situ simulations of common PICU admissions. Postsimulation, participants completed a survey comparing the perception of preparedness pre- and postsimulation (via a 10-point Likert scale). Participants were resurveyed 6 months postmove to assess whether effects persisted. Qualitative data were obtained via thematic review of the survey comment section and from postsimulation debriefing. RESULTS: Response rates were initially 100% and 67% at the 6-month follow-up. In the initial phase, all questions had statistically significant improvements in post- versus presimulation scores. Participants felt better prepared (presimulation: 6.20, postsimulation: 7.90, P < .001) and more confident about caring for real patients (presimulation: 5.49, postsimulation: 7.41, P < .001). They felt more comfortable working in the new unit (presimulation: 5.65, postsimulation: 7.50, P < .001) and better able to deliver safe care (presimulation: 5.85, postsimulation: 7.60, P < .001). Six months postmove, participants still believed that simulation was helpful (7.43, SD: 2.20) and still reported improved team confidence (7.36, SD: 2.11). Only 1 of 28 participants preferred less simulation. Exercises were described as helpful in identifying process and latent patient safety issues. CONCLUSIONS: Our pediatric intensive care team found simulations to be beneficial in preparation for providing care to critically ill children in a complex new setting. Simulations uncovered latent process, personnel, and patient-safety issues that were addressed before actual patient care.