Lessons learned in preparing for and responding to the early stages of the COVID-19 pandemic: one simulation’s program experience adapting to the new normal

Abstract

Use of simulation to ensure an organization is ready for significant events, like COVID-19 pandemic, has shifted from a “backburner” training tool to a “first choice” strategy for ensuring individual, team, and system readiness. In this report, we summarize our simulation program’s response during the COVID-19 pandemic, including the associated challenges and lessons learned. We also reflect on anticipated changes within our program as we adapt to a “new normal” following this pandemic. We intend for this report to function as a guide for other simulation programs to consult as this COVID-19 crisis continues to unfold, and during future challenges within global healthcare systems. We argue that this pandemic has cemented simulation programs as fundamental for any healthcare organization interested in ensuring its workforce can adapt in times of crisis. With the right team and set of partners, we believe that sustained investments in a simulation program will amplify into immeasurable impacts across a healthcare system.

COVID-19 pandemic preparation: using simulation for systems-based learning to prepare the largest healthcare workforce and system in Canada

“…Our use of simulation for systems integration involved taking a project approach to the initiation, planning, execution, and reporting [39] (e.g., shared learnings) to enable proactive improvement work for safer, more efficient, and reliable care processes for patients and healthcare teams [43][44][45][46][47][48][49][50]. This paper adds to the emerging literature on using simulation for pandemic planning and preparedness [8,9] as it describes a highly coordinated COVID-19 pandemic simulation response using a centralized team, robust valid curriculum, and data outcomes team to analyze and rapidly share an unprecedented volume of simulation data for a large-scale SIS project across the largest single health authority in Canada.…”

“…Diekmann et al also described the potential of using simulation to improve hospital responses to the COVID-19 crisis [6]. Recently published COVID-19 simulation papers [8,9] share lessons learned in an attempt to support organizations that may seek to use simulation for diagnosing, testing, and embedding these approaches within pandemic constraints. While these papers do not provide specific outcomes from their system simulations, they share practical tips, tools, scenarios, debriefing questions, and resources which can be used to analyze the current needs and responses to potentially mitigate the negative impacts of the COVID-19 crisis.…”

“…With the emergence of the COVID-19 pandemic of 2020, healthcare resources have been strained to unforeseeable capacities, promoting the need for rapid, effective, and efficient preparedness. This has prompted the emergence of just-in-time preparedness strategies, including simulation for systems evaluation and healthcare provider (HCP) learning to support planning across healthcare sectors [1][2][3][4][5][6][7][8][9]. Simulation has been pivotal for systems testing and integrating new and improved components such as novel workflows, protocols, and cognitive aids with rapid changes to practice and care delivery.…”

“…The rapid onset of the COVID-19 crisis is having a profound impact on global health, increasing demand, and risks on healthcare systems due to rapidly changing and unpredictable circumstances. The use of in situ simulation as a proactive risk mitigation strategy to prepare healthcare organizations for pandemic planning is well supported in the literature [ 8 , 9 , 26 – 28 ]. Pandemics place high demands on clinical care and potential risk of contamination for HCP, which increases the fear of spread to others [ 1 , 36 , 37 ].…”

In-situ simulations for COVID-19: a safety II approach towards resilient performance

“…Institutions around the world have shifted their perceptions of simulation as a "backburner" training tool to a "first choice" strategy for ensuring staff and system readiness in the face of COVID-19 [16], yet we cannot disregard the practical constraints of performing simulations, especially in situ during the pandemic, such as the need for physical distancing, rigorous infection control for the simulators, the equipment, and the participants [17]. Within this dichotomy, we are given the opportunity to assess the staff's and the system's flexibility to adapt their day-to-day activities to suit the uncertainties caused by the COVID-19 pandemic.…”