Skip to content

How Can Simulation Drive Quality Improvement in Your Healthcare Setting?

Simulation isn’t just for educating and training individuals—it can expose system flaws, test solutions, and drive real improvements so providers in all fields of healthcare can deliver safer, better care. 

“Historically simulation was used as an education and training technique in healthcare, but now has an emerging role in improving quality and safety. Simulation-based techniques can be applied to help understand healthcare settings and the practices and behaviours of those who work in them.”1  

Dr. Victoria Brazil

Director, Bond Translational Simulation Collaborative; Professor of Emergency Medicine and Director of Simulation, Bond University

Dr Victoria Brazil circle

There is More to Simulation Than Education and Training

When most healthcare teams think about simulation, they picture education and training—practicing infection control, managing codes, onboarding new staff and so on. But what if simulation could be more than a teaching tool? What if it could actively improve the systems that make up patient care?  

Hospitals are complex, adaptive systems. Even in the hands of top-tier clinical talent, small breakdowns in workflow, handoffs, or the use of technology can result in patient harm. These breakdowns often remain hidden until it's too late—unless we design ways to test the system itself.

That’s where simulation, when integrated into Quality Improvement (QI) efforts, makes a big impact. 

Simulation as a Quality Improvement Multiplier

When simulation is used for training and education, it is being used to create experts. When it is used for QI, it is about optimizing the world in which experts can succeed. QI is about proactively designing safer, smarter systems. Simulation supports this by allowing healthcare teams to understand how care is actually delivered in their real environments and to identify what needs to change.

 

“Traditionally, simulation was about making teams and people better, more confident, and more adept in their practice. We now realize that health care is more than simply having a good team; it’s about working in an incredibly complex environment. In situ simulation enables us to recreate events in the actual space where people work. It’s become a testing ground for latent safety threats, things that lie beneath the surface that might not manifest themselves on a daily basis but that, under certain circumstances, impact how we deliver care.”

- Dr. Andrew Petrosoniak MSc (Med Ed), FRCPC, 
Emergency Physician and Trauma Team Leader at St. Michael’s Hospital in Toronto, Canada

Andrew

 

Here are just a few examples:

1. Latent Safety Threats: Understanding Systems in Action

Simulation allows teams to examine how care unfolds across time, teams, and departments. It exposes mismatches between policy and practice—helping identify what are often called latent safety threats (LSTs).

Dr. Andrew Petrosoniak, trauma physician and simulation lead at St. Michael’s Hospital in Toronto, shares:

“We used in situ simulation as a novel and iterative quality improvement technique to reduce the mean time between massive hemorrhage protocol activation and blood administration during actual trauma resuscitations.”3  

 

2. Look before you leap: Testing Ideas Before Implementing

Simulation offers a risk-free way to test changes—before they’re rolled out hospital-wide.

Dr. Petrosoniak describes one such project.

“We believe that we should simulate scenarios as a means to test the equipment and the space, ensuring that it works as we imagine it will”, he explains.  “We do this so that by the time we open for patient care, we’ll know that all systems are a go.”4  

 

3. Practice Makes Permanent: Embedding Change for Long-Term Impact

New workflows and protocols only work if teams adopt them. Simulation allows organizations to embed new practices by helping teams rehears and adjust them under realistic conditions.

In her work, Dr. Brazil emphasizes this embedding function through repeat practice.

“Simulation offers a safe place to practice procedural skills, decision-making and teamwork without placing patients at risk …”, she writes.  She then goes on to explain, “[While] reliance on educational paradigms may fail to realize the full potential of simulation to contribute to quality and safety in healthcare.”5  

Simulation in the quality improvement arena helps to ensure contextual fit and staff adoption.

From Risk Management to Co-Design

Healthcare leaders, risk managers, and simulation professionals are beginning to collaborate in new ways — using simulation not only to identify risk but also to co-create solutions with frontline staff and patients.

Dr. Brazil describes simulation as an opportunity for: “Problem-solving and co-design, channeling the perspectives of staff and patients into system improvement.”6

This collaborative approach is powerful in high-risk areas like:

ems-rescuer-icon.png

Emergency Department trauma handovers

infant.png

Neonatal code blue response

pregnancy-icon.png

Obstetric hemorrhage protocols

lungs-icon.png

ICU ventilator management during rapid case surges

By gathering different perspectives and simulating together, hospitals can build systems that reflect the realities of care delivery—not just policies on paper.

 

Start Small, Think Big—Then Reach Out To Us

Ready to expand your simulation program beyond training?

Here are a few first steps:

  • Identify a recurring safety issue—a delay, a near miss, or a breakdown in teamwork
  • Use in situ simulation (simulation in your actual care environment) to observe and understand how the issue occurs in real-time
  • Involve stakeholders from multiple departments to co-design solutions
  • Repeat the simulation after changes to test and embed improvements
  • Once you’re ready…contact us to learn how you can formalize your approach using QI principles and tools.

Key Takeaway

 

Simulation isn’t there just to create competent staff—it’s a design tool. Use it to see how your system actually works, test new solutions, and embed safer practices so that your competent staff can deliver the best care possible.

 

Ready to rethink your next QI initiative? Contact us to explore further how you can start with simulation.

How can we help you?
Consent

We will handle your personal contact details with care as outlined in Laerdal's Privacy Policy.

We will handle your personal contact details with care as outlined in Laerdal's Privacy Policy.

References

  1. Brazil, V., Purdy, E., & Bajaj, K. (2023). Simulation as an Improvement Technique. Elements of Improving Quality and Safety in Healthcare. https://doi.org/10.1017/9781009338172
  2. Jones, K. (2020, January 6). Translational simulation connects learnings to patient outcomes. Hospital News. https://hospitalnews.com/translational-simulation-connects-learnings-to-patient-outcomes/
  3. Gray, A., Chartier, L. B., Katerina Pavenski, McGowan, M., Lebovic, G., & Petrosoniak, A. (2020). The clock is ticking: using in situ simulation to improve time to blood administration for bleeding trauma patients. Canadian Journal of Emergency Medicine, 23(1), 54–62. https://doi.org/10.1007/s43678-020-00011-9
  4. New trauma bay at St. Michael’s Hospital shows the impact of simulations on hospital design. (2020, January 28). Unity Health Toronto. https://unityhealth.to/2020/01/new-trauma-bay-at-st-michaels-hospital-shows-the-impact-of-simulations-on-hospital-design/
  5. Brazil, V., & Reedy, G. (2024). Translational simulation revisited: an evolving conceptual model for the contribution of simulation to healthcare quality and safety. Advances in Simulation, 9(1). https://doi.org/10.1186/s41077-024-00291-6
  6. Sautter, M. & Egeland, B. (Hosts) (2023, January 20). Can Patient Simulation be Used for Continuous Improvement? (No. 2) [Audio podcast episode]. In One Million Lives Podcast. Laerdal Medical. https://laerdal.com/us/information/one-million-lives-podcast/