We sat down with Ryan Aga, System Director of Clinical Simulation at HealthPartners, to discuss how simulation can drive meaningful improvements in healthcare quality. Watch the video or read the transcript below. 

Tell us about yourself.

“My name is Ryan Aga. I’m the system-wide director of simulation for HealthPartners. We’re a large integrated health system in the upper Midwest, based out of Minneapolis and Bloomington, and the Minneapolis-St. Paul area.” 

How can simulation help healthcare teams strengthen both patient safety and human connection during high-risk clinical events?

“I see simulation as an area where humans automatically connect. They come into a space around a scenario and the human perspective is drawn into that container of space in simulation. People are able to share their most vulnerable moments of what they did well and what they didn’t do well at all. 

It’s rare in healthcare, having been in healthcare over two decades, that teams have this opportunity to come into a space to take this time to share and to fail over and over again and to collectively work together to improve.” 

“One fundamental piece that I find that I bring to our team and our program is the call to action by the Joint Commission, that safety and quality teams need to partner with simulation. 
 
Essentially, we’ve had two passionate teams about quality and safety—but we’ve been asynchronously working in different spheres and different verticals. And now, with that call to action, is that both teams come together, we learn off of each other, and learn how to work collaboratively to make a better outcome for patients and quality and safety.” 

In your experience, how does simulation contribute to broader quality improvement across a hospital—not just individual training?

“This has been really cool and fun to work with. I think what takes the priority is the relationship with quality and safety at HealthPartners. We’ve developed an amazing relationship with our Chief Quality Officer, Cara. Cara has been able to see all of the quality entities across our hospitals, our clinics, and our dental clinics. 

I essentially went into her office and I said, ‘Cara, where do you need us now? And where do you need us in the next five years and ten years?’ So she’s been able to really identify very collectively, from the highest level of quality and safety, on where these areas of opportunity are for patient safety and quality.”

“One of the areas that she identified for us to work on was sepsis—particularly, a new initiative on Code Septic Shock. We developed a translational simulation exercise with the emergency department, clinicians, physicians, nurses, pharmacy, EPIC (the electronic medical record team), and safety and quality.  
 
We brought them all together around a shared mental model of how to improve septic shock outcomes, particularly antibiotic delivery within septic shock.  
 
We put this team through the development of the protocol. We used simulation to develop the policy and the protocol—something that we have not done traditionally in simulation.  
 
What we were able to do is use it to develop the Code Red Septic Shock protocol and policy. We identified through that simulation eight different [issues] that the clinical team said, ‘That doesn’t work, we need more enhancement, we need different equipment or supplies to carry out this protocol.’ 
 
We created it, we iterated many different times the things that needed to be fixed before it went out to care delivery. And I can mention to you, as a clinician at the bedside, if a protocol policy was developed without input of the frontline, what we would quickly do on the frontline is, we would develop a workaround. Workarounds are hazardous. They are a risk to the patient.” 

“So it’s fundamentally the relationship … developing that with quality and safety, and then really identifying, where are the pinch points that they need simulation?”

How can hospitals sustain a culture of continuous learning and improvement after launching simulation programs? 

“We are housing probably some of the richest data for healthcare organizations within simulation. So really democratizing that this is a very, very powerful specialty…that we have essentially everything from the frontline that people are saying is incorrect or needs improvement … or, things that are working very well.  
 
For a learning organization to embrace simulation … from a long game perspective, simulation is it. Simulation is the core construct of learning through academia and health systems, because we’ve got all of this rich, amazing data that should be disseminated up and down the verticals and across to save patients’ lives.”  

If hospital leaders want to improve patient safety today, how should they think differently about the role of simulation in their organization?

“I would say one of our last threads to keeping us financially sound or supported is value-based care, and that’s all based on quality and safety. Leaders have seen the successes of simulation in training. What they need to shift towards now is how simulation can not only be used in procedural training, but how it can be used for new technology integration into a health system.

We are in the immersion of an AI tsunami. How do we use simulation with an AI tool that comes into a large integrated health system? How do we use simulation? How do we interact with AI? How do we bring teams together, just like we have with legacy training and education simulation, and use simulation across all entities of the healthcare construct?

I think leaders in healthcare have been traditionally down that track that simulation is used for education and training. But when you look at value-based care, and what I just talked about is that a 25% improvement on antibiotic delivery…your patients are going to survive, you’re going to have less regulatory burden.  

So double down with simulation on quality improvement, return on investment to keep us financially supported and growing in healthcare is…it’s no longer a nice-to-have. It’s a moral, ethical must-have in healthcare organizations to keep them fundamentally running for the future.”