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How Hospitals Can Train Staff for Disaster Readiness and Risk Reduction

When disasters occur, healthcare providers play a critical role as part of the response team. Although hospitals have general emergency management plans in place, experts say the majority of facilities are not prepared for large-scale catastrophes.1

Laying significant groundwork is required to ensure that a hospital remains operational during and after natural and man-made disasters, pandemic outbreaks, and other mass-casualty incidents. In this article, we explore how simulation training can prepare your organization to manage a crisis. And, in training for the worst, healthcare providers can feel confident that they will reduce risk in single patient emergencies as well.

 
Risk =
Threat x Vulnerability x Consequence*

Locate Vulnerabilities In The System

During a mass-casualty event (when every hospital bed and square-foot of space is taken) is not the time to run into latent system threats. As part of a larger risk reduction program, in situ simulation (taking place in the real, clinical environment) has been proven effective at minimizing this risk.3

By practicing in the real-world care environment, team members are better able to spot process issues, flaws in room arrangement and storage, and other factors slowing a team’s response time. And, these issues can be resolved prior to a real patient entering the room.

In addition to identifying vulnerable areas of care, training through in situ simulation can also lead to:4
  • Increased confidence
  • Better knowledge acquisition
  • A higher rate of skill application at the bedside among learners.

Provide Advanced Team Training

Chaos in the middle of an emergency can be off-set by command and coordination. Designated leaders, defined roles and responsibilities, and proper communication help teams stay focused and take meaningful action toward the same goal.

Simulation affords the opportunity for healthcare providers to develop these skills together, rather than in the silos of their own discipline. Bringing together an unfamiliar team can provide practice in:
  • Handing off patients
  • Navigating a crowded room or hallway
  • Giving report to one another
  • Requesting and administering medication
  • Closed-loop communication skills
  • Donning personal protection gear and clothing

Multi-disciplinary simulation training can effectively transfer to the bedside, even in emergencies when new team members are added and patients begin to outnumber healthcare providers.5

It’s also worth considering the psychological impact that a disaster can have on the care team, patients, and their families. Stress, emotion, and shock can all affect the overall care given to a patient. As a precaution, hospitals can work toward reducing errors in patient care by reinforcing the usefulness of the two-challenge rule and CUS (concerned, uncomfortable, safety) warnings.

In high-stress situations, it is critical that healthcare providers feel empowered to assert their concerns with one another.

Prepare For Uncommon Patient Emergencies

Single patient emergencies can sometimes feel like small-scale disasters. Increased adrenaline levels, less familiar procedures and protocols, and a higher probability of making errors all contribute to this feeling. Fortunately, simulating massive incidents can provide a framework for safely treating patients every day.

The level-headed situational awareness, effective communication and quick decision-making skills used in a disaster have been proven to reduce common medical errors.6 Specifically, research shows that simulation practice for physicians, nurses, and pharmacists led to:7

  • Lower rates of drug administration and preparation errors
  • Better compliance with checklists
  • Improved detection of medication errors
Learning by simulation is an additional support in educational programs for healthcare professionals involved in risk management.8

By strengthening the competencies required to respond to large-scale disasters, healthcare providers may feel better prepared for low-frequency, high-acuity patient cases too.

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References

  1. Muchmore, S. (2017). What does it mean for a hospital to be ready for disaster? Healthcare Dive. Retrieved from https://www.healthcaredive.com/news/what-does-it-mean-for-a-hospital-to-be-ready-for-disaster/505573/
  2. Toner, E. (2017). Healthcare preparedness: Saving lives. Health Security, 15(1), 8-11. DOI: 10.1089/hs.2016.0090
  3. Patterson, M.D., Geis, G.L., Falcone, R.A., LeMaster, T., & Wears, R.L. (2013). In situ simulation: detection of safety threats and teamwork training in a high-risk emergency department. BMJ Quality & Safety, 22, p. 468-477. DOI: 10.1136/bmjqs-2012-000942
  4. McGaghie, W. C., Issenberg, S. B., Petrusa, E. R., & Scalese, R. J. (2010). A critical review of simulation-based medical education research: 2003–2009. Medical education, 44(1), 50-63.
  5. Teamwork and Communication Working Group. (2011). Improving patient safety with effective teamwork and communication: Literature review needs assessment, evaluation of training tools and expert consultations. Edmonton (AB): Canadian Patient Safety Institute.
  6. Loprieato, J.O. (2018). How does healthcare simulation affect patient care? Agency for Healthcare Research and Quality. Retrieved from https://psnet.ahrq.gov/perspectives/perspective/255/How-Does-Health-Care-Simulation-Affect-Patient-Care
  7. Ibid
  8. Ibid

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