Integration of In Situ Simulation Into an Emergency Department Code Orange Exercise in a Tertiary Care Trauma Referral Center.

Harrison Carmichael, George Mastoras, Caroline Nolan, Hung Tan, Jeffrey Tochkin, Cari Poulin, Andrew Willmore, Glenn Posner
Author Information
  1. Harrison Carmichael: Department of Emergency Medicine University of Ottawa Ottawa Ontario Canada. ORCID
  2. George Mastoras: Department of Emergency Medicine University of Ottawa Ottawa Ontario Canada.
  3. Caroline Nolan: the Department of Emergency Management The Ottawa Hospital Ottawa Ontario Canada.
  4. Hung Tan: the Department of Emergency Management The Ottawa Hospital Ottawa Ontario Canada.
  5. Jeffrey Tochkin: the Department of Emergency Management The Ottawa Hospital Ottawa Ontario Canada.
  6. Cari Poulin: Department of Emergency Medicine University of Ottawa Ottawa Ontario Canada.
  7. Andrew Willmore: Department of Emergency Medicine University of Ottawa Ottawa Ontario Canada.
  8. Glenn Posner: and the Department of Obstetrics & Gynecology Department of Innovation in Medical Education University of Ottawa Ottawa Ontario Canada.

Abstract

OBJECTIVES: Disaster-preparedness and response are a commonly overlooked aspect of hospital policy and can frequently be outdated and undertested. Simulation-based education has become a core education modality within Canadian medical training programs. We hypothesized that integrating in situ simulation (ISS) into a hospital-wide, mass-casualty response exercise would enhance realism and our ability to identify latent safety threats (LSTs).
METHODS: Using ISS we created a simulated mass shooting scenario with 20 patients, played by actors in full moulage, presenting to a large tertiary care hospital over a 50-minute period.
RESULTS: Integrating ISS into our exercise created a realistic experience for the participants involved and improved participant education, while imparting enough systemic stress to expose LSTs associated within patient care and hospital policy.
CONCLUSION: Overall, ISS was successfully used and enhanced a large-scale test of our hospital's mass-casualty response plan.

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Word Cloud

Created with Highcharts 10.0.0ISSresponsehospitaleducationpolicywithinmass-casualtyexerciseLSTscreatedcareOBJECTIVES:Disaster-preparednesscommonlyoverlookedaspectcanfrequentlyoutdatedundertestedSimulation-basedbecomecoremodalityCanadianmedicaltrainingprogramshypothesizedintegratingsitusimulationhospital-wideenhancerealismabilityidentifylatentsafetythreatsMETHODS:Usingsimulatedmassshootingscenario20patientsplayedactorsfullmoulagepresentinglargetertiary50-minuteperiodRESULTS:IntegratingrealisticexperienceparticipantsinvolvedimprovedparticipantimpartingenoughsystemicstressexposeassociatedpatientCONCLUSION:Overallsuccessfullyusedenhancedlarge-scaletesthospital'splanIntegrationSituSimulationEmergencyDepartmentCodeOrangeExerciseTertiaryCareTraumaReferralCenter

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