Documentation framework for healthcare simulation quality improvement activities

Medical simulation methodology is increasingly being utilised beyond the traditions of education to evaluate patient care workflows, processes, and systems within the health context. A literature review of healthcare facility testing showed that individual clinical departments and singular patient flow processes had been tested under a variety of simulated conditions, such as virtual environments, table top exercises, and live simulation exercises. Each method demonstrated strengths and weaknesses in finding active or latent system failures [ 1 , 2 , 3 , 4 ]. With the building of our new healthcare facility, it was decided that live (physical) testing of the environment using a medical simulation methodology was the best approach to bridge the gap from architectural plans, to real-world efficient and effective patient care, and for orientation and training of teams to their new environment [ 4 , 5 , 6 , 7 ]. Although the hospital had yet to open, testing the systems under immersive simulated conditions at the point of care delivery effectively replicated real-world workflows and systems [ 1 , 6 ]. Within Australia, two new hospitals reported using medical simulation to test specific clinical scenarios and patient flow journeys prior to service delivery. Unfortunately in both instances, testing beyond the first round did not occur due to funding and human resource limitations. This led to considerable staff workarounds, rectification of process errors after commencement of patient care, and unfavourable media reports [ 8 , 9 ].