6115 Embedding in-situ simulation and identifying latent safety threats in a busy paediatric emergency department

Objectives In-situ simulation (ISS) is widely recognised to improve team working and to identify patient safety threats.1 2 Anecdotally, the greatest barrier to overcome in delivery of ISS is workload and availability of facilitators. Our aim was to establish ISS within the everyday work environment as an opportunistic learning session. Methods A group of 10 facilitators were recruited to the scheme. Each were given a briefing document outlining the scope of ISS sessions e.g. half an hour sessions with nursing and medical colleagues. 2 facilitators itemised equipment that was already available in the department. All facilitators had access to a bank of scenarios and were briefed to prompt learners to complete a post-session questionnaire. ISS sessions were opportunistically delivered when workload allowed by 2 or more facilitators, and roughly occurred on a fortnightly basis. Learning outcomes were disseminated to the department via email after the session and facilitators held responsibility to address safety threats. Results Over a period of 6 months, we have successfully delivered 11 sessions with different clinical themes to 44 staff members (doctors, nurses, physician associates, nursing associates, trainee Nurse Practitioners). On average, the confidence in dealing with the clinical scenarios increased from 1.8 out of 5 (whereby 1 denotes not being confident at al and 5 represents being very confident) to 4.2. Learners can suggest further topics to cover and these are used to plan the next ISS sessions. Through these ISS sessions, we have distributed 5 learning bulletins, as well as exposed latent safety threats which have been raised and acted on within the department. Conclusion We have demonstrated that ISS can be embedded into the daily workplace of a busy paediatric emergency department. To successfully deliver ISS, a group of motivated and skilled facilitators can easily deliver frequent short sessions when the correct tools are easily available to them. Our ISS sessions demonstrate that, despite how stretched staff in emergency departments may be, they appreciate opportunities to learn and can help identify safety issues. This in turn will improve quality of care and hopefully patient satisfaction. Moving forward, we hope to continue delivering ISS sessions especially to test any new safety initiatives that have been implemented from this project. References Patterson MD, Geis GL, Falcone RA, LeMaster T, Wears RL. In situ simulation: detection of safety threats and teamwork training in a high risk emergency department. BMJ Quality 22(6):468–77. Petrosoniak A, Auerbach M, Wong AH, Hicks CM. In situ simulation in emergency medicine: moving beyond the simulation lab. Emergency Medicine Australasia. 2017 Feb;29(1):83–8.