Abstract
The current estimate of preventable harm is 440,000 lives harmed per year (James J Patient Saf 9:122–8, 2013). One can’t help but wonder why despite the multiple strategies devised for preventing adverse events, healthcare has not succeeded at achieving a sustainable patient safety platform that reduces adverse events. In fact by one estimate, healthcare is the third leading cause of death in the United States (US) (Makary et al. BMJ 353:i2139, 2016). It is in this landscape that a new immersive learning tool—namely simulation—is making an impact on improving the quality and safety of healthcare delivery. Simulation is an educational technique that replaces or amplifies real experiences with guided experiences in order to create a situation or environment to allow persons to experience a representation of a real event for the purpose of practice, learning, evaluation, testing, or to gain understanding of systems or human actions (Healthcare Simulation Dictionary. 1st ed. 2016. p. 33. www.ssih.org/dictionary). Simulation has been used by system engineers and human factor experts in industries outside of healthcare to better understand and improve service delivery by individuals, teams, and systems (Deutsch et al. Hum Factors 58:1082–95, 2016). This immersive learning strategy has particular relevance in high-stake industries, such as healthcare, which is challenged by a constant influx of trainees, high rates of staff turnover, and the need for continuing medical education to maintain skills (IOM. Redesigning continuing education in the health professions. Washington, D.C.: The National Academies Press; 2010). Simulation offers healthcare a strategy to improve the quality and safety of patient care.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
James JT. A new, evidence-based estimate of patient harms associated with hospital care. J Patient Saf. 2013;9(3):122–8.
Makary MA, et al. Medical error—the third leading cause of death in the US. BMJ. 2016;353:i2139.
Healthcare Simulation Dictionary. 1st ed. 2016. p. 33. www.ssih.org/dictionary.
Deutsch ES, et al. Leveraging health care simulation technology for human factors research: closing the gap between lab and bedside. Hum Factors. 2016;58(7):1082–95.
IOM. Redesigning continuing education in the health professions. Washington, D.C.: The National Academies Press; 2010.
Said by Paul Batalden, quoted in article by Kimberly Mitchell, Like Magic? (Every system is perfectly designed…”), Friday August 21, 2015. www.Ihi.org.
Makary MA, Daniel M. Medical error-the third leading cause of death in the US. BMJ. 2016;353:i2139.
Institute of Medicine (IOM). In: Kohn LT, Corrigan JM, Donaldson MS, editors. To Err is Human: building a safer health system. Washington, D.C: National Academy Press; 2000.
Crosby PB. Quality is free. New York: McGraw-Hill; 1979.
Duffy GL. The ASQ quality improvement pocket guide: basic history, concepts, tools, and relationships. Milwaukee, Wisconsin: ASQ Quality Press; 2013. p. 62–5.
Chang TP, Gerard J, Pusic MV. Screen-based simulation, virtual reality, and haptic simulators. In: Comprehensive healthcare simulation: pediatrics. Cham: Springer; 2016. p. 105–114.
Schwid H, Rooke G, Alec MD, et al. Use of a computerized advanced cardiac life support simulator improves retention of advanced cardiac life support guidelines better than a textbook review. Crit Care Med. 1999;27(4):821–4.
Tan GM, Ti LK, Tan K, Lee T. A comparison of screen-based simulation and conventional lectures for undergraduate teaching of crisis management. Anaesth Intensive Care. 2008;36(4):565–9.
Schwid HA, Rooke GA, Michalowski P, et al. Screen-based anesthesia simulation with debriefing improves performance in a mannequin-based anesthesia simulator. J Teach Learn Med. 2001;13(2):92–6.
Schwid HA, Rooke GA, Ross BK, Sivarajan M. Use of computerized advanced cardiac life support simulator improves retention of advanced cardiac life support guidelines better than a textbook review. Crit Care Med 1999;27:821–824.
McClusky DA, Gallagher AG, Ritter EM, et al. Virtual reality training improves junior residents’ operating room performance: results of a prospective, randomized, double-blinded study of the complete laparoscopic cholecystectomy. J Am Coll Surg. 2004;199:73–8.
Aggarwal R, Grantcharov T, Moorthy K, et al. A competency-based virtual reality training curriculum for the acquisition of laparoscopic psychomotor skill. Am J Surg. 2006;191(1):128–33.
Neis F, Brucker S, Henes M, et al. Evaluation of the HystSim™-virtual reality trainer: an essential additional tool to train hysteroscopic skills outside the operation theater. Surg Endosc. 2016;30(11):4954–61. Epub 2016 Mar 9
Mohtashami F, Dadelszen P, Allaire C, et al. A surgical virtual reality simulator distinguishes between expert gynecologic laparoscopic surgeons and perinatologists. JSLS. 2011;15(3):365–72.
Cohen AR, Lohani S, Manjila S, Natsupakpong S, et al. Virtual reality simulation: basic concepts and use in endoscopic neurosurgery training. Childs Nerv Syst. 2013;29(8):1235–44.
Haycock A, Koch A, Familiari P, et al. Training and transfer of colonoscopy skills: a multinational, randomized, blinded, controlled trial of simulator versus bedside training. Gastrointest Endosc. 2010;71(2):298–307.
Olasky J, Sankaranarayanan G, Seymour N, et al. Identifying opportunities for virtual reality simulation in surgical education: a review of the proceedings from the Innovation, Design, and Emerging Alliances in Surgery (IDEAS) conference: VR surgery. Surg Innov. 2015;22(5):514–21.
Weigl M, Stefan P, Abhari K. Intra-operative disruptions, surgeon’s mental workload, and technical performance in a full-scale simulated procedure. Surg Endosc. 2016;30(2):559–66.
Zigmont JJ, Wade A, Edwards T, Hayes K, Mitchell J, Oocumma N. Utilization of experiential learning, the learning outcomes model reduces RN orientation time by more than 35%. Clin Simul Nurs. 2015;11:79–94.
Dearmon V, Graves RJ, Hayden S, et al. Effectiveness of simulation-based orientation of baccalaureate nursing students preparing for their first clinical experience. J Nurs Educ. 2013;52(1):29–38.
Malekzadeh S, Malloy KM, Chu EE, et al. ORL emergencies boot camp: using simulation to onboard residents. Laryngoscope. 2011;121(10):2114–21.
Will KK, Stepanek J, Brewer KK, et al. Interprofessional orientation for health professionals utilizing simulated learning: findings from a pilot study. J Interprof Care. 2016;30(2):254–6.
Fey MK, Miltner RS. A competency-based orientation program for new graduate nurses. J Nurs Adm. 2000;30(3):126–32.
John Ovretveit. Achieving “value improvements” changes which improve quality and save money. The International Society for Quality in Health Care (ISQua). http://www.isqua.org/docs/geneva-2012-docs/john-ovretveit.pdf?sfvrsn=0.
Pian-Smith MC, Simon R, Minehart RD, et al. Teaching residents the two-challenge rule: a simulation-based approach to improve education and patient safety. Simul Healthc. 2009;4(2):84–91.
Raemer DB, Kolbe M, Minehart RD, Rudolph JW, Pian-Smith MC. Improving anesthesiologists’ ability to speak up in the operating room: a randomized controlled experiment of a simulation-based intervention and a qualitative analysis of hurdles and enablers. Acad Med. 2016;91(4):530–9.
Beattie BE, Kinney J, Fitzgerald M, et al. Dental and dental hygiene students’ perceptions of a standardized patient instructor conflict resolution program. J Dent Educ. 2014;78(10):1397–404.
Foley KM, Gelband H. Improving palliative care for cancer: summary and recommendations. Washington, D.C.: Institute of Medicine and National Academy Press; 2001.
Back A, Arnold R, Baile W, et al. Efficacy of communication skills training for giving bad news and discussing transitions to palliative care. Arch Intern Med. 2007;167:453–60.
Karkowsky CE, Landsberger EJ, Bernstein PS, et al. Breaking bad news in obstetrics: a randomized trial of simulation followed by debriefing or lecture. J Matern Fetal Neonatal Med. 2016;29(22):3717–23.
Lamba S, Tyrie LS, Bryczkowski S, Nagurka R. Teaching surgery residents the skills to communicate difficult news to patient and family members: a literature review. J Palliat Med. 2016;19(1):101–7.
Jewll K, McGiffert L. “To err is human—to delay is deadly” consumers union. 2009. Available at: http://www.safepatientproject.org/pdf/safepatientproject.org-to_delay_is_deadly-2009_05.pdf.
Weaver SJ, Salas E, Lyons R, et al. Simulation-based team training at the sharp end: a qualitative study of simulation-based team training design, implementation, and evaluation in healthcare. J Emerg Trauma Shock. 2010;3:369–77.
Riley W, Begun JW, Meredith L, et al. Integrated approach to reduce perinatal adverse events: standardized processes, interdisciplinary teamwork training, and performance feedback. Health Serv Res. 2016;51:2431.
Herbers MD, Heaser JA. Implementing an in situ mock code quality improvement program. Am J Crit Care. 2016;25(5):393–9.
Steinemann S, Berg B, Skinner A, et al. In situ, multidisciplinary, simulation-based teamwork training improves early trauma care. J Surg Educ. 2011;68(6):472–7.
Yager P, Collins C, Blais C, et al. Quality improvement utilizing in-situ simulation for a dual-hospital pediatric code response team. Int J Pediatr Otorhinolaryngol. 2016;88:42–6. Epub 2016 Jun 7
Ragazzoni L, Ingrassia PL, Echeverri L, et al. Virtual reality simulation training for Ebola deployment. Disaster Med Public Health Prep. 2015;9(5):543Y6.
Rosen MA, Hunt EA, Pronovost PJ, et al. In situ simulation in continuing education for the health care professions: a systematic review. J Contin Educ Health Prof. 2012;32:243–54.
Patterson MD, Geis GL, Falcone RA, LeMaster T. In situ simulation: detection of safety threats and teamwork training in a high risk emergency department. BMJ Qual Saf. 2013;22(6):468–77. https://doi.org/10.1136/bmjqs-2012-000942.
Wheeler DS, Geis G, Mack EH, LeMaster T, Patterson MD. High-reliability emergency response teams in the hospital: improving quality and safety using in situ simulation training. BMJ Qual Saf. 2013;22(6):507–14. https://doi.org/10.1136/bmjqs-2012-000931. Epub 2013 Mar 1.
Wetzel EA, Lang TR, Pendergrass TL, Taylor RG, Geis GL. Identification of latent safety threats using high-fidelity simulation-based training with multidisciplinary neonatology teams. Jt Comm J Qual Patient Saf. 2013;39(6):268–73.
McEvoy MD, Field LC, Moore HE, et al. The effect of adherence to ACLS protocols on survival of event in the setting of in-hospital cardiac arrest. Resuscitation. 2014;85(1):82–7.
Paul R, Neuman MI, Monuteaux MC, Melendez E. Adherence to PALS sepsis guidelines and hospital length of stay. Pediatrics. 2012;130:e273–80.
Smith KK, Gilcreast D, Pierce K. Evaluation of staff’s retention of ACLS and BLS skills. Resuscitation. 2008;78(1):59–65. [PubMed: 18406037]
Chan PS, Nichol G, Krumholz HM, Spertus JA, Nallamothu BK. American Heart Association National Registry of cardiopulmonary resuscitation I. hospital variation in time to defibrillation after in-hospital cardiac arrest. Arch Intern Med. 2009;169(14):1265–73. [PubMed: 19636027]
Kessler DO, Walsh B, Whitfill T, et al. Disparities in adherence to pediatric sepsis guidelines across a spectrum of emergency departments: a multicenter, cross-sectional observational in situ simulation study. Emerg Med. 2016;50(3):403–15.e1-3.
Kerner RL Jr, Gallo K, Cassara M, et al. Simulation for operational readiness in a new freestanding emergency department: strategy and tactics. Simul Healthc. 2016;11(5):345–56.
DeRosier J, Stalhandske E, Bagian JP, et al. Using health care failure mode and effect analysis: the VA national center for patient safety’s prospective risk analysis system. Jt Comm J Qual Improv. 2002;28:248–67.
Davis S, Riley W, Gurses AP, Miller K, Hansen H. Failure modes and effects analysis based on in situ simulations: a methodology to improve understanding of risks and failures. In: Henriksen K, Battles JB, Keyes MA, Grady ML, editors. Source advances in patient safety: new directions and alternative approaches, Performance and tools, vol. 3. Rockville: Agency for Healthcare Research and Quality; 2008.
Viswanathan HN, Salmon JW. Accrediting organizations and quality improvement. Am J Manag Care. 2000;6(10):1117–30.
Alkhenizan A, Shaw C. Impact of accreditation on the quality of healthcare services: a systematic review of the literature. Ann Saudi Med. 2011;31(4):407–16.
Regular standards and checklist for accreditation of ambulatory surgery facilities. In: American Association for Accreditation of ambulatory surgery facilities I, ed. Version 144, Gurnee; 2016.
Miller GE. The assessment of clinical skills/competence/performance. Acad Med. 1990;65(Suppl):S63–7.
Scalese RJ, Obeso VT, Barry Issenberg S. Simulation technology for skills training and competency assessment in medical education. J Gen Intern Med. 2008;23(Suppl 1):46–9. PMC. Web. 11 Nov. 2016
https://www.acgme.org/Portals/0/MilestonesGuidebook.pdf?ver=2016-05-31-113245-103.
McSparron JI, et al. Simulation for skills-based education in pulmonary and critical care medicine. Ann Am Thorac Soc. 2015;12(4):579–86.
Devitt JH, et al. The validity of performance assessments using simulation. Anesthesiology. 2001;95(1):36–42.
Sidi A, et al. Simulation-based assessment to evaluate cognitive performance in an anesthesiology residency program. J Grad Med Educ. 2014;6(1):85–92.
Michelson J, et al. Competency assessment in simulation-based procedural education. Am J Surg. 2008;196(4):609–15.
Adrales GL, et al. A valid method of laparoscopic simulation training and competence assessment. J Surg Res. 2003;114(2):156–62.
Fried GM. FLS assessment of competency using simulated laparoscopic tasks. J Gastrointest Surg. 2008;12:210–2.
Ma IW, et al. Use of simulation-based education to improve outcomes of central venous cathetrization: a systematic review and meta-analysis. Acad Med. 2011;86(9):1137–47.
Hafford ML, Van Sickle KR, Willis RE, et al. Ensuring competency: are fundamentals of laparoscopic surgery training and certification necessary for practicing surgeons and operating room personnel? Surg Endosc. 2013;27:118.
Smith R, et al. Fundamentals of robotic surgery: a course of basic robotic surgery skills based upon a 14-society consensus template of outcome measures and curriculum development. Int J Med Robotics Comput Assist Surg. 2014;10:379–284.
Royal College of Physicians and Surgeons of Canada Format of the comprehensive objective examination in internal medicine. http://www.royalcollege.ca/cs/groups/public/documents/document/y2vk/mday/~edisp/tztest3rcpsced002085.pdf.
American Board of Anesthesiology. Applied examination objective structure clinical examination content outline. http://www.theaba.org/PDFs/APPLIED-Exam/APPLIED-OSCE-ContentOutline.
Ross BK, Metzner J. Simulation for maintenance of certification. Surg Clin N Am. 2015;95(4):893–905.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Guttman, O.T., Goff, K.L., Watkins, S.C. (2020). Role of Simulation in Healthcare Quality Assurance. In: Mahoney, B., Minehart, R., Pian-Smith, M. (eds) Comprehensive Healthcare Simulation: Anesthesiology . Comprehensive Healthcare Simulation. Springer, Cham. https://doi.org/10.1007/978-3-030-26849-7_7
Download citation
DOI: https://doi.org/10.1007/978-3-030-26849-7_7
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-26848-0
Online ISBN: 978-3-030-26849-7
eBook Packages: MedicineMedicine (R0)