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Patient Safety, Simulation and Human Factors …Part II …the applications of simulation

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Out of all my blogs the one that seems to have stimulated most interest was the one I wrote on how simulation should be seen as part of patient safety activity ( click here for that blog )  rather than the typical thought that it is just a form of training and often just resuscitation training at that. Spurred on following some Twitter (@NWSEN) and face to face interactions I wanted to write a blog which built on this work and in particularly looking at the art of the possible and how simulation can, and in fact is, being used to support some of the emerging patient safety concepts.  Remember we are describing simulation as a spectrum of activity ( blog on this is here ) with a variety of underpinning educational theories aligned to the learning outcomes, these learning outcomes can be ones for the individual, team or organisation. Additionally simulation should be a quality assured education event that can be delivered in a variety of ways including with real people ( see
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Distraction - sorry to interrupt, but can I just show you this ECG

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Distractions  Following a slight blogging holiday (bloggiday?) I thought it would be interesting to think about distractions - recently I helped deliver a human factors session at Walsall Manor Hospital, supporting a fantastic local Human Factors initiative that had seen a real culture change within the organisation.   The session I led was around distraction and cognition and allowed me over the day to start to draw together the discussions into some type of working model on how to reduce distractions.  The problem Fundamentally, I really do think that distractions are so commonplace in healthcare they are seen as the norm - to such an extent we are blind to them  how many times will the consultant in ED running the trauma call be asked to look at a 12 lead ECG for another patient in majors listen to the melee of alarms screaming for attention in a critical care area the staff member waiting slightly impatiently to discuss another patient while a clinician perform
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Patient Safety, Simulation and Human Factors: should we all work together?

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So up until now my blogs have focussed on the individual elements of patient safety, simulation and human factors but not really brought them together into a unified piece of work - so here we are - what does Patient, Safety and Human Factors have in common and how can they collaborate to improve patient safety? This actually is very timely too, as it links to the recent Opening Doors (link)  publication from the CQC recognising that we are not reducing Never Events and signalling the need for an improved safety culture and the fact that NHSI are currently developing a Patient Safety Strategy link that aims to half avoidable harm in the NHS. What is clear is that there is some really good examples of good practice and activity going on within NHS organisations but there seems to be a lack of a way to scale up and share these. I do also think this is not just an issue for or with NHS organisations as indeed the same culture exists, and to an extent is reinforced,
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In-situ simulation: The Holy Grail or just another distraction?

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Over the last fifteen years there has been a shift from only delivering simulation sessions in a designated simulation area to more simulation being delivered in clinical areas in so called in-situ simulations. Clearly in-situ simulation offers the ability to increase simulation capacity and become more inclusive, but sometimes it is claimed to be the optimal place to deliver simulation - it may offer lots of benefits but it isn’t without some degree of risk. Benefits - the ability to simulate in the participants clinical area, with their clinical equipment and their team has clear benefits and we know that all to often staff sent for simulation in a dedicated area, will be cherry picked and will not be representative of the skill mix in the real environment. Also, as it is the real working area, it also enables detection of those ergonomic issues (or latent issues) i.e. when people coming from different areas can’t find the location, equipment isn’t available etc. Worklo
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