A Simulation-Based Clinical Systems Testing at the Newly Built LMU University Hospital: Comparison Between In Situ Full-Scale Simulation and Process Simulation.

backgroundBefore opening new clinical facilities, the optimal preparation of health care personnel is essential. A simulation-based clinical systems testing (SbCST) using simulation is a valid instrument for reaching this goal. During SbCST, so-called latent safety threats (LSTs) can be identified that endanger patient safety. LSTs should be addressed before actual patient harm occurs. The aim of this study was to compare the outcomes and the categories of identified LSTs in 2 simulation types of SbCST, in situ full-scale simulation and process simulation.

methodsWe conducted SbCST at the newly built LMU University Hospital using in situ full-scale simulation and process simulation. To evaluate SbCST, we used a pre-session and post-session survey. The participants also mapped the identified LSTs into risk matrices according to their probability of occurrence and their impact on patient safety and staff strain.

resultsIn total, 120 participants were included in the analysis. Regardless of the simulation type, most participants rated the simulation as (very) good and highlighted the usefulness of SbCST before the opening of new clinical facilities. In both simulation types, the majority of the identified LSTs included equipment, followed by team aspects, room layout, and accessibility. Regarding patient safety and staff strain, fewer LSTs were rated as highly severe in full-scale simulation than in process simulation.

conclusionOur study showed that, depending on the construction progress, in situ full-scale and process simulation are both appropriate tools for identifying LSTs and preparing health care professionals to work in new clinical facilities. To support hospital administrators in prioritizing these items, the use of an existing risk management tool is valuable.