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大风暴前的平静:在 COVID-19 大流行期间使用现场模拟评估替代护理医院的准备情况。

The Calm Before the Storm: Using In Situ Simulation to Evaluate for Preparedness of an Alternative Care Hospital During the COVID-19 Pandemic.

机构信息

Department of Emergency Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA.

Departments of Emergency Medicine and Pediatrics, Warren Alpert Medical School, Brown University, Providence, RI, USA.

出版信息

Disaster Med Public Health Prep. 2022 Oct;16(5):1780-1784. doi: 10.1017/dmp.2021.80. Epub 2021 Mar 25.

Abstract

OBJECTIVES

Coronavirus disease (COVID-19) has been identified as an acute respiratory illness leading to severe acute respiratory distress syndrome. As the disease spread, demands on health care systems increased, specifically the need to expand hospital capacity. Alternative care hospitals (ACHs) have been used to mitigate these issues; however, establishing an ACH has many challenges. The goal of this session was to perform systems testing, using a simulation-based evaluation to identify areas in need of improvement.

METHODS

Four simulation cases were designed to depict common and high acuity situations encountered in the ACH, using a high technology simulator and standardized patient. A multidisciplinary observer group was given debriefing forms listing the objectives, critical actions, and specific areas to focus their attention. These forms were compiled for data collection.

RESULTS

Logistical, operational, and patient safety issues were identified during the simulation and compiled into a simulation event report. Proposed solutions and protocol changes were made in response to the identified issues.

CONCLUSION

Simulation was successfully used for systems testing, supporting efforts to maximize patient care and provider safety in a rapidly developed ACH. The simulation event report identified operational deficiencies and safety concerns directly resulting in equipment modifications and protocol changes.

摘要

目的

冠状病毒病(COVID-19)已被确定为一种急性呼吸道疾病,可导致严重的急性呼吸窘迫综合征。随着疾病的传播,对医疗保健系统的需求增加,特别是需要扩大医院的容量。替代护理医院(ACH)已被用于缓解这些问题;然而,建立 ACH 存在许多挑战。本次会议的目的是进行系统测试,使用基于模拟的评估来确定需要改进的领域。

方法

设计了四个模拟案例,使用高科技模拟器和标准化患者来描述 ACH 中常见和高 acuity 的情况。一个多学科观察员小组收到了汇报表,列出了目标、关键行动和需要关注的具体领域。这些表格被汇编用于数据收集。

结果

在模拟过程中发现了后勤、运营和患者安全问题,并将其汇编成模拟事件报告。针对确定的问题提出了解决方案和协议变更。

结论

模拟成功用于系统测试,支持在快速发展的 ACH 中最大限度地提高患者护理和医务人员安全的努力。模拟事件报告确定了操作缺陷和安全问题,直接导致了设备修改和协议变更。

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