Research Department, Stavanger University Hospital, Stavanger, Norway.
Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
BMC Health Serv Res. 2022 Apr 26;22(1):563. doi: 10.1186/s12913-022-07826-5.
The first wave of the COVID-19 pandemic caused stress in healthcare organizations worldwide. Hospitals and healthcare institutions had to reorganize their services to meet the demands of the crisis. In this case study, we focus on the role of simulation as part of the pandemic preparations in a large hospital in Norway. The aim of this study is to explore hospital leaders' and simulation facilitators' expectations of, and experiences of utilizing simulation-based activities in the preparations for the COVID-19 pandemic.
This is a qualitative case study utilizing semi-structured in-depth interviews with hospital leaders and simulation facilitators in one large hospital in Norway. The data were sorted under three predefined research topics and further analyzed by inductive, thematic analysis according to Braun and Clarke within these pre-defined topics.
Eleven members of the hospital leadership and simulation facilitators were included in the study. We identified four themes explaining why COVID-19 related simulation-based activities were initiated, and perceived consequences of the activities; 1) a multifaceted method like simulation fitted a multifaceted crisis, 2) a well-established culture for simulation in the hospital was crucial for scaling up simulation-based activities during the crisis, 3) potential risks were outweighed by the advantages of utilizing simulation-based activities, and finally 4) hospital leaders and simulation facilitators retrospectively assessed the use of simulation-based activities as appropriate to prepare for a pandemic crisis.
The hospital leadership's decision to utilize simulation-based activities in preparing for the COVID-19 crisis may be explained by many factors. First, it seems that many years of experience with systematic use of simulation-based activities within the hospital can explain the trust in simulation as a valuable tool that were easy to reach. Second, both hospital leaders and simulation facilitators saw simulation as a unique tool for the optimization of the COVID-19 response due to the wide applicability of the method. According to hospital leaders and simulation facilitators, simulation-based activities revealed critical gaps in training and competence levels, treatment protocols, patient logistics, and environmental shortcomings that were acted upon, suggesting that institutional learning took place.
COVID-19 大流行的第一波浪潮给全球医疗保健组织带来了压力。医院和医疗机构不得不重组其服务以满足危机的需求。在本案例研究中，我们专注于模拟作为挪威一家大医院大流行准备工作的一部分的作用。本研究的目的是探讨医院领导人和模拟促进者对利用基于模拟的活动进行 COVID-19 大流行准备工作的期望和经验。
这是一项定性案例研究，对挪威一家大医院的医院领导人和模拟促进者进行了半结构化深入访谈。根据 Braun 和 Clarke 在这些预先确定的主题内，根据预先确定的三个研究主题对数据进行分类，并通过归纳、主题分析进一步分析。
该研究纳入了 11 名医院领导人和模拟促进者。我们确定了四个主题，解释了为什么启动与 COVID-19 相关的基于模拟的活动，以及这些活动的预期后果；1）模拟等多方面的方法适合多方面的危机，2）医院内建立良好的模拟文化对于在危机期间扩大基于模拟的活动至关重要，3）利用基于模拟的活动的优势超过了潜在风险，最后 4）医院领导人和模拟促进者回顾性地评估了使用基于模拟的活动为大流行危机做准备是合适的。
医院领导层决定在 COVID-19 危机准备中利用基于模拟的活动，可以用许多因素来解释。首先，似乎医院多年来系统地使用基于模拟的活动的经验可以解释对模拟作为一种有价值工具的信任，这种工具很容易获得。其次，医院领导人和模拟促进者都认为模拟是优化 COVID-19 应对的独特工具，因为该方法具有广泛的适用性。根据医院领导人和模拟促进者的说法，基于模拟的活动揭示了培训和能力水平、治疗方案、患者物流和环境缺陷方面的关键差距，并采取了行动，表明机构学习发生了。
