Table 1 Description of the UHT-SP led initiatives in response to major requests from organizational senior leadership

Organizational request: how can UHT-SP test new spaces and new models of care for COVID-19 patients?

All healthcare professionals screening COVID-19 patients.

To design a COVID-19 Assessment and Screening Centre with optimized physical spacing, staffing allocation, and patient flow

Iterative process using prototypes and mock-ups to guide construction of physical space, simulations with staff and standardized patients, iterative development of signage placement and design

Finalized data-informed protocols, signage, and workflows prior to the opening of the screening center

All critical care clinicians, as well as clinicians with potential to be redeployed to work in the ICU

To evaluate a proposed model of care, from primary care to team-based care, in anticipation of increased number of ICU patients and shortage of critical care trained clinicians

Videoconferencing to present the proposed model of care, multiple tabletop simulations using videoconference platform, in-person tabletop simulations for select groups, in-person in situ simulation in critical care setting

Derived themes from tabletop simulation discussions and synthesized into an executive summary about the model of care for professional practice teams and senior leadership

Identified limitations of tabletop simulation led clinician participants to ask for the model to be piloted in actual ICUs with COVID-19 positive patients

Organizational request: how can UHT-SP ensure our individuals and teams follow the safest clinical protocols and procedures?

Healthcare professionals and trainees working on various clinical units; each listed below with one example of each unit’s objectives.

To develop and refine hospital-based protocols in situ, and to feedforward information to leadership for command center decision-making

Rapid cycle in situ simulation scenarios focused on usability testing, identifying latent safety threats, and optimizing signage/visual aids; process was coupled with mock-ups and tabletop simulations

Identified and addressed gaps in new and pre-existing hospital policies and protocols

Refined and finalized all policies and checklists/visual aids to guide further training to prepare for patient surges.

Early simulation activities in the ICU sparked and cemented collaborations between UHT-SP, the IPAC team, and clinical units

Emergency department (ED)

Intensive care unit (ICU)

Operating room (ORs)

Labor and delivery (L&D) OR

Inpatient medical units

Hospital morgue

Organizational request: how can UHT-SP ensure healthcare professionals have the minimal competence (and confidence) to practice safely?

Healthcare professionals, support staff, and trainees in the ED, ICU, ORs, L&D OR, inpatient medical units, and the morgue

To translate refined COVID-19 policies and protocols into training materials

To train all healthcare professionals, repetitively where possible, to apply refined protocols to their general practices, as well as to specific procedures

In situ simulation scenarios in the early phase of protocol development; shifted to center-based simulation to run standardized scenarios for larger groups of healthcare professionals

Staff reported feeling less anxious, including an increased sense of safety and confidence following training.

Practicing professionals, who typically view simulation as an educational tool for their trainees only, attended sessions in overwhelming numbers and their anecdotes suggest more extensive participation in future simulations.

First responders at all three sites

To ensure all first responders’ basic life support (BLS) skills meet the hospital network’s standard

To expose learners to COVID-19 considerations, especially PPE use

Centralized curriculum, adapted to each site’s requirements in classroom or center-based setting; task trainers for protected BLS skills using “PPE buddy” approach

Upskilled approximately 180 participants

Staff reported refresher helped reorganize their skills, and improved confidence they could stay safe and protected in their roles.

Registered nurses (RNs) across departments

To prepare non-critical care RNs to transition to work on COVID-19 ICUs via upskilling in, for example, aerosol-generating procedural skills

Center-based simulation, including part-task trainers, role play, and theater-based scenarios; train-the-trainer approach used to scale up the training from the original cohort to other nursing staff members

Completed training with 90 RNs, with most reporting reduced anxiety, increased confidence in providing safe care

Simulation educators and trained RNs facilitators provided training for over 90 additional RN colleagues.