|Clinical target group/location||Overall objective(s)||Simulation and/or technology-enhanced modality||Impacts|
|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)||Sample objective: to optimize the escalation protocol for transporting a COVID-19 positive patient from the ED to the ICU|
|Intensive care unit (ICU)||Sample objective: to modify standard operating procedures to ensure they account for unique issues presented by COVID-19, including PPE use, novel specific COVID-19 equipment bundles, and “protected” procedures|
|Operating room (ORs)||Sample objective: to translate the pre-existing PPE protocols developed by the IPAC team for non-OR areas to meet the needs of all perioperative staff, while maintaining IPAC established standards|
|Labor and delivery (L&D) OR||Sample objective: to test and iteratively refine the policies associated with L&D team care for a laboring mom with a positive COVID-19 diagnosis|
|Inpatient medical units||Sample objective: to implement protected code blue protocols established in the ICU on the acute care inpatient medical units, to determine how best to refine protocols in those settings|
|Hospital morgue||Sample objective: to test and modify the protocols for transferring deceased COVID-19 positive patients from units to morgue and from morgue to funeral homes to inform the organization’s new expedited death response policy|
|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.