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Table 1 Needs assessment—neurology clinic example

From: Building impactful systems-focused simulations: integrating change and project management frameworks into the pre-work phase

Step 1: Planning group identifies changes (objectives) in each category

Step 2: Rank according to impact/risk

Step 3: Build scenarios incorporating identified changes (objectives)

Example:

Example:

Example:

New neurology clinic

Impact: frequent event =high impact, intermittent frequency= medium impact, rare event= low impact

Scenario A: Routine patient visit for seizures. Patient sees neurologist, gets EEG, has seizure, requires emergency response and transfer

Risk: If fails, risk for significant patient harm= high risk. If fails, possibility of minor patient harm/delays in care that is likely to be detected = medium risk. If fails, unlikely to result in harm/delays and likely to be caught= low risk.

Scenario B: Routine visit for chronic headaches.

Objectives

Impact, risk

Scenario

People (roles/responsibilities):

 New medical assistant role

High impact, low risk

A +B

 Adjacent clinic nursing staff will respond to emergencies in neurology clinic

Low impact, high risk

A

Processes:

 New process for rooming patients

High impact, low risk

A + B

 New process for communicating EEG reviews

High impact, medium risk

A

 New response team/process for emergency response

Low impact, high risk

A

Tools/technology:

 New phones

High impact, medium risk

A + B

 New alarm system

Low impact, high risk

A

Environment:

 New waiting area to be shared with other clinics

High impact, low risk

A + B

 New emergency equipment layout

High impact, high risk

A

 New EEG room, distant from clinic/team

Medium impact, high risk

A

 New transport route to emergency department

Low impact, high risk

A