Using a bespoke database to manage latent safety threats identified through in situ simulation

Simulation has garnered success in healthcare through its ability to teach professionals technical and non-technical skills without exposing patients to the novice practitioner.1 In situ simulation takes this teaching technique into the workplace, using the real systems, equipment and workforce. A significant benefit of in situ simulation is the testing of healthcare systems without exposing a patient to indolent risks that have the potential to cause delays and harm. The source of these risks can be related to deficits in training, resources, environment, processes or protocols. These risks can be difficult to identify without a live test of the system.2 The harm from these latent safety threats (LSTs) can be averted if identified through in situ simulation and rectified before a patient is exposed. Research has suggest that in situ simulation is superior in eliciting these LSTs over laboratory-based simulation.3 By identifying safety threats it is possible to demonstrate a quantitative impact on patient safety. At the Royal Cornwall Hospital, a rural district general trust, we have used a custom-made database to record and manage these LSTs, making it an integral part of our simulation training. In 2017, the simulation department at Royal Cornwall Hospital designed a database to record and respond to significant LSTs that arise during in situ simulation. LSTs are identified during a scenario debrief. This is recorded on a paper form, along with details of the simulation, location and …