Simulation
Several latent risks were observed which would be amenable to
interventions using simulation. Although training is seen as a weak
intervention there is good evidence supporting improvements in team
performance and skill retention using simulation-based education in a
“low dose, high frequency” model . Whilst simulation training is
regarded as standard in many CRFs (including OxCRF) to support staff in
maintaining and developing skills for the management of emergency
situations, we identified opportunities to better design and focus the
scenarios to fit local practice, address skill gaps, focus on the most
likely clinical situations that would be faced by staff (e.g. tailored
to on-going or imminently opening studies) and for these to be offered
more frequently than is routinely recommended by the UK CRF network.
Simulation is also a useful tool to test work systems, pathways and
environments and has been used in a variety of clinical settings
including Emergency Departments , Maternity Units and for major incident
responses. The simulated transfer of a participant to the CT scanner in
this study revealed several issues including the risk of transfer of
pathogens to door surfaces and uncertainty around the exact route to be
taken. Simulated walk throughs of tasks or procedures could be extended
to reveal further potential safety threats and allow mitigations to be
put in place pre-emptively.