Simulation as a vehicle for clinical practice and service improvement within the Australian Quality & Safety Framework

Background: Education is a key element of maintaining quality and safety in health care and is encoded in the Australian Commission for Quality and Safety in Health Care standards (ACQSHC). Simulation has been identified as a learning strategy that is able to improve competency levels, teamwork and collaboration to enhance and support system redesign. This project aims to facilitate health service improvement through use of simulation as a vehicle to bridge the gap between Quality and Safety Governance, workplace learning and changes in clinical practice.

Methods: The project will be conducted using a multilevel action learning approach situated within the Quality & Safety framework. The project will map organisational capacity, processes and responses against ACQSHC standards: Standard 1 – Governance for Quality & Safety, Standard 6 - Clinical Handover and Standard 9 – Recognising and responding to clinical deterioration in adult, pediatric and obstetric patients. In particular, the process from incident to response, threshold for response and the nature of response will be examined. The process by which responses are developed to remedy issues identified in the quality and safety reporting processes will be explored to see how ISS simulation could be used in both a proactive and reactive manner to address issues. A model for use of simulation in this context will be developed, trialled and refined. Outcome measures will include evaluation of simulation activities by participants; improved capacity (knowledge, attitudes and confidence); improved clinical performance (observer rating scores, mannequin data, participant feedback); improved patient safety (workplace climate survey); impact on patient care (quality, monitoring and compliance indicator data) and redesign and sustainability (audit of documents, policy and procedural changes following implementation).

Conclusions: This project will develop a model that links quality and safety governance with clinical education strategy that uses simulation to support organisational quality and safety initiatives.