Can hands-on rehearsals help operating-room teams adopt new safety procedures during a pandemic?

Details

During the first surge of the COVID-19 pandemic, routine workflows were redesigned to standardize patients’ perioperative management and minimize staff exposure to the virus and transmission to staff. Just-in-time (JIT), in situ simulation training—rehearsals delivered on site when urgently needed—was adopted to implement these changes. Its value during a public health crisis had not previously been explored.

This workflow implementation evaluation delivered JIT, in situ simulation training over 3 weeks to participants from anesthesia, nursing, and surgery within a healthcare network. A postsimulation training survey using Likert scale assessments and free-text responses assessed the training’s perceived value. To assess changes in practice, the researchers measured compliance with new COVID-19 workflows for confirmed or suspected COVID-19 cases managed in the operating room between March and August 2020.

Survey responses from 110 of 428 participants (25.7%) showed significant positive shifts on the Likert scale in perceived knowledge of the new workflows, comfort with adopting them in practice, and the perceived probability that training would affect future practice (all P values < 0.001). Free-text responses expressed appreciation for the training being timely, hands-on, and interprofessional.

Compliance with the new COVID-19 workflow protocols was 95% (121 of 127 cases). This was associated with lower-than-expected healthcare worker test-positive rates (<1%) within the network during the same period.

The authors concluded that these findings support JIT, in situ simulation training as a preparedness measure for perioperative care of COVID-19 patients and demonstrate the approach’s value during public health crises.