# Interprofessional Collaboration in Building In Situ Simulations to Identify Threats to Patient Safety Before Transitioning to a New Healthcare Environment: Neonatal Intensive Care as an Example

## TL;DR

This study shows how teamwork and simulations can find and fix hidden safety risks before moving to a new neonatal ICU, improving patient safety and staff readiness.

## Contribution

The study introduces a structured approach using interprofessional collaboration and in situ simulations to identify and resolve latent safety threats before transitioning to a new healthcare environment.

## Key findings

- 108 healthcare professionals identified 89 latent safety threats across eight themes during simulations.
- 76% of the identified threats were resolved before the transition to the new NICU.
- Parental involvement improved patient-centered care and communication systems in the new environment.

## Abstract

Background and objective

While transitioning to a new healthcare environment (HCE) offers opportunities to enhance patient safety and outcomes, it can also introduce hidden risks. This study aimed to explore how interprofessional collaboration (IPC) and in situ simulations (ISS) can proactively identify and resolve these latent safety threats (LSTs) before transitioning to a new single-patient room neonatal ICU (NICU).

Methodology

We conducted a prospective, simulation-based intervention study involving healthcare professionals (HPs) and prior NICU parents. Three simulation activities were conducted to identify LSTs before the transition. The Canadian Interprofessional Competency Framework was employed to formulate realistic scenarios.

Results

A total of 108 HPs participated in six simulation sessions, identifying 89 LSTs across eight themes. The majority (76%) of these threats were resolved before the transition. Survey analysis revealed significant increases in systems readiness and staff preparedness post-simulations (p<0.001). Parental involvement significantly enhanced the focus on patient-centered care, leading to improvements in environmental design and communication systems.

Conclusions

The study demonstrates the efficacy of IPC and ISS in identifying and mitigating LSTs during HCE transitions, fostering a collaborative and safety-oriented culture. This approach prepares healthcare teams for new environments and emphasizes the value of incorporating family perspectives. Interprofessional ISS is a pivotal strategy to enhance patient safety and system readiness during transitions to new HCEs. The study also highlights the importance of IPC in conducting ISS before transitioning to a new HCE. Coordinating large-scale simulations is worth the time and cost investment necessary to identify LSTs, optimize systems readiness, and promote patient safety. We hope that the shared lessons can help future interprofessional teams in terms of plan testing and transitions to other HCEs.