As Realistic As Possible

Knowing they could be thrust into an emergency at any time is why healthcare professionals often prepare with action plans addressing potential situations. But what can these professionals do when an unprecedented event like the COVID-19 pandemic uncovers gaps in an organization’s plans and processes that were once standards for preparedness?

If there’s one thing the current pandemic has shown us, it’s the importance of relying on the healthcare community for support, and reaching out to other organizations to share knowledge and collaborate – all with the goal of tackling new challenges together and providing better care to patients.

In early September, a team specializing in emergency preparedness from Scarborough Health Network (SHN) did just that, by using tabletop exercises to train staff from two of the community’s long-term care (LTC) homes.

Tabletop exercises allow for organizations to gather a variety of stakeholders to simulate scenarios, apply current procedures, and identify areas of improvement in existing or soon to be implemented plans or processes.

Simulating Reality

During the tabletop exercise, the SHN team challenged LTC participants by creating scenarios like extending resident capacity to increase the number of residents exposed, incorporating a facility outage, and putting a significant strain on access to personal protective equipment (PPE).

“Our goal was to make the simulations as realistic as possible,” says Elyse Hosein, Emergency Preparedness Lead at SHN. “These restrictions made participants think about other ways to access resources, like reaching out to external organizations, or finding alternate locations to support operations within the community.”

“With simulations, we’re not testing people, we’re testing processes developed in a safe environment,” added Renee Blomme, Director of Privacy and Risk Management at SHN. “In a tabletop exercise, you want to simulate what might happen, identify opportunities for improvement and then make necessary changes to provide better care.”

While engaged in the simulations, both the team from SHN and LTC staff learned a great deal about one another like how the other operates when responding to emergencies. During the first wave, it was clear the LTC staff excelled at being quick to isolate symptomatic patients or staff members, perform contact tracing, and communicating with staff and residents.

“As a clinician, I was truly impressed by seeing how long-term care staff pulled together to make sure they were sharing information,” added Blomme.

Hands-on Learning and the Value of a Space

However, the tabletop exercises did offer a number of vital lessons to be learned, including the importance of providing an environment that fosters a sense of psychological safety for all staff.

Simulations are not only an excellent way of testing an organization’s plans and processes, they also provide a safe space for healthcare providers to train and practice. This space affords participants the ability to share their thoughts, make mistakes, think critically and provide multiple perspectives on a scenario.

Participants come away from tabletop exercises with a better understanding of their roles and responsibilities, equipped with the knowledge that they are not alone in handling difficult situations.

“The tabletop exercises gave LTC staff the confidence that they have both the tools and necessary experience to manage a second wave,” says Hosein. “They have the right plans and processes in place, and a great relationship with Scarborough Health Network for support.”

Creating Your Tabletop Exercise

According to the SHN team, a key component to the success of these tabletop exercises was the positive leadership and collaborative spirit provided by SHN’s Elizabeth Buller, President and CEO, and Dr. Albert Lauwers, Executive Vice President of Medical and Clinical Programs. Their vision for collaborative training and support programs in LTC homes helped develop close relationships with staff across sites.

“All the work done in the LTC homes was collaborative,” says Blomme. “The staff saw we were there to support them, and it was great to establish a relationship and maintain it afterwards.”

When asked what the first few steps are in organizing and preparing a tabletop simulation exercise, Blomme and Hosein suggest the following:

• Keep in mind that drafting a simulation exercise is a lot of work. Make sure you take the time to craft something that will provide value for all participants and be as detailed as possible.
• Prepare your participants with the necessary background information and set the expectations ahead of time, so they know it’s interactive.
• Reach out to fellow Risk / Safety Managers because there’s so much knowledge out there. Pick up the phone or email a colleague and find out if they’ve done a similar exercise – dig deeper to find out what worked and what didn’t. It’ll ensure your exercise holds the interest of participants.
• Share your successes. We’re fortunate to have a great relationship with our partners at HIROC and so when we shared our success, they knew other HIROC Subscribers would definitely find it valuable. It’s all about sharing knowledge and scaling those learnings right across the healthcare system!

“We always want to collaborate and support our colleagues,” says Blomme. “We’re all about sharing – there’s no sense in reinventing the wheel.”

Watch a recording of our interview with Elyse Hosein on Talk with HIROC

By Marc Aiello, Communications and Marketing Coordinator, HIROC