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Use of simulation in undergraduate nursing education is increasing. Although research results indicate it is an effective teaching–learning strategy, little is published about how to sustainably manage the infrastructure necessary to effectively run a simulation laboratory. This article describes a collaboration with industrial engineers to develop an inventory control system that minimizes the burden on available resources, accommodates fluctuations in simulation utilization, and does not require inventory management software. The new system reduced space requirements for inventory storage by 68%, time to manage inventory by 53%, and carrying costs by 38% even with increased center utilization. Taking time to design a structured approach to inventory storage and a pull system to manage inventory reordering may be extremely beneficial to simulation centers. Our improvements highlight the potential for reducing the amount of time and money dedicated to inventory-related activities and the benefit of partnering with colleagues, such as industrial engineers, whose expertise can facilitate process redesign. More importantly in an academic setting, the time and money saved allows faculty and staff to engage in value-added activities that will enhance student learning.

Patients scheduled for primary care appointments often cancel or no show. For diabetic patients, nonattendance can affect continuity of care and result in higher emergency department (ED) and hospital use. Nonattendance also impacts appointment scheduling, patient access, and clinic work load. While no show has received significant attention, little research has addressed the prevalence and impact of appointment cancellation. Data on 46,710 appointments for 7586 adult diabetic patients was used to conduct a prospective cohort study examining primary care appointment behavior. The independent variable was the status of the INDEX appointment, which was attended, cancelled, or no showed. Dependent variables included the dates of (1) the last attended appointment, (2) scheduling the NEXT appointment, (3) the next attended follow-up appointment, and (4) ED visits and hospitalizations within six months of the INDEX. Cancellation was more prevalent than no show (17.7% vs 12.2%). Of those who cancelled and scheduled a next appointment, 28.8% experienced over 30 days delay between the INDEX and NEXT appointment dates, and 59.9% delayed rescheduling until on or after the cancelled appointment date. Delay in rescheduling was associated with an 18.6% increase in days between attended appointments and a 26.0% increase in ED visits. For diabetic patients, cancellation with late rescheduling is a prevalent and unhealthy behavior. Although more work is necessary to address the health, intervention, and cost issues, this work suggests that cancellation, like no show, may be problematic for many clinics and patients.