Simulation and patient safety: The use of simulation to enhance patient safety on a systems level

Summary Errors in healthcare feature in the 10 leading causes of death. The identification of the sources of such errors and the development of countermeasures whether against errors made by individuals or errors occurring due to latent conditions at system level are the key strategies in tackling this large problem. Simulation-based teaching can make meaningful contributions to this process in many ways and at many levels. At the level of the individual healthcare professional simulated clinical scenarios can raise awareness of the nature of the problem and demonstrate the relevance and need for training in a crew resource management type of course. At the level of an anaesthetic department such courses can help provide a common approach to problems in an area neglected by traditional teaching and so improve communication in this area. The use of simulation also extends to research and development. Study of the use of key resources, such as personnel or equipment, under stressful conditions in a simulated environment can help not only detect possible sources of error but can also help develop strategies to provide effective specific countermeasures.