Enhancing departmental preparedness for COVID-19 using rapid cycle in situ simulation.

In response to COVID-19, we developed a rapid-cycle in situ simulation (ISS) programme to facilitate identification and resolution of systems-based latent safety threats. The simulation involved a possible COVID-19 case in respiratory failure, using a manikin modified to aerosolize phosphorescent secretions. 36 individuals participated in and 20 observed five ISS sessions over six weeks. Debriefing identified latent safety threats from four domains: personnel, PPE, supply/environment, and communication. These threats were addressed and resolved in later iterations. 94% of participants felt more prepared to care for a potential COVID-19 patient after the ISS.