Implementation strategies for high-performance health care simulation centres: A multicentre exploratory case study in China

Introduction: The number of health care simulation centres (HSCs) in mainland China has increased exponentially recently. However, the performance of these centres varies significantly between hospitals. The aim of this study is to address two research questions: (i) what are the critical factors for implementing high-performance HSCs and (ii) how are these critical factors used in the development of implementation strategies to achieve satisfactory performance? Methods: Following a literature review on information technology (IT) implementation, we identified a framework comprising four key dimensions for HSCs implementation: technology, organisation, environment and individuals. This TOEI (technology-organisation-environment-individual) framework was then used as a basis for a multicentre case study through which data collection and analysis proceeded. We collected 12 one-to-one in-depth interviews alongside secondary data from six high-performance HSCs in mainland China. Results: Our study identifies critical TOEI factors that collectively influence HSC implementation performance and major activities at the six high-performance HSCs. Three strategies for implementing high-performance HSCs are also identified: facility management platform, education and training centre and innovation centre. Conclusions: HSC implementation is an holistic approach. The critical TOEI factors collectively build a foundation for centre activities. An HSC's implementation strategy highly relies on organisational strategic goals. Additionally, HSCs in mainland China face some common challenges such as faculty retention and future opportunities such as expanding the research scope. Our study also provides insights for hospital leadership, medical associations and policymakers.