Patient Safety

The publication of the Institute of Medicine’s report “To Err is Human” in 1999 served as a call to arms for medical educators to address patient safety issues. Simulation has been proposed as a method that can help identify errors, uncover system and provider vulnerabilities, and promote the practice of safe behaviors. Models and mannequins have allowed a safe space for deliberate practice of procedures. Practicing low frequency, high acuity cases in the simulation lab can improve provider confidence and skills. Additionally, in situ simulation—where a standardized patient or portable mannequin is placed within the work setting and the simulation case is conducted in the typical care area-- has been utilized to train interdisciplinary teams in the environment where clinical care is actually delivered. Effective teamwork is essential for the safe practice of medicine and in situ simulation lends itself well to identify and address failures of communication within teams. While much of the existing research has shown that simulation training improves confidence, communication, and teamwork, demonstrating improved patient safety outcomes has proved elusive. More research is necessary and we hope this chapter will identify areas where further progress simulation research can be conducted to improve patient safety in the emergency department (ED).