How simulation techniques and approaches can be used to compare, contrast and improve care: an immersive simulation of a three-Michelin star restaurant and a day surgery unit.
How simulation techniques and approaches can be used to compare, contrast and improve care: an immersive simulation of a three-Michelin star restaurant and a day surgery unit.
复制标题
如何使用模拟技术和方法来比较、对比和改善护理：米其林三星级餐厅和日间手术室的沉浸式模拟。
DOI：
10.1136/bmjstel-2018-000433
复制
发表时间：
2020
影响因子：
1.1
通讯作者：
Weldon SM
中科院分区：
文献类型：
--
作者：
Weldon SM
在这篇社论中，我们展示了一段5分钟的纪录片风格的短片，探索如何使用身临其境的分布式模拟来让公众参与到护理体验中来，以便产生关于什么是护理手段的更广泛的讨论。传统上，也是更常见的是，医疗保健中的模拟一直用于培训、质量改进和评估目的。虽然这是对模拟技术的一种明显和有效的使用，但很少有人考虑如何在此基础上使用模拟。1 2此外，Knebone 3认为，目前对模拟的使用反映了实践，将其限制在临床“内部”框架内，将患者、家庭、公众甚至管理人员、专员、政策制定者和其他部门排除在其目的、设计和实施之外，尽管这些观点是临床实践的重要组成部分，可以加强当前的护理方法。目前对模拟技术和方法的利用往往集中在反映医疗实践的单一医疗要素上，而不是寻求改变它们，而且外部参与有限。然而，我们相信它的应用可以比目前的范围广泛得多。通过利用模拟的主要好处(在安全环境中重建现实医疗场景的能力)，我们一直在测试模拟对一系列目标的适用性。到目前为止，我们已经使用模拟方法进行了与以下相关的一些干预措施：直接患者护理与初级和二级护理利益攸关方接触，制定综合护理的新方法4-6；作为多学科工作人员和患者改善青少年哮喘护理的工具7；多专业人员和患者在医院环境中改善临终护理8 9；以及分享整个伦敦区产科护理服务的优势和挑战。10病人和公众的参与/参与，使公众在今后的外科手术和与伦理有关的问题上与公众接触11；作为一种工具，使公众和病人参与新的临床点诊断测试12；使公众参与冠状动脉护理程序13；使父母参与其身体不适的儿童可避免的住院治疗，并使高危青少年参与刀伤相关事件的护理途径。14.
In this editorial, we present a short 5 min documentary-style film to explore how immersive distributed simulation can be used to engage members of the public in the experience of care in order to generate a wider discussion on what care means. Traditionally, and more commonly, simulation in healthcare has been used for training, quality improvement and assessment purposes. Although this is an obvious and effective use of simulation techniques, little thought has been given to how simulation could be used beyond this. 1 2 Furthermore, Kneebone 3 argues that the current use of simulation has mirrored practice by restricting it to a clinical ‘insider’frame, excluding patients, families, the public and even managers, commissioners, policymakers and other sectors from its purpose, design and implementation, although these perspectives are an essential component of clinical practice that could enhance current approaches to care. Current utilisation of simulation techniques and approaches often focuses on single elements of healthcare that mirror healthcare practices rather than looking to transform them, and with limited external involvement. However, we believe its application can be much wider than its current scope. By capitalising on simulations' main benefits (the ability to recreate realistic healthcare scenarios in a safe environment), we have been testing simulations' applicability for a range of objectives. To date, we have used simulation approaches for a number of interventions relating to the following:Direct patient care to engage with primary and secondary care stakeholders in developing new approaches to integrated care 4–6; as a tool for multidisciplinary staff and patients to improve adolescent asthma care 7; for the improvement of end-of-life care by multiprofessionals and patients in a hospital setting 8 9; and to share the strengths and challenges of maternity care services across a borough of London. 10 Patient and public engagement/involvement to engage with members of the public in the future of surgery and ethical-related issues 11; as a tool for public and patient engagement in a new point-of-care diagnostic test 12; to engage publics in coronary care procedures 13; to engage parents in the avoidable hospital admissions of their unwell children and to engage at-risk teenagers in the care pathway of knife crimerelated incidents. 14