Simulation to Enhance Coordination: How Dénia's Doctors Improve Emergency Care

How do doctors prepare for critical situations? At Dénia Hospital, they have chosen to expose their professionals to simulation procedures to better coordinate their work in the Emergency Department. This new training programme, based on clinical simulation, aims not only to improve coordination but also to standardise the actions of all professionals in the most sensitive procedures.

The Ministry of Health points out that this methodology is "very innovative," as it recreates real medical emergency scenarios "without putting the patient at risk" and allows professionals to train in a "safe and controlled" environment.

The high-fidelity simulator can reproduce vital signs such as heart rate, oxygen saturation, or blood pressure. These variables can be modified in real-time to present different clinical situations that require an immediate response from the team.

Moreover, the sessions are conducted with the same equipment and materials used in the Emergency Department, promoting an immersive and realistic experience. They are designed with a dual approach: on one hand, a clinical scenario with specific technical objectives is presented (for example, a cardiac arrest, an anaphylactic crisis, or an acute stroke). On the other hand, non-technical objectives related to teamwork, stress management, or communication in adverse contexts are included. At the end of each practice, the group reflects on the experience, analyses the decisions made, and suggests possible improvements.

The initial sessions have focused on basic life support training, aimed at porters, auxiliary nursing care technicians (TCAEs), and administrative staff. These groups are often the first to receive a critical patient, so their specific training is essential to ensure a quick and effective response.

In addition to enhancing individual competence, the programme is generating organisational changes in the daily operation of the Emergency Department. One of the first outcomes has been the implementation of a visible board indicating, at the start of each day, the team responsible for responding to an emergency. This simple measure improves preparedness and reduces reaction time in vital emergency situations.

Another benefit of clinical simulation is the ability to identify improvement opportunities in the service's logistics. During the sessions, protocols have been reviewed, available resources in resuscitation carts checked, and key contacts for activating certain circuits, such as Stroke Code or Sepsis Code, updated. Additionally, proposals have been made to reorganise materials or improve accessibility to certain devices.