Using cognitive aids and healthcare simulation as tools to improve patient safety

This thesis explores two innovative approaches to enhance patient safety in healthcare, through the utilisation of Cognitive Aids and healthcare simulation.
Part 1 focuses on Cognitive Aid Bundles (CABs), examining their implementation, design, and effectiveness in various clinical settings. The key findings of this part, include a slower than expected adoption of CABs in Dutch anaesthesia departments, no significant difference in effectiveness between two different CAB designs, regardless of the designs both reduce the number of missed critical steps in simulated emergencies. In addition, CABs significantly improve adherence to best practices in managing postoperative complications. A case study demonstrated CABs' value in preventing critical management step omissions during a severe anaphylactic shock.
Part 2 investigates the role of healthcare simulation's in improving patient safety through systems integration, research, assessment, and education. Notable outcomes include identification of in-situ simulation training as a method to enhance procedural sedation safety, the existence of a significant gap between demand and supply of Simulation-Based Medical Education in residency programs and unexpected results showing no significant improvement in awake Fibreoptic Intubation skills during difficult airway scenarios with regular simulator practice. The research also established consensus on crucial crisis scenarios for Simulation-Based Team Training in cardiac surgery and developed a novel video-assisted team debriefing model using Medical Data Recordings, which received high satisfaction rates.
The thesis concludes that both Cognitive Aids and healthcare simulation are valuable tools for enhancing patient safety and quality of care, with potential for further optimization and integration into clinical practice.