Simulation-based Healthcare Design Testing Aimed at Proactively Improving Veteran Care - VHA SimLEARN
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Simulation-based Healthcare Design Testing Aimed at Proactively Improving Veteran Care

By: LeAnn Schlamb MSN Ed.S, Associate Director | SimLEARN Assessment Collaboration and Outreach

Sherri Boisvert PhD, MSN, RN, Rural Health and Process Improvement Nurse | SimLEARN Assessment Collaboration and Outreach

Devin Harrison, Project Manager | SimLEARN Assessment Collaboration and Outreach

SimLEARN's Assessment Collaboration and Outreach (ACO) team, formerly named Simulation Outreach Network, provides process simulation to assess vulnerabilities in patient flow, workflow, and equipment. ACO evolved its name to be reflective of the exciting, innovative services it is continuing to grow and develop. In addition to System/Hospital Activation (SHA), ACO has now implemented pre-construction testing and post-construction activation, Simulation-based Healthcare Design Testing (SbHDT). The ACO portfolio has developed a partnership with the Office of Construction Facilities Management to conduct SbHDT. From October 18-21, 2021, SbHDT took place at the focused Community Based Outpatient Center (CBOC) Patient Care Room at SimLEARN’s National Simulation Center (NSC) in Orlando, FL. Below are the highlights of that four-day meeting:   

  • An interprofessional team of VA employees representing primary and specialty care providers, front-line staff from the VHA Office of Primary Care, Dentistry, and Ophthalmology, healthcare design architects, and simulation experts created a full-scale mock-up of the CBOC’s “General Patient Care Room.” The mockup included representative equipment, furnishings, and supplies from the CBOC Design Guide which is currently being updated. 
  • The CBOC General Patient Care Room mock-up was built in two sizes to evaluate the safety and performance of the two sizes being considered in the Design Guide update.
  • Specialty care services of dental care and eye care were tested to see if one of the room sizes could potentially be used as a ‘Universal Room Template’ that could apply to most of the Patient Care Rooms included in a VA CBOC.
  • An immersive simulation experience was used to evaluate the safety and functionality of these spaces.    

The team identified positive and potentially negative impacts to staff workflow and patient flow, staff/patient interaction, and safety hazards. By working together, the team was able to mitigate many of the identified challenges and barriers which resulted in a more functional and safe design. A proactive approach will have a direct impact on decisions made during the design phase of clinical spaces. SbHDT can translate into significant cost-savings and/or cost avoidance to VHA and positively influence the triple aim components of per capita cost, efficient bedside care, and improved Veteran experience of care. This strategy will improve the quality and accuracy of VA Standards for Space Criteria and Design Standards.  

For additional information on Simulation based Design Testing, System/Hospital Activation, or enhancement courses: Sim Essentials, Cardiac Toolbox, and Escape Room “Outbreak,” please contact the ACO team at