A Guide to Healthcare Facility Dress Rehearsal Simulation Planning

Simplifying the Complex

Kelly Guzman

• Publisher: Emerald Publishing Limited
• Year: 2021
• Print ISBN: 9781801175555
• eBook ISBN: 9781801175562
• Topic: Business
• Subtopic: Business Strategy
• Index: Business

In 2009 three consultants, green to the consulting industry were tasked with a new challenge, the activation and licensing of a new, 100 bed hospital, in only 90 days. Pulling from concept of "Day in the Life" simulations used in the military, the Hospital Incident Command System (HICS), and adult learning theories the consultants developed a method that healthcare facilities could use to ensure readiness. Thus, was born the concept of Dress Rehearsal.

A Guide to Healthcare Facility Dress Rehearsal Simulation Planning: Simplifying the Complex provides a step-by-step scalable framework to coordinate an Interdisciplinary Dress Rehearsal event for a project or facility of any size.

Developed for use as a resource throughout your Dress Rehearsal journey, each chapter of this guide builds upon the last and should be read in succession. We hope you leverage our lessons learned and experience and apply them to your facility to support a safe Day 1 activation.

Chapter 1

Getting Started

Christina Olivarria

Upon completion of this chapter, the reader will be able to:

• Define Dress Rehearsal.
• State the goals of Dress Rehearsal.
• Summarize the phases of the Dress Rehearsal timeline.
• Distinguish how Dress Rehearsal fits into the overall Transition and Activation Timeline.
• List the required inputs to build a Dress Rehearsal program.
• Recognize the organizational factors that affect Dress Rehearsal planning.
• Name the major categories included in the Dress Rehearsal Project Plan.

Introduction

When activating a new healthcare facility, most of the staff’s anxiety and resistance to the new space stem from fear of the unknown. Although teams are excited about working in a new and modernized environment, there are often concerns about how the “new and different” will change daily workflows and the ability to care for patients. Although healthcare organizations’ primary focus tends to be on the physical layout, systems, and construction of the new facility, operations management must be equally important. After all, construction ultimately ends, but operations will continue long after the facility opens its doors.

This chapter provides the reader with a high-level introduction to the Dress Rehearsal program and describes the types of events and the associated goals. The content presents an overview of how Dress Rehearsal fits into the overall Transition and Activation Planning schedule, including the required inputs from other Transition and Activation phases. Important considerations such as resources and culture affect an organization’s approach to planning, so they are vital to assess at the start of the project. Lastly, this chapter provides an overview of the Dress Rehearsal Project Plan, including inputs, milestones, and descriptions of the significant program planning categories.

What is Dress Rehearsal?

Dress Rehearsal is a simulation-based event conducted before Day 1 Activation that involves departments using scenarios to validate new workflow processes and space functionality. Providing an opportunity to work in the new healthcare facility in advance of Day 1 Activation prepares staff to safely and confidently care for patients. There are three types of Dress Rehearsal events: Tabletop Exercises, department-specific Dress Rehearsals, and interdisciplinary Dress Rehearsals. Fig. 1.1 provides a summary of the different types of Dress Rehearsal events.

Fig. 1.1. Summary of Dress Rehearsal Events.

The primary objective of Dress Rehearsal is to ensure that the staff and the facility are ready for Day 1 Activation. Testing equipment, systems, and technology with scenarios allow teams to validate functionality assumptions and uncover gaps that may have otherwise gone unnoticed. Additionally, the organization can evaluate training effectiveness and amend training plans if required. Lastly, by identifying issues before Day 1 Activation, the organization can prioritize, manage, and develop action plans to resolve high-priority items that impact operations, patient care, and staff satisfaction. The goals of Dress Rehearsal are listed in Fig. 1.2.

All organizations are unique in culture and composition, so it is essential to conduct an early assessment of the individual and organizational factors that can affect the Dress Rehearsal program. Observing a Dress Rehearsal event at another organization and speaking with peers who have already activated their new facility are practical first steps for an organization to understand what will be required to make the event successful. All types of healthcare settings conduct Dress Rehearsals, from large academic medical campuses to small individual clinics. When reaching out to another organization for guidance, it is beneficial to understand its Dress Rehearsal program needs. Conducting an internal assessment allows the organization to tailor the material presented in this guide to suit the project’s needs.

Fig. 1.2. Dress Rehearsal Goals.

An organization activating a 150- to 200-bed community hospital should begin Dress Rehearsal planning one year before the first Dress Rehearsal event, as shown in Fig. 1.3. This runway provides the organization with the time required to plan and coordinate Dress Rehearsal and its preceding activities. The significant Dress Rehearsal activities include scenario development, readiness planning, Dress Rehearsal events, and the issues management process.

• Scenario development begins nine months before the first Dress Rehearsal event. This activity focuses on creating and reviewing standardized action lists used during the Dress Rehearsal sessions in Host Departments. Scenarios guide teams through the activities typically conducted in the department to validate planned workflow processes and to test the space.
• Dress Rehearsal Readiness Planning begins six months before the first Dress Rehearsal event. Readiness planning focuses on coordinating Tabletop Exercises’ logistics, department-specific, and interdisciplinary Dress Rehearsals, including overall readiness, event planning, contingency plans, and the issues management process.
• Tabletop Exercise(s) takes place approximately three months before the first interdisciplinary Dress Rehearsal event.
• Department-specific Dress Rehearsal events occur about two weeks before the first interdisciplinary Dress Rehearsal. Departments that are experiencing significant change in the new environment should consider these events.
• Interdisciplinary Dress Rehearsal events begin three months before Day 1 Activation. Dress Rehearsal events are an excellent method to prepare the organization, facility, and staff for any required regulatory surveys. Events should be scheduled to occur before regulatory inspection(s) when possible.
• Dress Rehearsal Issues Management begins after Tabletop Exercise and will continue post-activation. During each event, issues are documented, prioritized, and assigned for resolution.

Fig. 1.3. Dress Rehearsal Timeline.

Dress Rehearsal Inputs

Before beginning Dress Rehearsal planning, it is necessary to understand where Dress Rehearsal falls in the Transition and Activation Planning continuum. Fig. 1.4 displays a sample two-year Transition and Activation timeline.

Fig. 1.4. A Sample Two-Year Transition and Activation Planning Timeline.

It is important to note the various activities before Dress Rehearsal as they impact an organization’s Dress Rehearsal planning efforts. The three primary inputs required for Dress Rehearsal planning are service line placement, equipment, system and technology decisions, and workflow plans. The Dress Rehearsal program incorporates these inputs, specifically in the scenario validation steps. Failure to dedicate time to these components will have downstream impacts such as rework, additional training, and post-occupancy issues.

Service Line Placement

A requirement for Dress Rehearsal planning is deciding which services will be relocating to the new space. Departmental adjacencies, distance from support departments, and general space layouts impact day-to-day operations. For stakeholders to appropriately plan department-specific workflows, communicate service line placement decisions early in the transition planning phase. Often there is a false assumption that if the plan is for the same departments to occupy the new space, then the transition from the existing location to the new will be seamless. Failure to account for departmental adjacencies and space layout changes will impact future operations and pose post-occupancy challenges. The development of a stacking diagram and a floor-by-floor department list will allow end-users to plan for future operations properly. Additionally, time studies evaluating new distances to commonly traveled existing lo...

Table of contents

• Cover
• Title
• Chapter 1. Getting Started
• Chapter 2. Dress Rehearsal Roles
• Chapter 3. Scenario Development
• Chapter 4. Round Robin
• Chapter 5. Dress Rehearsal Readiness
• Chapter 6. Tabletop Exercises
• Chapter 7. Dress Rehearsal Events
• Chapter 8. Issues Management
• Chapter 9. Event Follow-Up and Close-Out
• Chapter 10. Dress Rehearsal Budget Planning and Resource Requirements
• Chapter 11. Special Scenarios in New Healthcare Environments
• Chapter 12. Reflections and Conclusions
• Glossary
• Index