title: [Innovation in healthcare processes and patient safety using clinical simulation].
abstract: OBJECTIVE
  Many excellent ideas are never implemented or generalised by healthcare organisations. There are two related paradigms: thinking that individuals primarily change through accumulating knowledge, and believing that the dissemination of that knowledge within the organisation is the key element to facilitate change. As an alternative, a description and evaluation of a simulation-based inter-professional team training program conducted in a Regional Health Service to promote and facilitate change is presented.
  
  
  METHODS
  The Department of Continuing Education completed the needs assessment using the proposals presented by clinical units and management. Skills and behaviors that could be learned using simulation were selected, and all personnel from the units participating were included. Experiential learning principles based on clinical simulation and debriefing, were used for the instructional design. The Kirkpatrick model was used to evaluate the program.
  
  
  RESULTS
  Objectives included: a) decision-making and teamwork skills training in high prevalence diseases with a high rate of preventable complications; b) care processes reorganisation to improve efficiency, while maintaining patient safety; and, c) implementation of new complex techniques with a long learning curve, and high preventable complications rate. Thirty clinical units organised 39 training programs in the 3 public hospitals, and primary care of the Regional Health Service during 2013-2014. Over 1,559 healthcare professionals participated, including nursing assistants, nurses and physicians.
  
  
  CONCLUSIONS
  Simulation in healthcare to train inter-professional teams can promote and facilitate change in patient care, and organisational re-engineering.
authors.affiliation: Dirección de Operaciones, Hospital virtual Valdecilla, Santander, España.
authors.forename: E
authors.initials: E
authors.lastname: Rojo
authors.affiliation: Dirección de Innovación Docente, Hospital virtual Valdecilla, Santander, España. Electronic address: jmmaestre@hvvaldecilla.es.
authors.forename: J M
authors.initials: JM
authors.lastname: Maestre
authors.affiliation: Subdirección de Desarrollo y Calidad Asistencial, Servicio Cántabro de Salud, Santander, España.
authors.forename: A R
authors.initials: AR
authors.lastname: Díaz-Mendi
authors.affiliation: Subdirección de Desarrollo y Calidad Asistencial, Servicio Cántabro de Salud, Santander, España.
authors.forename: L
authors.initials: L
authors.lastname: Ansorena
authors.affiliation: Dirección Ejecutiva, Hospital virtual Valdecilla, Santander, España.
authors.forename: I
authors.initials: I
authors.lastname: Del Moral
mesh_terms: D003695:Delivery of Health Care; D006282:Health Personnel; D006801:Humans; D010348:Patient Care Team; D061214:Patient Safety
keywords: Cultura organizacional; Debriefing; Gestión del cambio; Innovación organizacional; Organisational change; Organisational culture; Organisational innovation; Patient simulation; Programas de entrenamiento; Simulación clínica; Training programs