title: Simulation as a Tool to Facilitate Practice Changes in Teams Taking Care of Patients Under Investigation for Ebola Virus Disease in Spain.
abstract: BACKGROUND
  We analyzed the impact of simulation-based training on clinical practice and work processes on teams caring for patients with possible Ebola virus disease (EVD) in Cantabria, Spain.
  
  
  METHODS
  The Government of Spain set up a special committee for the management of EVD, and the Spanish Ministry of Health and foreign health services created an action protocol. Each region is responsible for selecting a reference hospital and an in-house care team to care for patients under investigation. Laboratory-confirmed cases of EVD have to be transferred to the Carlos III Health Institute in Madrid. Predeployment training and follow-up support are required to help personnel work safely and effectively. Simulation-based scenarios were designed to give staff the opportunity to practice before encountering a real-life situation. Lessons learned by each team during debriefings were listed, and a survey administered 3 months later assessed the implementation of practice and system changes.
  
  
  RESULTS
  Implemented changes were related to clinical practice (eg, teamwork principles application), protocol implementation (eg, addition of new processes and rewriting of confusing parts), and system and workflow (eg, change of shift schedule and rearrangement of room equipment).
  
  
  CONCLUSIONS
  Simulation can be used to detect needed changes in protocol or guidelines or can be adapted to meet the needs of a specific team.
authors.affiliation: From the Hospital Virtual Valdecilla (E.R., I.D.M., J.M.M.); and Hospital Universitario Valdecilla (C.O., D.S., G.G.), Santander, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Rojo
authors.forename: Clara
authors.initials: C
authors.lastname: Oruña
authors.forename: Dolores
authors.initials: D
authors.lastname: Sierra
authors.forename: Gema
authors.initials: G
authors.lastname: García
authors.forename: Ignacio
authors.initials: I
authors.lastname: Del Moral
authors.forename: Jose M
authors.initials: JM
authors.lastname: Maestre
mesh_terms: D002985:Clinical Protocols; D006282:Health Personnel / Q000193:education*; D019142:Hemorrhagic Fever, Ebola / Q000517:prevention & control / Q000628:therapy* / Q000635:transmission; D006801:Humans; D017053:Infection Control / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration; D058996:Quality Improvement / Q000458:organization & administration*; D000066908:Simulation Training / Q000458:organization & administration*; D013030:Spain; D013315:Stress, Psychological / Q000453:epidemiology