TABLE 1.

Impact of Simulation Programs on COVID-19 Patient Care

Simulation Program	Impacts
PPE training	Rearranged physical spaces to streamline and improve the safety of the doffing process. Added new physical barriers to better isolate doffing areas.
Intubation and airway management	Helped familiarize staff with a new COVID-19 intubation protocol. Uncovered knowledge gaps and staff misconceptions about the new protocol. Assigned specific airway team members with a cross-monitoring task to identify protocol deviations. Consolidated airway equipment for intubation with backup equipment readily available to ensure that there are no shortages.
Emergency code training	Contributed to the development of a systemwide cardiac arrest protocol. Addressed safety issues such as overcrowding, environmental and staff contamination by SARS-CoV-2 virus; created new roles such as a “gate keeper” and a doffing buddy, adjusted PPE requirements to better protect staff, streamlined medication delivery. Established new communication modalities during codes; use of pregenerated signs, walkie-talkies, and speaker phones.
Ventilator management training	Trained noncritical care providers deployed to ICUs on ventilator management of ARDS via distance learning; participants included hospitalists, pediatricians, nurses, physician assistants, and emergency medicine physicians.
Proning simulation	Trained providers in the rehabilitation department, including physical and occupational therapists, in patient proning in the setting of ARDS, contributed to the creation of a proning protocol.