Simulation in Public Health: A Decisive Step Toward Quality and Safety

Simulation in public health, in line with the Global Patient Safety Action Plan 2021-2030, is essential for improving safety, quality, and access to global healthcare. Projects such as the Padua Public Health Simulation Lab show how simulation addresses crucial challenges, from healthcare training to emergency management, helping to reduce inequalities and promote innovation in healthcare systems. A strategic approach to achieving global health and safety goals.

In 1969, Neil Armstrong, setting foot on the moon, uttered the famous phrase: “One small step for man, one giant leap for mankind.” Just as Armstrong’s small step marked a historic advance for all of humanity, so too could the wise integration of simulation into public health represent a small but significant cultural step toward greater safety and quality of care, even for low- and middle-income countries. Is this metaphor too ambitious? Perhaps, but perhaps not. In a world where 1 in 10 patients in high-income countries experience an adverse event during healthcare and where up to 1 in 4 patients in low- and middle-income countries suffer harm, with 134 million adverse events per year and approximately 2.6 million deaths, it is clear that the quality of care is an urgent challenge. Nearly 60% of deaths in low- and middle-income countries are attributable to poor or unsafe care (1). In an increasingly technologically advanced environment, it is essential to ensure that tools such as artificial intelligence and innovative educational approaches, such as virtual reality and the metaverse, do not remain the exclusive preserve of the richest countries, thereby further fueling social, educational, and access inequalities to quality services.

Clinical Governance: hard wiring quality and simulation

Simulation in Public Health and the Sustainable Development Goals

In this scenario, simulation can be an effective resource for addressing key public health challenges, such as the prevention of healthcare-associated infections, epidemic management, emergency management, disaster medicine, and public health preparedness. It can contribute to the achievement of the Sustainable Development Goals (SDGs), including: ensuring good health and well-being for all (SDG 3), ensuring inclusive and quality education (SDG 4), and reducing inequalities within and between countries (SDG 10)(2).

We are convinced that the introduction and widespread adoption of simulation in public health can foster a cultural and systemic transformation with global repercussions. And we are not alone in believing this. The World Health Organization (WHO) Global Patient Safety Action Plan 2021-2030 Call to Action clearly calls for the implementation of simulation-based programs, aimed at all stakeholders: governments, health services, and academia.

Seven key aspects of simulation in public health

In recent years, simulation has demonstrated enormous potential in the clinical setting, but it is also emerging as a key tool in public health, thanks to a flourishing proliferation of innovative applications. In addition to improving the preparedness of healthcare professionals, this innovative teaching and research methodology is helping to strengthen the efficiency and safety of healthcare systems, helping to reduce inequalities in access to quality services. With this in mind, we recently published an article in Frontiers in Public Health entitled Shaping the future of healthcare: improving quality and safety through integrating simulation into Public Health education, which highlights the urgent need to integrate simulation into public health and shares a concrete proposal to this end (3). To this end, we have highlighted seven aspects of simulation that we consider particularly relevant:

1. Education and quality improvement: standardizes healthcare training, thereby improving care and equity in access to quality services.
2. Economic savings: reduces costs associated with healthcare errors and inefficiencies in the healthcare system.
3. Non-technical skills and human factors: enhances leadership, communication, and teamwork.
4. Improved clinical outcomes: reduces adverse events and improves overall quality of care.
5. Patient and caregiver involvement: promotes greater participation and awareness.
6. Research and innovation opportunities: provides a safe environment for experimenting with new technologies and methodologies.
7. Ethical approach and safe learning: promotes learning that does not compromise the safety of patients and healthcare professionals.

The Padua Public Health Simulation Lab: a small step towards a big change

To build this vision, the Padua Public Health Simulation Lab (PPHSL) project was launched, an initiative born from the collaboration between academics, healthcare professionals, and students of the University of Padua in the context of the School of Specialization in Hygiene and Preventive Medicine, medical degree courses, and healthcare professions. This project responds to the call of the WHO’s Global Patient Safety Action Plan 2021-2030 and is aligned with the Guidelines on the development of simulation in healthcare in Italy, published by the Ministry of Health in July 2022 (4).

The main objective of the PPHSL is to promote the integration of simulation into public health courses, fostering the development of both technical and non-technical skills, such as leadership, effective communication, and teamwork. The project targets healthcare professionals in basic and postgraduate training, with a specific focus on issues such as healthcare-associated infections and antimicrobial resistance; hand hygiene; risk management; vaccine hesitancy; and health emergencies.

According to Sir Donald Acheson, public health is “the science and art of promoting health, preventing disease, and prolonging life” (5). In light of this definition, is considering simulation as an indispensable strategic resource for public health merely an ambitious vision or an opportunity that would be foolish not to seize?

To learn more:

Baldovin T, Bassan F, Bertoncello C, Buja A, Cocchio S, Fonzo M, and Baldo V (2024) Shaping the future of healthcare: improving quality and safety through integrating simulation into Public Health education. Front. Public Health 12:1446708. doi: 10.3389/fpubh.2024.1446708

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