Identification of latent safety threats involving on-site simulation in a Birthing Unit in response to the COVID-19 pandemic

We aimed to detect different types of latent safety threats (LSTs) by using on-site simulations for pregnant women with suspected COVID-19 presenting to the Birthing Unit. We recorded LSTs during on-site simulations. There were three scenarios, which involved the presentation of a suspected patient to the Birthing Unit, donning and doffing, and transportation to the operating room. LSTs were subcategorized into Gaps in Knowledge and Training, Maintenance and Equipment, and System and Processes. Sixty-five participants were involved. Eighty-one LSTs were observed: scenario 1 (n = 42, 51.8%), scenario 2 (n = 14, 17.2%) and scenario 3 (n = 25, 30.9%). Amongst the different themes, Gaps in Training and Knowledge comprised (n = 29, 35.8%), Maintenance and Equipment comprised (n = 46, 56.8%), and Systems and Processes comprised (n = 6, 7.4%). Pre-simulation surveys revealed only 10% of participants felt very prepared to care for these patients, while 92% responded the same way post-simulation.