Annals of emergency medicine
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Emergency department (ED) COVID-19 preparations required rethinking workflows and introducing the potential for errors. Simulation provides a nimble methodology integrating into situ training and systems testing to prepare staff, detect potential workflow latent safety threats and provide recommendations for mitigation. ⋯ Our study demonstrated that simulation-based clinical systems test methods are adaptable for rapid preparedness evaluation and training. In combination with rapid-cycle deliberate practice, many latent safety threats were identified prior to clinical implementation. Our work highlights a novel application of simulation systems to increase system preparedness and reduce the potential for errors which may be applicable in diverse settings for designing, evaluating, and training staff in new protocols and procedures.