Global mapping of simulation exercise materials: A health system view

Overview

The identified materials were examined from a health system resilience perspective, using the six health system building blocks outlined in the WHO health systems framework. Resilience was understood in relation to the maintenance of core health service functions, preparedness capacity, the effectiveness of the response and the ability to reorganize as required.

The majority of the materials identified tested PHE preparedness and response, with a limited proportion testing aspects of health systems resilience or recovery. Biological hazards, including pandemic influenza and emerging infections, were the most frequent hazard type used in testing, with the tabletop approach being the one most frequently applied. Although this was not the explicit focus, all materials tested at least one health system building block, although the tests were generally not integrated across all the relevant building blocks. Leadership and governance was the most frequent building block tested in the context of emergency response (43 out of 51 items), although the governance structures tested and the approach to measurement were often unclear. Aspects of Service delivery (42 of 51) and Health-care workforce (40 of 51) were also frequently tested, often with a focus on specific functional capabilities such as infection prevention and control (IPC) or surge capacity. These functional aspects were rarely tested across all relevant building blocks; for example, surge capacity was tested in relation to access to beds without due consideration of staffing or the training of staff pulled into the response.