How simulation can help improve the safety of processes

Pascal Bonnabry Pharmacy, Geneva University Hospitals (HUG),
Section of pharmaceutical sciences, University of Geneva, University of Lausanne,
Geneva, Switzerland

In high risk industries, simulation techniques are essential tools for the training of professionals. Who could imagine an aircraft pilot taking off without having been duly qualified in a flight simulation system, to learn how to manage unlikely critical situations? In the healthcare setting some discipline like anesthesiology understood that it wasn’t conceivable to perform complicated technical procedures for the first time on a patient and that simulation tools had to be integrated in the specialization cursus. Beyond the learning of technical skills, simulation platforms can also be very useful, like in the aviation, to learn how to work together and to communicate appropriately in critical situations.

In the field of pharmacy preparations, simulation techniques take more and more importance over time. Beyond their interest in production operator’s training, they can also be very useful in the continuing improvement of processes safety. Although we know that the reliability of humans is limited, few studies have investigated the real extent of this problem in the field of pharmacy preparations. The interest of simulation techniques is to set operators in worst case situations and to analyze carefully specific parts of the activity, independently of the rest of the process. The final objective is to measure the performance of operators and the interindividual variability, to identify means to improve the reliability of processes, to implement them and finally to measure their impact on the safety.

During this presentation, three examples of safety improvement projects involving simulation will be presented:

  • The measurement of chemical contamination during cytotoxic compounding with a non-toxic tracer;
  • The measurement of the dilution accuracy during cytotoxic compounding, without and with a gravimetric control;
  • The performance of operators in calculation, before and after a theoretical training session.

Any manager of a high-risk process must be worried about continuing improvement of process safety. Each responsible of an aseptic preparation unit must implement any possible action to identify weak points and to improve their reliability. Simulation techniques are now part of our toolkit to help us progressing in the identification of failures and in the validation of robust corrective actions.

The presentation can be downloaded: http://pharmacie.hug-ge.ch/ens/conferences.html

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