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“No-Go Considerations” for In Situ Simulation Safety

Bajaj, Komal, MD, MS-HPEd; Minors, Anjoinette, MD, FACOG; Walker, Katie, MBA, RN; Meguerdichian, Michael, MD, MPHEd; Patterson, Mary, MD, MEd

Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare: June 2018 - Volume 13 - Issue 3 - p 221–224
doi: 10.1097/SIH.0000000000000301
Concepts and Commentary

Summary Statement In situ simulation is the practice of simulation in the actual clinical environment and has demonstrated utility in the assessment of system processes, identification of latent safety threats, and improvement in teamwork and communication. Nonetheless, performing simulated events in a real patient care setting poses potential risks to patient and staff safety. One integral aspect of a comprehensive approach to ensure the safety of in situ simulation includes the identification and establishment of “no-go considerations,” that is, key decision-making considerations under which in situ simulations should be canceled, postponed, moved to another area, or rescheduled. These considerations should be modified and adjusted to specific clinical units. This article provides a framework of key essentials in developing no-go considerations.

From the Albert Einstein College of Medicine (K.B., A.M.); NYC Health + Hospitals/Simulation Center (K.B., K.W., M.M.); NYC Health + Hospitals/Jacobi (K.B., A.M.); NYC Health + Hospitals/North Central (K.B.), Bronx, NY; NYC Health and Hospitals/Harlem (M.M.), New York, NY; Children’s National Medical Center (M.P.), Washington, DC.

Reprints: Anjoinette Minors, MD, FACOG, NYC Health + Hospitals/Jacobi Department of Obstetrics and Gynecology, 1400 Pelham Parkway S, Bronx, NY 10461 (e-mail:

M.P. provides occasional consulting for SimHealth Group. K.B. is the Medical Director of Simulation for Level-Ex. The remaining authors declare no conflict of interest.

According to the policy activities that constitute research at New York City Health + Hospitals, this work met criteria for operational improvement activities exempt from review.

© 2018 Society for Simulation in Healthcare