Simulation in the executive suite: Lessons learned for building patient safety leadership

Michael A. Rosen, Christine A. Goeschel, Xin Xuan Che, Joseph Oluyinka Fawole, Dianne Rees, Rosemary Curran, Lillee Gelinas, Jessica N. Martin, Keith C. Kosel, Peter J. Pronovost, Sallie J. Weaver

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Introduction: Simulation is a powerful learning tool for building individual and team competencies of frontline health care providers with demonstrable impact on performance. This article examines the impact of simulation in building strategic leadership competencies for patient safety and quality among executive leaders in health care organizations. Methods: We designed, implemented, and evaluated a simulation as part of a larger safety leadership network meeting for executive leaders. This simulation targeted knowledge competencies of governance priority, culture of continuous improvement, and internal transparency and feedback. Eight teams of leaders in health care organizationsVa total of55participantsVparticipated in a4-hour session. Each teamperformed collectively as a new chief executive officer (CEO) tasked with a goal of rescuing a hospital with a failing safety record. Teamsworked on a modifiable simulation board reflecting the current dysfunctional organizational structure of the simulated hospital. They assessed and redesigned accountability structures based on information acquired in encounter sessions with confederates playing the role of internal staff and external consultants. Results: Data were analyzed, and results are presented as qualitative themes arising from the simulation exercise, participant reaction data, and performance during the simulation. Key findings include high degrees of variability in solutions developed for the dysfunctional hospital system and generally positive learner reactions to the simulation experience. Conclusions: This study illustrates the potential value of simulation as a mechanism for learning and strategy development for executive leaders grappling with patient safety issues. Future research should explore the cognitive or functional fidelity of organizational simulations and the use of custom scenarios for strategic planning.

Original languageEnglish
Pages (from-to)372-377
Number of pages6
JournalSimulation in Healthcare
Issue number6
StatePublished - 2015


  • Executive leadership
  • Organizational simulation
  • Patient safety
  • War gaming


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