Association between mass casualty in-situ simulation format with ongoing operational and patient care metrics in an adult emergency department: a retrospective cohort study

BACKGROUND: In situ simulation (ISS) has seen broad use in academic emergency medicine (EM). Studies with limited clinical data suggest a dual paradigm model to assess the efficacy of these educational activities based on their impact on both ongoing and future quality of care. We conducted a retrospective cohort study to assess the impact of government-mandated mass casualty incident (MCI) ISS drills on ongoing department operations and quality clinical care. METHODS: We conducted a retrospective study of patients presenting to an adult tertiary academic emergency department during scheduled and unscheduled ISS MCI drills. We assessed the impact of ISS on operational and triage metrics by comparing scheduled and unscheduled drills. RESULTS: Being treated during an ongoing MCI ISS, in both the scheduled and unscheduled simulation formats, was associated with a higher average door to triage times (20.6 min in the MCI ISS cohort vs 15.8 min in the control cohort; p