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Strategy Submission

A Mock Hospital: Collaborating to Improve Quality and Safety


Ann M. Stalter

RN, PhD, M. Ed


Associate Professor



Wright State University College of Nursing and Health


Competency Categories:

Teamwork and Collaboration

Learner Level(s):

New Graduates/Transition to Practice, Pre-Licensure ADN/Diploma, Pre-Licensure BSN, RN to BSN

Learner Setting(s):


Strategy Type:

General Strategy

Learning Objectives:

Upon completion of the Ten Week Mock Hospital experience, learners will: 1)Take professional ownership for their Mock Hospital by naming it and their units, assuring organizational mission, philosophy and strategic plans are in place, preserving its reputation, maintaining evidence-based quality, and mitigating errors for the safety of its patients and employees (skill). 2)Collaborate in teams to solve patient, family, and agency issues to achieve quality and safety (QSEN, Defining competency). 3)Communicate with team members regarding the clinical problems (case studies) (QSEN, Teamwork & Collaboration, skill). 4)Involve the patent and family as partners in examining assurance and improvement of assuring safe, quality care (QSEN, Patient-Centered Care, knowledge). 5)Employ evidence based practice from reliable sources in solutions that integrate best practice into the work environment (QSEN, EBP, knowledge and skill). 6)Appreciate how technology supports clinical decision-making, error prevention and care coordination to enhance patient outcomes (QSEN, Safety, attitude). 7)Value own role in error prevention (QSEN, Safety, attitude). 8)Acknowledge own potential in contributing to effective team functioning (QSEN, Teamwork & Collaboration, attitude). 9)Appreciate the importance of teamwork and collaboration (QSEN, Teamwork & Collaboration, attitude). 10)Contribute to resolution of conflict (QSEN, Teamwork & Collaboration, attitude). 11)Value the influence of system solutions in achieving effective team functioning (QSEN, Teamwork & Collaboration, attitude). 12)Reflect on assignments to transfer key learning points into clinical practice (skill). 13)Employ systems thinking to reduce personal effort and reliance on authority, while increasing critical reasoning and system interdependencies (skill). 14)Employ conflict resolution skills to improve group functioning and to advance safe nursing practice. 15)Participate in debriefing exercises in order to analyze and synthesize key learning (skill). 16)Employ reflection as a means of transferring knowledge, skills and attitudes to clinical practice (skill). 17)Participate in a root cause analysis of a sentinel event (QSEN, Quality Improvement, skill). 18)Participate in a Mock Debriefing Panel 19)Serve on a Mock Hospital Board 20)Review a budget

Strategy Overview:

This innovative teaching strategy could be used in online, hybrid or face-to-face environments. It suggested that it be used using hybrid format in a Leadership/Management, BSN senior-level course. This strategy is designed to accommodate 24-60 students. It has several working parts: The Mock Hospital Board, the Mock Unit Meetings and the Debriefing Panel. The students are assigned to work in six groups with up to 10 students per group. The greater the number of students, the more complex and challenging it is to manage. This teaching strategy employs four theory-based educational approaches (Appendix A). This teaching strategy is designed for 90 minute in-class sessions across 10 weeks. There are pre-class and after-class assignments integrated into the teaching strategy. Suggested Time Frame for each week Prep work (before class) 1 hour* (includes voiced over Powerpoint, readings, videos & website perusal) IRAT (in-class) 20 minutes TRAT (in-class) 10 minutes Mock Board (in-class) 15 minutes Unit Meeting (in-class) 30 minutes Debrief (in-class) 15 minutes Journal (After class reflection) 30 mniutes Each week the Mock Hospital Board, Mock Units and Debriefing Panels meet. Ideally, each group member should rotate across The Mock Hospital Board, the Mock Unit Meetings and the Debriefing Panel over the course of the academic session. Larger groups may have a difficult time with rotating. Within the Unit, each group member rotates the following roles each week: Patient/Family member, Secretary, Nurse Manager, Objective Observer, and Staff Nurse. Each student must assume each role at least once during the academic session, but may assume it more than once throughout the academic session. Other roles that may be assigned are: Clinical expert, Patient advocate, Quality improvement nurse. Additional roles could include other members of the health care team (physical therapy, social work, clergy, etc.), administrators (Chief Nursing Officer, Chief Executive Officer), or other roles (mentor, clinical nurse educator, preceptor, nurse practitioner, nurse researcher, infection control nurse, wound specialist, etc.). A sample of the following job descriptions are provided: Staff Nurse, Secretary, Nurse Manager & Objective Observer. Additional sample job descriptions are available (free domain) for use and adaptation on (See link on attached document) (Appendix B) To assure rotations across groups, have the Nurse Manager for the week participate on the Mock Board and have the Objective Observer serve on the Debriefing Panel. Members of the Mock Board are as follows: Chair, Vice Chair, Secretary, Treasurer, and up to six Ex-officio members. The members participate by script. Suggested Topical Outline for Module/Topic by Week is as follows Week Module Topic 1 1 Forming Teams to Design the Mock Hospital Organizational Structures 2 2 Leading and Managing Teams to Follow Quality and Safety Initiatives 3 3 Storming for Success: Conflict Resolution 4 4 Collaborating to Improve Patient/population Outcomes 5 5 Norming: Civility as a Value 6 6 Using Evidence to Promote a Culture of Health 7 7 Performing: The Aim for Excellence 8 8 Systems Thinking to Lead Quality and Safety in Complex Organizations 9 9 Transforming: The Value of Change 10 10 Adjourning: Organizational Restructuring Suggested Concepts by Module, Suggested Group Assignments by Module and Suggested Debriefing Questions are provided (Appendix C). Suggested Tools for Module 1 include: A Sample Module Template, Mock Board Script, Case Study, Class Assignment (Charter), IRAT and TRAT quizzes, a Rubric, and Faculty Preparation Tips for Module 1 (Appendix D).

Additional Materials:

Based on the QSEN peer review comments, modules 2-10 will be provided if they are wanted and in formats requested. If they are requested, the number of files to attach to the QSEN site will increase 9-fold. Otherwise, interested parties should contact me for the materials at

Appendix A: Integration of Four Theory-based Educational Approaches
Appendix B: Suggested Job Descriptions
Appendix C: Curriculum Alignment: Content and Evaluation
Appendix D: Suggested Tools for Module 1

Evaluation Description:

The innovative teaching strategy is evaluated through pre and post surveys assessment. Confidence in mastery of each objective is measured using a 5 point Likert agreement scale. T-tests can be used to quantify learning outcomes. The surveys are provided in Appendix C. Students who enjoy team based learning enjoy this teaching strategy; those who prefer passive learning are more resistant. Overall, student feedback is positive.
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