Though the question, "What would you change in healthcare to improve patient safety?" is straightforward, the answer is quite nebulous. In an attempt to be concise yet still provide an answer with broad application, Leah and I spoke of the concept of creating a virtual simulated environment where system solutions could be worked out early, rather than discovered during or after implementation.

The closest thing that I can use as a reference point to describing such a simulation would be the stock room in the movie The Matrix. You see, within the stock room, the characters have access to all the equipment they could ever need. Jean Baudrillard puts forth the "question of substituting signs of the real for the real itself; that is, an operation to deter every real process by its operational double, a metastable, programmatic, perfect descriptive machine which provides all the signs of the real and short-circuits all its vicissitudes."

My recent experiences working with health departments and hospitals to prepare for the threat of Ebola Virus Disease (EVD) has left me wishing for the technology I and Jean speak of. Because of limited supply of personal protective equipment (PPE), facilities have had to create ensembles that have not been designed to "fit" together. For example, available coveralls may not connect well with available face shields and hoods; this may provide the potential for exposure. Furthermore, the ensembles may prove to be quite uncomfortable which will lead to distraction, fatigue, and unsafe care delivery. Facilities may not be able to predict the "fit" of the PPE until it is ordered en masse and tried out.

Instead, consider the ability to have a virtual stock room where all PPE choices that are obtainable are available; healthcare workers could try out the equipment and even conduct simulated activities in the virtual equipment before expensive systems- and human-level mistakes are generated.

Hopefully, this Holodeck for healthcare will be available within my lifetime...

James Davis, MSN, RN, CCRN, CIC, HEM
Senior Infection Prevention Analyst, ECRI Institute