Interprofessional patient-specific simulation preparation to improve management of neonatal high acuity low occurrence (HALO) scenarios.

Abstract Fetal compressive intrapericardial teratoma is a rare and life-threatening condition qualifying as a high acuity low occurrence (HALO) event. To prepare for delivery and immediate neonatal management, specialists from pediatric cardiology, cardiac surgery, maternal-fetal-medicine, neonatology, cardiac anesthesia, critical care, clinical perfusion, obstetrical nursing, and operating room nursing convened. An in situ operating room simulation was utilized to identify and introduce key team members, derive and practice the anticipated clinical management algorithm, strategically position human and equipment resources, and ensure each specialist team was familiar with the environment and available equipment. As rehearsed in the simulation, the cesarean delivery of the patient and neonatal cardiac surgery was uncomplicated and yielded a favourable clinical outcome. A patient-specific HALO simulation preparation (PSHSP) can facilitate positive clinical outcomes and improved health care team confidence in HALO scenarios such as the birth of newborns anticipated to have cardiorespiratory instabilty.