The Floor - Emergency Department Simulation

Free COVID-19 expansion pack

Emergency Departments (ED) are the medical frontline of the COVID-19 pandemic. They are rapidly changing their floor layout, writing new pathways and managing staff while maintaining the highest possible levels of infection control and patient care.

Managing an ED during a pandemic is new to everyone and circumstances are changing rapidly. To help ED teams test and refine their COVID-19 pathways we have developed a COVID-19 expansion pack for the game.

The expansion pack offers 9 new COVID-specific starting scenarios and 50 COVID-patient profiles based on real patient cases (not all COVID positive). Extra Spin and Lifeline cards help you to simulate a range of realistic situations that best suit the current situation in your ED.  

The expansion pack was created by Dr Salwa Malik an Emergency Medicine Consultant at Brighton and Sussex University Hospitals NHS Trust.

All you need to run a COVID-19 simulation is up to 12 people* for 90 minutes; any senior member of staff can facilitate the game without external support. These sessions also offer an opportunity for staff to ‘decompress’ and address their own wellbeing during the debrief.

We are offering the COVID-19 expansion pack free-of-charge to anyone who already owns a copy of the game and for anyone buying a copy of The Floor – Emergency Department Simulation. The expansion pack consists of:

• 9 Starter cards
• 50 Patient cards
• 18 Spin cards
• 18 Lifeline cards

*If you don't want 12 people in the same room some or all of them can participate remotely via an online video call.

Managing a hospital emergency department (ED) takes years of study, practical experience and training. Effective training is essential, and it forms part of the Royal College of Emergency Medicine (RCEM) curriculum. The Floor a flexible, intense and enjoyable table-top training tool to help staff and students develop the skills needed to manage a busy emergency department. The game was invented by Dr Salwa Malik, an Emergency Medicine Consultant and the Emergency Department Simulation Lead at Brighton and Sussex University Hospitals NHS Trust (BSUH).

It is designed for up to 12 people working together for 90 minutes to manage an imaginary ED visually recreated within the game. The game has been played with a range of ED healthcare professionals including doctors of all grades, nurses, health care assistants and management teams. The Floor is used routinely at BSUH during Major Incident training days and is formally part of the teaching and training programme for junior doctors of all grades. It has been tested in a range of organisations in the UK, USA and Myanmar.

"This game is great at simulating the actions undertaken in a major incident and it has become an integral part of our major incident training." Justin Walford, Senior Practice Development Nurse, Charge Nurse, Brighton and Sussex University Hospitals NHS Trust.

What does The Floor do?

1. Simulates the normal workings of a major trauma centre in an intense game-based training experience for clinicians, managers and students.
2. Can recreate specific situations to help staff identify and fix problems and to explore stress test strategies.
3. Helps staff improve the way they work together in a multi-disciplinary team.
4. Effective way of supporting and informing senior decision making.
5. A flexible training resource that can be used for daily departmental management as well as major incident training.

"It's a great game/learning tool which I found particularly useful when starting out as a band 7. I played it alongside another, more senior band 7 and it helped to see how they tackled different situations." Katie Durrell, Junior ED Sister, Brighton and Sussex University Hospitals NHS Trust.

How is The Floor being used?

The game has now been played with a range of ED healthcare professionals –senior house officers and foundation doctors, registrars (SpRs), consultants, nurses, health care assistants (HCA) and management teams. It has been played and tested in a range of organisations and settings in the UK, USA and Myanmar.

At Brighton and Sussex University Hospitals NHS Trust, where the game was invented, it has been used formally in training 10 times with over 100 clinicians and managers of all grades. The game is now used regularly as part of continuous professional development.

"I am a first-year medical student. I thought that the game was a brilliant simulation of the stresses that we face in A&E on a day to day basis, whilst at the same time being really enjoyable to play. It was also a great team-building exercise." Zac Lanza, 1st year Medical Student and HCA, Leeds University.

The cost: for unlimited group ED simulation training

The Floor is a sophisticated group training tool designed to help improve performance and safety, it is not a family board game.

If you only use the game once with 12 people = £75 per person for 90 minutes of training.

But, you can use The Floor as often as you want. Every time you play the cost is diluted. At Brighton and Sussex University Hospitals they’ve used their game 10 times this year with over 100 staff members. The cost is now:

Less than £10 per person for 90 minutes of training.

The training happens in the workplace, so disruption is minimised. No external support is required so there are no hidden costs. How does this compare to other forms of training?