SSH LST Workgroup Position Statement

Society for Simulation in Healthcare Releases New Position Statement on Latent Safety Threats
 

(February 2025) - The Society for Simulation in Healthcare (SSH) has released a new Latent Safety Threat Position Statement and Companion Document, establishing consensus-based guidance for the identification, reporting, mitigation, and follow up of latent safety threats discovered through in situ healthcare simulation.

The new documents provide the simulation community with a shared language and structured framework to strengthen patient safety and systems improvement efforts. They define key terminology, outline recommended processes, and clarify roles and responsibilities related to latent safety threat management. At the core of the guidance is a three-tiered framework designed to support consistent and ethical management of latent safety threats across institutions of varying size, scope, and maturity.

Latent safety threats—hidden system vulnerabilities that can contribute to patient harm—are often uncovered during in situ simulation activities conducted in real clinical environments. While many programs identify these threats, variation in how they are reported, mitigated, and integrated into broader quality systems has created inconsistencies across organizations. SSH’s new guidance aims to reduce that variation and support a more standardized approach.

The three-tiered structure allows simulation programs to intentionally scaffold organizational integration based on available resources, infrastructure, and context. This flexible design recognizes that programs differ widely in maturity and alignment within their institutions, while reinforcing simulation’s critical role in proactive risk identification and systems testing. By strengthening collaboration with quality and safety partners, the framework positions simulation programs as integral contributors to high reliability and continuous improvement in healthcare.

The initiative originated from a Hospital-Based Simulation Programs Section membership needs assessment, which identified significant variation in latent safety threat workflows and highlighted the absence of industry standards. In response, SSH convened a dedicated workgroup in collaboration with the Patient Safety and Simulation Collaborative and the In Situ and Mobile Outreach Simulation Affinity Group.

The workgroup conducted a comprehensive literature review and surveyed SSH members to better understand current practices and gaps. Through iterative drafting and expert consensus, the team developed an evidence-informed framework that reflects both research and frontline experience. The final position statement and companion document underwent internal review, alignment with SSH strategic priorities, and approval by the SSH Board of Directors.

Together, these documents mark an important step toward advancing simulation-based systems improvement and elevating patient safety practices across healthcare organizations worldwide.