Patients as partners in readiness for COVID-19: using 'live simulation' to implement infection prevention and control procedures in the maternity operating theatre.

Insitu simulation can be used to improve care within a particular setting and has specific value in developing and testing guidelines and procedures. However, it can be challenging to undertake simulation when clinical work is ongoing. Responding to the need to develop infection prevention and control procedures for coronavirus disease 2019 in the obstetric operating theatre, we asked three patients who required operative intervention to consent to be managed according to preliminary standard operating procedures as if they were severe acute respiratory syndrome-coronavirus-2 positive. With this method, we were able to run scenarios in real-time without interrupting clinical work. As well as allowing us to develop and refine procedures, these 'live simulations' provided staff training and highlighted system problems that needed to be addressed as the first wave of the pandemic approached. In this case series, we describe our procedure for live simulation, report the learning points that this approach yielded, present the feedback from patient participants and reflect on the ethical implications of this technique.