INTRODUCTION
Simulation is often employed as a method to test mass casualty and disaster response planning within hospitals. Effective simulation needs to achieve high quality recreation of scenarios, which is resource intensive. The delivery of large scale, interdisciplinary team and system simulation requires consideration of physical safety, system integrity for real patients, simulation team communication, and effective dissemination of outcomes.

AIM
To describe challenges and potential solutions for effective delivery of disaster simulations, drawn from Simulation Service experience at Gold Coast Hospital and Health Service (GCHHS). 

METHODS 
This case study reviews strategies used to deliver a large-scale multi-team in-hospital disaster and trauma simulation, involving more than 75 participants drawn from paramedic/ambulance, emergency, trauma service, anaesthetics, perioperative, surgical, and hospital administrative teams. 

RESULTS 
Issues reviewed include simulation delivery team composition and briefing, safety strategies, matching simulation methodology to exercise objectives, the use of real-time communications technologies and apps for real time communication and performance tracking, and leveraging the simulation experience for observers by narrated Facetime stream.  Following the simulation, a debrief was conducted with participants to address performance, communication and interfaces, strengths and weaknesses and overall opportunity for improvement. Facility wide dissemination of messages through standardised reporting, infographics and video vignettes is also reviewed.

CONCLUSION 
Simulation is an engaging way to assess protocols and practices for disaster response within a tertiary hospital, and effectiveness can be enhanced through strategic use of contemporary techniques and technologies.

Enhancing the Effectiveness of Disaster Simulations Through Contemporary Simulation Design and Technology