| Sumario: | Systems integration (SIS) simulation and system-focused debriefing is an approach to test new processes with health care teams to inform its design and utility and identify systems issues proactively. Learner-focused simulations support team training with a focus on individual knowledge and skills. These strategies combined provide a highly effective quality improvement approach to test and implement new processes. This article will describe how we used SIS followed by learner-focused simulations and debriefings to introduce, test, refine, and train our team on a new, locally adapted cardiac arrest protocol after cardiac surgery (early chest opening). • We used an effective simulation-based quality improvement approach to test and implement a new protocol. • The use of simulation for systems integration and debriefing to implement new processes informs the design and utility and identifies systems issues proactively. • The adoption of this protocol resulted in paradigm shift in early postoperative management and significant practice changes. • The teamwork constructs evaluated by the MHPTS showed statistically significant higher scores after session. • This approach ensured a safe and reliable implementation of a high-risk, low-frequency protocol.
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