Abstract
<title>Abstract</title> <p>Hospital relocations expose healthcare systems to safety risks as staff encounter unfamiliar environments, workflows and equipment. Translational simulation has been proposed as a means to identify system-level vulnerabilities in healthcare settings. However, few methods combine structured debriefing with a formalised digital reporting pathway to organisational leadership. This is a methodological article which describes the development and large-scale implementation of SAFE(E)-R — a translational simulation and debriefing framework based on the SAFEE tool — during the relocation of a university hospital in Norway. SAFE(E)-R builds on the original SAFEE (Summarize, Anchor, Facilitate, Explore, Elicit) structure and adds a Report phase to the debriefing tool. We developed a digital reporting platform that distributes reports to clinical and organisational leadership and permits aggregation of findings across simulation events. During the implementation period (20 August–6 November 2025), translational simulation was conducted across 31 clinical units, and 127 simulation reports were submitted from 18 clinical units, documenting the involvement of 3,082 participants, identifying 263 improvement areas and 191 proposed solutions. The five most frequently coded themes were: signage and orientation (n = 153), equipment (n = 66), doors and elevators (n = 55), alarms and communication systems (n = 55), and workflows and roles (n = 42). Our experience suggests that structured digital reporting is feasible and effective for organisational learning in translational simulation. The framework is now being adapted for broader implementation across the health region.</p>