Improving Hospital Mass Casualty Preparedness Through Ongoing Readiness Evaluation

Adini, Bruria; Laor, Daniel; Hornik-Lurie, Tzipi; Schwartz, Dagan; Aharonson‐Daniel, Limor

doi:10.1177/1062860611432303

Cited by 18 publications

(35 citation statements)

References 17 publications

(27 reference statements)

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“…Contrary to the reluctance to invest efforts in ensuring emergency preparedness, the results of not being prepared can be devastating, and can lead to severe costs in human lives, damage to the environment, and collapse of infrastructure, as well as social and political calamities [2,4]. Thus, there is a need to design and implement mechanisms that may encourage both medical facilities and authorities to build their preparedness prior to the materialization of adversities, and to maintain it effectively over time [5,32,38,39]. As there are numerous hazardous materials that may cause release scenarios, there is a need to build the emergency preparedness based on the risk assessment of the severity of hazards, the likelihood of their release, and their potential public health impact.…”

Section: Discussionmentioning

confidence: 99%

Maintaining Preparedness to Severe Though Infrequent Threats—Can It Be Done?

Siman‐Tov

Davidson

Adini

2020

IJERPH

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Background: A mass casualty incident (MCI) caused by toxicological/chemical materials constitutes a potential though uncommon risk that may cause great devastation. Presentation of casualties exposed to such materials in hospitals, if not immediately identified, may cause secondary contamination resulting in dysfunction of the emergency department. The study examined the impact of a longitudinal evaluation process on the ongoing emergency preparedness of hospitals for toxicological MCIs, over a decade. Methods: Emergency preparedness for toxicological incidents of all Israeli hospitals were periodically evaluated, over ten years. The evaluation was based on a structured tool developed to encourage ongoing preparedness of Standard Operating Procedures (SOPs), equipment and infrastructure, knowledge of personnel, and training and exercises. The benchmarks were distributed to all hospitals, to be used as a foundation to build and improve emergency preparedness. Scores were compared within and between hospitals. Results: Overall mean scores of emergency preparedness increased over the five measurements from 88 to 95. A significant increase between T1 (first evaluation) and T5 (last evaluation) occurred in SOPs (p = 0.006), training and exercises (p = 0.003), and in the overall score (p = 0.004). No significant changes were found concerning equipment and infrastructure and knowledge; their scores were consistently very high throughout the decade. An interaction effect was found between the cycles of evaluation and the hospitals’ geographical location (F (1,20) = 3.0, p = 0.056), proximity to other medical facilities (F (1,20) = 10.0 p = 0.005), and type of area (Urban vs. Periphery) (F (1,20) = 13.1, p = 0.002). At T5, all hospitals achieved similar high scores of emergency preparedness. Conclusions: Use of accessible benchmarks, which clearly delineate what needs to be continually implemented, facilitates an ongoing sustenance of effective levels of emergency preparedness. As this was demonstrated for a risk that does not frequently occur, it may be assumed that it is possible and practical to achieve and maintain emergency preparedness for other potential risks.

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Section: Discussionmentioning

confidence: 99%

Maintaining Preparedness to Severe Though Infrequent Threats—Can It Be Done?

Siman‐Tov

Davidson

Adini

2020

IJERPH

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“…These factors may mean that there are CMO configurations unique to the experience of local personnel working in health departments in low resource countries which are not adequately reflected in the literature we have analysed. Although many of the CMO configurations synthesised in this RRR have been drawn from literature on disaster and emergency health events in high-income countries, the findings are applicable and transferrable to other setting due to the ‘all-hazard approach’ in disaster management, which emphasises that important systems issues will be common across disasters [21]. …”

Section: Discussionmentioning

confidence: 99%

“…The goal of the assessment is to identify the fundamental strengths and weaknesses of a recent response to a natural disaster and propose recommendations to optimise systems performance [20]. These insights provide an evidence-base for the development of policies that support the improvement of future disaster response processes [21]. …”

Section: Methodsmentioning

confidence: 99%

Monitoring and evaluation of disaster response efforts undertaken by local health departments: a rapid realist review

Gossip

Gouda

Lee

et al. 2017

BMC Health Serv Res

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BackgroundLocal health departments are often at the forefront of a disaster response, attending to the immediate trauma inflicted by the disaster and also the long term health consequences. As the frequency and severity of disasters are projected to rise, monitoring and evaluation (M&E) efforts are critical to help local health departments consolidate past experiences and improve future response efforts. Local health departments often conduct M&E work post disaster, however, many of these efforts fail to improve response procedures.MethodsWe undertook a rapid realist review (RRR) to examine why M&E efforts undertaken by local health departments do not always result in improved disaster response efforts. We aimed to complement existing frameworks by focusing on the most basic and pragmatic steps of a M&E cycle targeted towards continuous system improvements. For these purposes, we developed a theoretical framework that draws on the quality improvement literature to ‘frame’ the steps in the M&E cycle. This framework encompassed a M&E cycle involving three stages (i.e., document and assess, disseminate and implement) that must be sequentially completed to learn from past experiences and improve future disaster response efforts. We used this framework to guide our examination of the literature and to identify any context-mechanism-outcome (CMO) configurations which describe how M&E may be constrained or enabled at each stage of the M&E cycle.ResultsThis RRR found a number of explanatory CMO configurations that provide valuable insights into some of the considerations that should be made when using M&E to improve future disaster response efforts. Firstly, to support the accurate documentation and assessment of a disaster response, local health departments should consider how they can: establish a culture of learning within health departments; use embedded training methods; or facilitate external partnerships. Secondly, to enhance the widespread dissemination of lessons learned and facilitate inter-agency learning, evaluation reports should use standardised formats and terminology. Lastly, to increase commitment to improvement processes, local health department leaders should possess positive leadership attributes and encourage shared decision making.ConclusionThis study is among the first to conduct a synthesis of the CMO configurations which facilitate or hinder M&E efforts aimed at improving future disaster responses. It makes a significant contribution to the disaster literature and provides an evidence base that can be used to provide pragmatic guidance for improving M&E efforts of local health departments.Trial registrationPROSPERO 2015:CRD42015023526.

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“…The tool is targeted to save lives upon an occurrence of a public health threat/biological event. The parameters integrated in the evaluation tool serve as benchmarks for the healthcare facilities that delineate actions that need to be implemented in order to achieve preparedness for biological events (20). The parameters enable both the governing authorities and each facility to independently evaluate the level of readiness.…”

Section: Discussionmentioning

confidence: 99%

Continued Vigilance â€“ Development of an Online Evaluation Tool for Assessing Preparedness of Medical Facilities for Biological Events

Adini

Verbeek

Trapp

et al. 2014

Front. Public Health

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Objective: Effective response to biological events necessitates ongoing evaluation of preparedness. This study was a bilateral German–Israeli collaboration aimed at developing an evaluation tool for assessing preparedness of medical facilities for biological events.Methods: Measurable parameters were identified through a literature review for inclusion in the evaluation tool and disseminated to 228 content experts in two modified Delphi cycles. Focus groups were conducted to identify psychosocial needs of the medical teams. Table-top and functional exercises were implemented to review applicability of the tool.Results: One hundred seventeen experts from Germany and Israel participated in the modified Delphi. Out of 188 parameters that were identified, 183 achieved a consensus of >75% of the content experts. Following comments recommended in the Delphi cycles, and feedback from focus groups and hospital exercises, the final tool consisted of 172 parameters. Median level of importance of each parameter was calculated based on ranking recommended in the Delphi process. Computerized web-based software was developed to calculate scores of preparedness for biological events.Conclusion: Ongoing evaluation means, such as the tool developed in the study, can facilitate the need for a valid and reliable mechanism that may be widely adopted and implemented as quality assurance measures. The tool is based on measurable parameters and indicators that can effectively present strengths and weaknesses in managing a response to a public health threat, and accordingly, steps can be implemented to improve readiness. Adoption of such a tool is an important component of assuring public health and effective emergency management.

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Improving Hospital Mass Casualty Preparedness Through Ongoing Readiness Evaluation

Cited by 18 publications

References 17 publications

Maintaining Preparedness to Severe Though Infrequent Threats—Can It Be Done?

Maintaining Preparedness to Severe Though Infrequent Threats—Can It Be Done?

Monitoring and evaluation of disaster response efforts undertaken by local health departments: a rapid realist review

Continued Vigilance â€“ Development of an Online Evaluation Tool for Assessing Preparedness of Medical Facilities for Biological Events

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