Abstract:Atlanta-area hospitals participated in an innovative regional exercise that pushed facilities beyond traditional scopes of practice and brought together numerous health care community response partners. Using lessons learned from this exercise coupled with subsequent real-world events and training exercises, participants have significantly enhanced preparedness levels and increased the metropolitan region's medical surge capacity in the case of a multiple casualty disaster.
“…Benefits of MI simulation Improved understanding of roles in an MI 1,7,39 Improved understanding of MIRP 1,7 Familiarity with paradigm shift of managing resources to maximize survival 1,7,39,40 Identification of latent errors and systems safety issues 7,11,40,41 Identification of areas of improvement 7,11,40–42 Testing surge capacity from a resource perspective 11,40–42 Testing clinical tools for MI 2 …”
Section: Resultsmentioning
confidence: 99%
“…Areas of improvement identified by MI simulation Communication 7,11,40,41 Lack of working knowledge of MIRP 7,11,39–41 Staffing, and medical resources 7,11,40,41 Command structure 11 Lack of compatibility between prehospital and hospital teams, or between departments. 41 Improved security during events 39 Engagement with community partners and first responders 39,43 Documentation 7 Media strategy 9 …”
Major incidents are occurring in increasing frequency, and place significant stress on existing health-care systems. Simulation is often used to evaluate and improve the capacity of health systems to respond to these incidents, although this is difficult to evaluate. A scoping review was performed, searching 2 databases (PubMed, CINAHL) following PRISMA guidelines. The eligibility criteria included studies addressing whole hospital simulation, published in English after 2000, and interventional or observational research. Exclusion criteria included studies limited to single departments or prehospital conditions, pure computer modelling and dissimilar health systems to Australia. After exclusions, 11 relevant studies were included. These studies assessed various types of simulation, from tabletop exercises to multihospital events, with various outcome measures. The studies were highly heterogenous and assessed as representing variable levels of evidence. In general, all articles had positive conclusions with respect to the use of major incidence simulations. Several benefits were identified, and areas of improvement for the future were highlighted. Benefits included improved understanding of existing Major Incident Response Plans and familiarity with the necessary paradigm shifts of resource management in such events. However, overall this scoping review was unable to make definitive conclusions due to a low level of evidence and lack of validated evaluation.
“…Benefits of MI simulation Improved understanding of roles in an MI 1,7,39 Improved understanding of MIRP 1,7 Familiarity with paradigm shift of managing resources to maximize survival 1,7,39,40 Identification of latent errors and systems safety issues 7,11,40,41 Identification of areas of improvement 7,11,40–42 Testing surge capacity from a resource perspective 11,40–42 Testing clinical tools for MI 2 …”
Section: Resultsmentioning
confidence: 99%
“…Areas of improvement identified by MI simulation Communication 7,11,40,41 Lack of working knowledge of MIRP 7,11,39–41 Staffing, and medical resources 7,11,40,41 Command structure 11 Lack of compatibility between prehospital and hospital teams, or between departments. 41 Improved security during events 39 Engagement with community partners and first responders 39,43 Documentation 7 Media strategy 9 …”
Major incidents are occurring in increasing frequency, and place significant stress on existing health-care systems. Simulation is often used to evaluate and improve the capacity of health systems to respond to these incidents, although this is difficult to evaluate. A scoping review was performed, searching 2 databases (PubMed, CINAHL) following PRISMA guidelines. The eligibility criteria included studies addressing whole hospital simulation, published in English after 2000, and interventional or observational research. Exclusion criteria included studies limited to single departments or prehospital conditions, pure computer modelling and dissimilar health systems to Australia. After exclusions, 11 relevant studies were included. These studies assessed various types of simulation, from tabletop exercises to multihospital events, with various outcome measures. The studies were highly heterogenous and assessed as representing variable levels of evidence. In general, all articles had positive conclusions with respect to the use of major incidence simulations. Several benefits were identified, and areas of improvement for the future were highlighted. Benefits included improved understanding of existing Major Incident Response Plans and familiarity with the necessary paradigm shifts of resource management in such events. However, overall this scoping review was unable to make definitive conclusions due to a low level of evidence and lack of validated evaluation.
“…This Various studies on educational program development and prioritization during medical surge have been performed. [20][21][22][23][24] However, no single standardized program has been widely endorsed. If cultural and social circumstances are sufficiently mature, emergency care personnel have a high level of awareness of disaster preparedness, and a multidisciplinary communication system is well-organized, it would be effective to perform a training program with no-notice exercises, as Waxman reported.…”
Objective:
The purpose of this study was to investigate differences in the perception of disaster issues between disaster directors and general health care providers in Gyeonggi Province, South Korea.
Methods:
The Gyeonggi provincial committee distributed a survey to acute care facility personnel. Survey topics included awareness of general disaster issues, hospital preparedness, and training priorities. The questionnaire comprised multiple choices and items scored on a 10-point Likert scale. We analyzed the discrepancies and characteristics of the responses.
Results:
Completed surveys were returned from 43 (67%) of 64 directors and 145 (55.6%) of 261 health care providers. In the field of general awareness, the topic of how to triage in disaster response showed the greatest discrepancies. In the domain of hospital level disaster preparedness, individual opinions varied most within the topics of incident command, manual preparation. The responses to “accept additional patients in disaster situation” showed the biggest differences (> 21 versus 6~10).
Conclusions:
In this study, there were disaster topics with discrepancies and concordances in perception between disaster directors and general health care providers. The analysis would present baseline information for the development of better training programs for region-specific core competencies, knowledge, and skills required for the effective response.
“…113 During a regional full-scale simulation of release of 2 dangerous chemicals, security and decontamination were noted to require continued assessment. 114 Also, disaster debris can complicate response and recovery efforts and block access for emergency staff, including law enforcement. 115 Disaster waste also may pose a significant public health risk and its continued presence serves as a reminder of community hardship.…”
Funding and support: By JACEP Open policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have stated that no such relationships exist.
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