Performance indicators for initial regional medical response to major incidents: a possible quality control tool

Nilsson, Heléne; Vikström, Tore; Jonson, Carl‐Oscar

doi:10.1186/1757-7241-20-81

Cited by 18 publications

(15 citation statements)

References 22 publications

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“…Conversely, proactive decisions based on estimations, e.g. the delivery of information pertinent to staff stamina, or estimating in uence on daily activities, were delayed or not made, consistent with a previous retrospective study assessing decision-making (11) . Of particular interest is the correlation between proactive decision-making indicators and staff procedure skills.…”

Section: Discussionsupporting

confidence: 84%

Hospital Incident Command Groups' Performance During Major Incident Simulations: A Prospective Observational Study.

Murphy

Kurland

Rådestad

et al. 2020

Preprint

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Background Hospital incident command groups’ (HICG) performance may have a profound impact on hospital response to major incidents. Previous research has assessed hospital incident command group capacity as opposed to performance and factors associated to performance. The objective was to assess associations between decision-making and staff procedure skills of the hospital incident command group.Methods This was a prospective observational study using performance indicators to assess hospital incident command groups’ decision-making and performance. A total of six hospitals in Stockholm, Sweden, with their respective HICGs participated. Associations between decision-making skills and staff procedure skills during major incident simulations were assessed using measurable performance indicators Results Decision-making skills are correlated to staff procedure skills and overall HICG performance. Proactive decision-making skills had significantly lower means than reactive decision-making skills and are significantly correlated to staff procedure skills.Conclusion There is a significant correlation between decision-making skills and staff procedural skills. Hospital incident command groups’ proactive decision-making abilities tended to be less developed than reactive decision-making abilities. These proactive decision-making skills may be a predictive factor for overall hospital incident command group performance. A lack of proactive decision-making ability may hamper efforts to mitigate the effects of a major incident.

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Section: Discussionsupporting

confidence: 84%

Hospital Incident Command Groups' Performance During Major Incident Simulations: A Prospective Observational Study.

Murphy

Kurland

Rådestad

et al. 2020

Preprint

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“…A vital component of the quality assurance process that should be emphasized is the assurance that the benchmarks that comprise the evaluation tool are available and accessible to the hospitals at all times. To date, despite the vital need to utilize validated and standard benchmarks for emergency preparedness of medical facilities, no global consensus has been reached concerning a specific tool that delineates indicators that are recommended for use [37,40,41]. Available and accessible evaluation indicators are still lacking in the healthcare emergency preparedness realm [10].…”

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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“…In the health care system, performance indicators are used in order to determine standards and measure quality to improve patient management. Performance indicators are addressed and implemented in the field of disaster medicine [63,126,127]. Preventable death is a performance indicator, defined as the proportion of all deaths judged to have been preventable if optimal care had been given.…”

Section: Trauma Care and Triage In Low-and Middle-income Countriesmentioning

confidence: 99%

“…However, qualitative research by using performance indicators is available and can be used to determine standards and measure quality to improve patient management. Performance indicators are addressed and implemented in the field of disaster medicine [63,126,127]. However, a significant limitation in research studies in the disaster medicine area is related to the lack of standards for collecting and reporting data [1].…”

Section: Scientific Approachmentioning

confidence: 99%

TRIAGE : Management of the trauma patient

Lampi¹

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Triage, derived from the French word for sorting, aims to assess and prioritize injured patients, regardless of whether the injuries are sustained from everyday road traffic accident with few injured or a mass casualty incident. Triage seeks to provide the greatest benefit to the largest number of casualties in order to minimize morbidity and mortality. Triage in a pre-hospital setting entails management and sorting of patients according to an assessment of medical need, prioritization, and evacuation. In-hospital triage aims to rapidly identify the most injured and ensure timely and appropriate treatment according to the patient's clinical urgency. A number of different systems for performing triage have been established and implemented globally. The methodology is recognized and utilized but there is still a need for an evidence-based strategy to optimize training and the efficacy of the different systems.The main aim of this thesis was to determine triage performance among prehospital personnel and investigate the potential advantage of a triage system for trauma patients. The papers included in this thesis evaluated the triage skills of physicians, pre-hospital personnel, and rescue services personnel by testing their performance before and after an educational intervention. The last paper evaluated potential benefits of using a triage system for trauma patients admitted to the emergency department at MOI Teaching and Referral Hospital in Eldoret, Kenya.The results presented in this thesis illustrate that triage skills are lacking among physicians. Experienced pre-hospital personnel are more skilled in performing triage than physicians. The triage skills of the rescue services personnel improved significantly after the educational intervention. Moreover, the potential benefit to trauma patients of implementing an in-hospital triage system in a resource-poor environment was shown. In conclusion, health care personnel, especially physicians without experience but highly involved in trauma patient management, seem to be in need of triage training. How to train, how to implement, and how to evaluate triage skills must be considered in order to develop effective training. POPULÄRVETENSKAPLIG SAMMANFATTNINGOrdet triage kommer från franskans "sortera" och är ett av det första stegen i omhändertagandet av skadade när det råder resursbrist. Från 1800-talets blodiga slagfält, till dagens skadeplats och akutmottagningar har sättet att triagera patienter utvecklats. Men då, som nu, är grundtanken den samma, att sortera och prioritera de skadade utifrån tillgängliga resurser och patienternas vårdbehov. Följaktligen har begreppet kommit att bli centralt inom ämnet katastrofmedicin. Att avlida till följd av skador i samband med allvarliga händelser men också skador i till exempel vardagstrafiken är ett globalt hälsoproblem. Tiden från olycka till sjukhusbehandling är en viktig och ofta avgörande överlevnadsfaktor för en patient. I det här sammanhanget talas det om "den gyllene timmen", som påvisar vikten av att få ...

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Performance indicators for initial regional medical response to major incidents: a possible quality control tool

Cited by 18 publications

References 22 publications

Hospital Incident Command Groups' Performance During Major Incident Simulations: A Prospective Observational Study.

Hospital Incident Command Groups' Performance During Major Incident Simulations: A Prospective Observational Study.

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

TRIAGE : Management of the trauma patient

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