Quality control in disaster medicine training—Initial regional medical command and control as an example

Abstract

Objective: The aim of this study was to show the possibility to identify what decisions in the initial regional medical command and control (IRMCC) that have to be improved.Design: This was a prospective, observational study conducted during nine similar educational programs for regional and hospital medical command and control in major incidents and disasters. Eighteen management groups were evaluated during 18 standardized simulation exercises.Main Outcome Measure: More detailed and quantitative evaluation methods for systematic evaluation within disaster medicine have been asked for. The hypothesis was that measurable performance indicators can create comparable results and identify weak and strong areas of performance in disaster management education and training.Methods: Evaluation of each exercise was made with a set of 11 measurable performance indicators for IRMCC. The results of each indicator were scored 0, 1, or 2 according to the performance of each management group.Results: The average of the total score for IRMCC was 14.05 of 22. The two best scored performance indicators, No 1 “declaring major incident” and No 2 “deciding on level of preparedness for staff,” differed significantly from the two lowest scoring performance indicators, No 7 “first information to media” and No 8 “formulate general guidelines for response.”Conclusion: The study demonstrated that decisions such as “formulating guidelines for response” and “first information to media” were areas in initial medical command and control that need to be improved. This method can serve as a quality control tool in disaster management education programs.

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

“…In simulation exercises, this type of strategic decision making has also been shown to be one aspect of regional management that needs to be improved [20]. However, such a plan might have been considered but was not recorded in the log file.…”

Hospital incident command system (HICS) performance in Iran; decision making during disasters

“…Also, no generally accepted methodology exists for the evaluation of HICS or hospital-based exercises [21]. The evaluation of performance in disaster management is a topic of great interest [22,23]. Performance is a measure of how well an activity is done and can be measured in terms of accuracy, time, and quality [24,25].…”

Studying distributed cognition of simulation-based team training with DiCoT

“…ETS has been used to train people in major civil incident doctrines 1 , preparedness, triage, patient management, command and control, coordination/liaisons and medical surge capacity (Heléne Nilsson et al 2013;Heléne Nilsson, Vikström, and Rüter 2010;Rådestad et al 2012). ETS is used to train and to evaluate different aspect of emergency medicine such as response and surge capacity.…”