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Performance indicators for major incident medical management: a possible tool for quality control?
Linköping University, Department of Biomedicine and Surgery. Linköping University, Faculty of Health Sciences.
Centre for Prehospital and Disaster Medicine, Göteborg, Sweden.
Centre for Teaching and Research in Disaster Medicine, Göteborg, Sweden.
2004 (English)In: International Journal of Disaster Medicine, ISSN 1503-1438 (print), 1651-3037 (online), Vol. 2, no 1-2, 52-55 p.Article in journal (Refereed) Published
Abstract [en]

Objective: The objective was to determine the outcome when applying a set of proposed performance indicators on previously published reports from major incidents.

Methods: A set of 20 different performance indicators were proposed. These indicators were applied to 13 reports from major incidents issued by the KAMEDO organization.

Results: The most frequently reported problems were command and control at the scene (11/13) followed by communication and command and control at the strategic level. In 25% of the published reports there was enough information available to apply the performance indicators, and in these the goal and/or objective was met in 67%.

Conclusion: Performance indicators for the medical management of major incidents and disaster can to a limited extent be applicable to retrospective studies. Performance indicators might be a tool for evaluating the medical response if reports are made with a different template. Further studies are needed in order to validate which indicators to use.

Place, publisher, year, edition, pages
2004. Vol. 2, no 1-2, 52-55 p.
Keyword [en]
control and command; objectives; goals; management; scene of accident; strategic level; KAMEDO reports
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-14197DOI: 10.1080/15031430410023355OAI: diva2:22883
Available from: 2007-01-04 Created: 2007-01-04
In thesis
1. Disaster medicine- performance indicators, information support and documentation: A study of an evaluation tool
Open this publication in new window or tab >>Disaster medicine- performance indicators, information support and documentation: A study of an evaluation tool
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The science of disaster medicine is more a descriptive than analytical type. Research, in most instances, has not employed quantitative methods and there is very sparse knowledge based on analytical statistics. One consequence of this is that similar mistakes are repeated over and over. Lessons that should be learned are merely observed.

Moreover, there are almost no practical or ethical ways in which randomised controlled studies can be performed.

The management, command and control of situations on different levels of hierarchy has eldom been evaluated and there have been no standards against which performance can be evaluated. Furthermore, the documentation of decisions and staff work is rarely sufficient enough to evaluate command and control functions.

Setting standards that may be used as templates for evaluation and research is an issue that is constantly being addressed by leading experts in the field of disaster medicine and this is also an important issue that is expressed in the Utstein Template.

Swedish National Board of Health and Welfare, templates of performance indicators were developed. These were tested on reports available from incidents, and our conclusion was that documentation in this form was not adequate enough for use in this method of evaluation.

Documentation must be improved and data probably need to be captured and stored with the help of information systems.

A template developed for the evaluation of medical command and control at the scene was tested in standardised examinations. When using this template in this setting it was possible to obtain specific information on those aspects of command and control that need to be improved.

An information system using on-line Internet technique was studied twice. The first study concluded that in spite of technical disturbances the system was acceptable to the organisation but could not yet be recommended for use during major incidents. The second study concluded that the retrieval of information was, in all respects not as good as the control system, a conventional ambulance file system.

In a study of staff procedure skills during training of management staffs in command and control it was concluded that documentation during training sessions was not adequate and this lack of staff procedure skills could possibly be a contributing factor to the fact that lessons in command and control are not learned from incidents.

Conclusions in thesis are that measurable performance indicators can be used in the training of command and control. If performance indicators are to be used in real incidents and disasters, functioning information systems have to be developed. This may lead to a better knowledge of command and control and could possibly contribute to a process where lessons are learned and mistakes are not repeated.

Place, publisher, year, edition, pages
Institutionen för biomedicin och kirurgi, 2006
Linköping University Medical Dissertations, ISSN 0345-0082 ; 972
disaster medicine, performance indicators, evaluation, information system, documentation, staff skills, command and control, management
National Category
Anesthesiology and Intensive Care
urn:nbn:se:liu:diva-7990 (URN)91-85643-55-6 (ISBN)
Public defence
2006-12-14, Aulan, Katastrofmedicinskt Centrum, Campus US, Linköpings Universitet, Linköping, 10:30 (English)
Available from: 2007-01-04 Created: 2007-01-04 Last updated: 2009-06-01

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