liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
Management of resources at major incidents and disasters in relation to patient outcome: A pilot study of an educational model
Linköping University, Department of Clinical and Experimental Medicine, Surgery. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Disaster Medicine and Traumatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Disaster Medicine and Traumatology.
2008 (English)In: European journal of emergency medicine, ISSN 0969-9546, E-ISSN 1473-5695, Vol. 15, no 3, 162-165 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND OBJECTIVES: Organizations involved in disaster response often have a defined operative level of management (command and control) that can take the overall decisions regarding the mobilization and distribution of resources and distribution of casualties. This level of management can be referred to as strategic management. The aim of this pilot study was to show the possibility, in simulation exercises, to relate decisions made regarding resources to patient outcome. METHODS: The simulation system used measures to determine if lifesaving interventions are performed in time or not in relation to patient outcome. Evaluation was made with sets of performance indicators as templates and all management groups were evaluated not only as to how the decisions were made (management skills), but also how staff work was performed (staff procedure skills). RESULTS: Owing to inadequate response and insufficient distribution of patients to hospitals, 11 'patients' died in the simulated incident, a fire at a football stand with subsequent collapse. The strategic level of management received 16 points out of a possible 22 according to a predesigned template of performance indicators. CONCLUSION: The pilot study demonstrated the possibility to, in simulation exercises, relate decisions made regarding resources to patient outcome. This training technique could possibly lead to increased knowledge in what decisions are crucial to make in an early phase to minimize mortality and morbidity. © 2008 Lippincott Williams & Wilkins, Inc.

Place, publisher, year, edition, pages
2008. Vol. 15, no 3, 162-165 p.
Keyword [en]
Bioterrorism Decision Making Disaster Planning/*methods Health Care Rationing Humans *Models, Educational Natural Disasters Pilot Projects *Quality Assurance, Health Care Sweden Triage
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-43451DOI: 10.1097/MEJ.0b013e3282f4d14bLocal ID: 73886OAI: diva2:264310
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2013-10-24Bibliographically approved
In thesis
1. Demand for Rapid and Accurate Regional Medical Response at Major Incidents
Open this publication in new window or tab >>Demand for Rapid and Accurate Regional Medical Response at Major Incidents
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The ultimate goal in major incidents is to optimize care for the greatest number of patients. This means matching patients with facilities that have the appropriate resources available in sufficient quantities to provide the necessary care. A major incident is a situation where the available resources are inadequate in relation to the urgent need. As health care resources have become increasingly constrained, it is imperative that all resources be optimized from a regional and sometimes a national perspective.

In Sweden, the number of major incidents per year is still unknown. In order to implement effective quality control of response to major incidents, specific standards for regional medical response need to be set and agreed on from a national perspective. This will probably also enhance follow-up and comparison of major incidents in the future.

The overall aim of this thesis is to improve understanding of the demand for rapid and accurate regional medical response at major incidents. The objectives were to systematically analyse specific decisions within regional medical response and to identify factors that can influence patient outcome in major incidents.

This research is based on four studies in which a set of 11 measurable performance indicators for initial regional medical command and control have been used as an evaluation instrument together with a simulation system where the assessment of each patient could be evaluated. The collection of data was made during several disaster management programs but also in real major incidents that occurred in two county councils in Sweden. In one of the studies, the national disaster medical response plan for burns was evaluated.

This research shows that measurable performance indicators for regional medical response allow standardized evaluation such that it is possible to find crucial decisions that can be related to patient outcome. The indicators can be applied to major incidents that directly or indirectly involve casualties provided there is sufficient documentation available and thereby could constitute a measurable part of regional and national follow-up of major incidents. Reproducible simulations of mass casualty events that combine process and outcome indicators can create important results on medical surge capability and may serve to support disaster planning.

The research also identified that there is a risk for delay in distribution of severely injured when many county councils needs to be involved due to different regional response times to major incidents. Furthermore, the coordination between health care and other authorities concerning ambulance helicopter transport in mass casualty events needs to be further addressed. It is concluded that there is a demand for rapid and accurate response to major incidents that is similar in all county councils. Like all other fields of medicine, these processes need to be quality assured.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2013. 98 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1350
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-86597 (URN)978‐91‐7519‐713‐5 (ISBN)
Public defence
2013-01-25, Aulan på Katastrofmedicinskt Centrum, Campus US, Linköpings universitet, Linköping, 13:00 (English)
Available from: 2012-12-19 Created: 2012-12-19 Last updated: 2013-10-24Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Nilsson, Helene
By organisation
SurgeryFaculty of Health SciencesDisaster Medicine and TraumatologyCenter for Disaster Medicine and Traumatology
In the same journal
European journal of emergency medicine
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 147 hits
ReferencesLink to record
Permanent link

Direct link