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Quality control in disaster medicine training: Initial regional medical command and control as an example
Linköping University, Department of Clinical and Experimental Medicine, Surgery. Linköping University, Faculty of Health Sciences.
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.
2010 (English)In: American journal of disaster medicine, ISSN 1932-149X, Vol. 5, no 1, 35-40 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Weston, MA, USA: Weston Medical Publishing, LLC , 2010. Vol. 5, no 1, 35-40 p.
Keyword [en]
performance indicators, disaster management, education, quality measurement
National Category
Engineering and Technology
Identifiers
URN: urn:nbn:se:liu:diva-57033PubMedID: 20349701OAI: oai:DiVA.org:liu-57033DiVA: diva2:324006
Available from: 2010-06-14 Created: 2010-06-09 Last updated: 2014-10-07
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.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1350
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-86597 (URN)9789175197135 (ISBN)
Public defence
2013-01-25, Aulan på Katastrofmedicinskt Centrum, Campus US, Linköpings universitet, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2012-12-19 Created: 2012-12-19 Last updated: 2017-12-14Bibliographically approved

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