To support learning, evaluations of crisis management efforts must be effective and lead to actionable recommendations that are implemented. However, little is known regarding what approaches are currently employed to evaluate crisis management efforts, the degree of implementation of recommendations, or if certain approaches are associated with a higher degree of implementation. This study explored these areas by analysing 24 evaluation reports from a Swedish regional public healthcare organisation and examining the implementation status of the presented recommendations.

The analysis of the evaluation reports showed that evaluations can be improved in terms of methodology and presentation, for example, by providing arguments for methodological choices and more clearly stating the purpose of evaluations.

A focus group categorised all 202 recommendations from the analysed evaluation reports to assess their implementation. The results showed that 28 % of the recommendations had been implemented with a clear connection to a specific evaluation, while 45 % were implemented with an unclear connection. Only 12 % were categorised as unimplemented, and 15 % were categorised as unknown. This suggests that evaluations of crisis management efforts have an impact. However, questions regarding their direct impact remain, given that most recommendations were categorised as implemented with unclear connections to specific evaluations.

Combining the results from the analysis of the evaluation reports with the categorisations by the focus group showed that including stakeholders in evaluations and providing arguments for why recommendations should be implemented can increase the direct impact of evaluations of crisis management efforts.

Introduction:

The Covid-19 pandemic strained most of the world’s health care organizations to, and sometimes beyond, their limits. To anticipate, coordinate, mobilize, and prioritize hospital resources, Sweden’s health care regions established regional medical command and control teams according to the medical major incident structure. This command structure was initially developed based on an all-hazards approach focused primarily on sudden mass casualty incidents with a relatively short time frame. Covid-19 management was active for several months with a most intense operations period during the spring of 2020. This study aimed at identifying competence needs by employing a co-creative approach with members of the staff involved in the pandemic management.

Method:

Data was collected and analyzed using a modified Delphi consensus method. The respondents were subject matter experts serving in the regional medical command and control teams during the COVID-19 pandemic. One workshop was held to gather opinions, which were included as statements in a consensus survey and answered by the participants after the first workshop. A second workshop was held to discuss statements that did not reach initial consensus in the survey and establish final consensus.

Results:

The consensus agreed statements were sorted into five themes, which constituted the collective agreement of medical command and control core abilities. The five core competence themes were: Situation report, Team organization, Co-operation, Competence management, and Analysis. The consensus agreed statements highlighted competencies needed for creating situation reports, organizing medical command and control teams, effective cross-organization co-operation, decision-making, and medical intelligence analysis.

Conclusion:

The core competencies of medical command and control identified in the present study can be used to further affirm current learning objectives and to formulate future learning objectives for education and exercises. The evaluation approach could potentially be used as a post-incident review to fine-tune an organization’s training plan.

This paper presents an ethnographic study consisting of non-participatory observations of a Swedish regional medical command and control team during their crisis response to the COVID-19 pandemic. The field-notes from the observations were analyzed using a deductive content analysis with categories representing teamwork processes. The content analysis showed that the studied regional medical command and control team was engaged in all but one of the predefined teamwork processes. Furthermore, the content analysis also added to the understanding of the regional medical command and control teamÂ’s work procedures by emphasizing how the team was engaged in the different processes. Lastly, the content analysis also made it possible to identify potential developmental needs of the studied regional medical command and control team.

Introduction:The Covid-19 pandemic strained health care organizations to their limits, and sometimes beyond. Different countries took different approaches to minimize the effects of the pandemic, both to protect public health and to safeguard the capability of the health care system.

A collaborative project between Sweden and Bosnia-Hercegovina with the aim to share and learn from experiences of managing the COVID-19 pandemic from a medical command and control perspective, initiated in 2021.

The project departed from three theoretical stances: sociotechnical systems perspective, experiential learning theory, and organizational learning theory. Framing the problem using a holistic systems approach, compared to focusing on individual experts, allows for understanding interactions on a system level. Hence, could these theories contribute to supporting individuals' learning and organizational change?

Method:A two-day workshop involving participants from both Swedish and Bosnian (N=21) medical command and control allowed for the exchange of experiences and another's perspective on similar challenges. During the workshop, two themes were addressed: common operational picture and evaluation. First, an introductory presentation was held, then the theme was discussed and reflected upon in small groups. After this, the groups presented their conclusions, and a full group discussion was moderated.

Results:The discussions resulted in participants sharing perspectives on the selected themes, providing personal insights and experience, allowing for deepened and increased understanding of the theme. In spite of major differences between the Swedish and the Bosnian health care systems and Covid-19 approaches, several shared conclusions were identified. For example, reflections on decision processes and strategies, as well as interest in improving the crisis organization.

Conclusion:Exposing participants to different views on well-known processes and challenges allows for reflecting, verbalizing, and reaching a deeper understanding. By displaying a culturally differently organized way of approaching the challenges the contrast is even more evident.

Planning, designing, facilitating, and evaluating are central activities for instructors when conducting exercises.When conducting these activities, instructors usually rely on past experiences since structured educations orguides for instructors do not exist. It is therefore evident that there is a need for such educations or guides.

In this study, the contents of a guide for instructors are proposed. The contents are based on seven semi-structuredinterviews with novel and experienced instructors, where they were asked to map their procedures for conductingexercises through a journey map. The interviews resulted in material which was transcribed and analysed using athematic analysis. The thematic analysis emphasized five themes to consider when acting as an instructor, namelyroles, realism, defining purpose and goals, learning, and planning and acting.

The results from the interviews, combined with past literature, resulted in proposed contents for an instructor’sguide which is currently being developed.

Introduktion

Mellan den 13:e och 15:e september 2022 anordnades övning Giron 2022 i Kiruna. Ett av målen med övningen var att den skulle kunna visa på ett övningskoncept som med regionala anpassningar kan användas för att öka takten inom utvecklingen av den civila beredskapen i Sverige. För att undersöka eventuella utvecklingsbehov kopplat till övningskonceptet utvärderades konceptet med fokus på övningsplaneringen och -genomförandet.

Metod

Vid utvärderingen användes en konsensusorienterad metod bestående av två workshops och en enkät däremellan. Under den första workshopen ombads de 27 deltagarna anteckna utvecklingsförslag baserat på lärdomar från övningsplaneringen och -genomförandet.

Utifrån deltagarnas anteckningar skapades en enkät med 55 påståenden. Denna enkät skickades till de 49 individer som var inbjudna till den andra workshopen. I enkäten ombads de 37 respondenterna besvara varje påstående på skalan ett till nio, där ett motsvarade instämmer inte alls och nio instämmer fullständigt. Enkätsvaren användes för att beräkna huruvida påståendena nådde konsensus, vilket antingen kunde vara för att behålla eller för att förkasta.

De påståenden som inte nådde konsensus i enkäten omformulerades inför den andra workshopen. Under detta tillfälle diskuterade de 32 deltagarna dessa påståenden, följt av en separat omröstning för varje påstående enligt samma metodik som i enkäten. Svaren från omröstningen användes för att beräkna konsensus likt enkätsvaren.

Resultat

De påståenden som nådde konsensus från enkäten och den andra workshopen delades in i sex teman och presenterades i en konsensusskrift. De sex temana är: övningskonceptet generellt, planering, föreläsningar, syfte och mål, övningsupplägg och utvärdering.

Påståendena visar bland annat att övningskonceptet fortsatt ska användas och utvecklas, att övningars syfte i främsta hand bör vara att höja förmågor snarare än bibehålla förmågor, att det ska läggas ett stort fokus på beslutsfattande i framtida övningar och att tekniska hjälpmedel såsom Rakel, WIS och GIS ska användas under övningar. 

Slutsats

För att utveckla övningskonceptet bör övningsorganisatörer som planerar genomföra framtida liknande övningar utifrån övningskonceptet Giron 2022 använda konsensusskriften som riktlinje under övningsplaneringen och -genomförandet.

The COVID-19 pandemic has had a global impact om society. Different countries and organizations have chosen different approaches to manage this crisis. This paper aims to describes how public Swedish actors (county administrative boards, municipalities, and regional councils) evaluated their management of the COVID-19 pandemic. Also, the paper aims to suggest improvements for crisis management strategies. Applying a meta-evaluation approach to open reports from the public organizations means collecting evaluation reports, determining if they fit the inclusion criteria, and if so, include them in the analysis. Included reports were categorized and given points indicating different types of merits. In addition, a thematic analysis of conclusions was conducted. 110 evaluation reports from 98 different organizations are included in the analysis. The importance of evaluating, having a structure for data collection, analysis, and reporting is reflected in the quality of the reports. Four identified themes offer an understanding of areas in need for development among Swedish regional councils, municipalities, and county administrative boards.

This paper presents an analysis of situation reports used and created by a crisis management team within the Swedish healthcare sector during the early phase of the COVID-19 pandemic. The analysis was conducted through a deductive content analysis, where categories were identified based on the concepts of common operational pictures, sensemaking, and situation awareness. In the analysis, support for all identified categories was found. Based on the analysis and the concepts, future recommendations regarding what type of information that ought to be included in situation reports were created. These recommendations include, amongst others, the categories of consequences, how it is perceived by the public, objectives, status and implications of information, future scenarios, actions, resources, and work procedures.