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Mahdi SS, Jafri HA, Allana R, Battineni G, Khawaja M, Sakina S, Agha D, Rehman K, Amenta F. Systematic review on the current state of disaster preparation Simulation Exercises (SimEx). BMC Emerg Med 2023; 23:52. [PMID: 37226121 PMCID: PMC10206538 DOI: 10.1186/s12873-023-00824-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 05/17/2023] [Indexed: 05/26/2023] Open
Abstract
INTRODUCTION The simulation exercise (SimEx) simulates an emergency in which an elaboration or description of the response is applied. The purpose of these exercises is to validate and improve plans, procedures, and systems for responding to all hazards. The purpose of this study was to review disaster preparation exercises conducted by various national, non-government, and academic institutions. METHODOLOGY Several databases, including PubMed (Medline), Cumulative Index to Nursing and Allied Health Literature (CINAHL), BioMed Central, and Google Scholar, were used to review the literature. Information was retrieved using Medical Subject Headings (MeSH) and documents were selected according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). To assess the quality of the selected articles, the Newcastle-Ottawa Scale (NOS) technique was utilized. RESULTS A total of 29 papers were selected for final review based on PRISMA guidelines and the NOS quality assessment. Studies have shown that many forms of SimEx commonly used in disaster management including tabletop exercises, functional exercises, and full-scale exercises have their benefits and limitations. There is no doubt that SimEx is an excellent tool for improving disaster planning and response. It is still necessary to give SimEx programs a more rigorous evaluation and to standardize the processes more thoroughly. CONCLUSIONS Drills and training can be improved for disaster management, which will enable medical professionals to face the challenges of disaster management in the 21st century.
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Affiliation(s)
- Syed Sarosh Mahdi
- Jinnah Medical and Dental College, Department of Community Dentistry, Sohail University, Karachi, Pakistan.
- Division of Clinical Oral Health Sciences, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.
| | - Hafsa Abrar Jafri
- Jinnah Medical and Dental College, Department of Community Dentistry, Sohail University, Karachi, Pakistan
| | - Raheel Allana
- Department of Paediatrics & Child Health, Aga Khan University Karachi, Karachi, 74800, Pakistan
| | - Gopi Battineni
- Clinical research centre, School of Medicinal and Health Products Sciences, University of Camerino, Camerino, 62032, Italy
| | - Mariam Khawaja
- Jinnah Medical and Dental College, Department of Community Dentistry, Sohail University, Karachi, Pakistan
| | - Syeda Sakina
- Sociology department, University of North Texas, Denton, TX76203, USA
| | - Daniyal Agha
- Jinnah Medical and Dental College, Department of Community Dentistry, Sohail University, Karachi, Pakistan
| | - Kiran Rehman
- Division of Restorative Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Francesco Amenta
- Clinical research centre, School of Medicinal and Health Products Sciences, University of Camerino, Camerino, 62032, Italy
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Schumacher L, Senhaji S, Gartner BA, Carrez L, Dupuis A, Bonnabry P, Widmer N. Full-scale simulations to improve disaster preparedness in hospital pharmacies. BMC Health Serv Res 2022; 22:853. [PMID: 35780151 PMCID: PMC9250711 DOI: 10.1186/s12913-022-08230-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 06/20/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose Assess whether full-scale simulation exercises improved hospital pharmacies’ disaster preparedness. Methods Swiss hospital pharmacies performed successive full-scale simulation exercises at least four months apart. An interprofessional team created two scenarios, each representing credible regional-scale disasters involving approximately fifty casualties (a major road accident and a terrorist attack). Four exercise assessors used appraisal forms to evaluate participants’ actions and responses during the simulation (rating them using five-point Likert scales). Results Four hospital pharmacies performed two full-scale simulation exercises each. Differences between exercises one and two were observed. On average, the four hospitals accomplished 69% ± 6% of the actions expected of them during exercise one. The mean rate of expected actions accomplished increased to 84% ± 7% (p < 0.005) during exercise two. Moreover, the average quality of actions improved from 3.0/5 to 3.6/5 (p = 0.01), and the time required to gather a crisis management team drastically decreased between simulations (from 23 to 5 min). The main challenges were communication (reformulation) and crisis management. Simulation exercise number one resulted in three hospital pharmacies creating disaster action plans and the fourth improving its already existing plan. Conclusion This study highlighted the value of carrying out full-scale disaster simulations for hospital pharmacies as they improved overall institutional preparedness and increased staff awareness. The number of expected actions accomplished increased significantly. In the future, large-scale studies and concept dissemination are warranted.
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Affiliation(s)
- Laurence Schumacher
- Specialised Centre for Emergency and Disaster Pharmacy, Institute of Pharmaceutical Sciences of Western Switzerland, School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland.,Pharmacy of the Eastern Vaud Hospitals, Rennaz, Switzerland
| | - Salim Senhaji
- Pharmacy, Geneva University Hospitals, Geneva, Switzerland
| | | | - Laurent Carrez
- Service of Pharmacy, Lausanne University Hospital, Lausanne, Switzerland
| | - Arnaud Dupuis
- Surgery Department, Geneva University Hospitals, Geneva, Switzerland.,Specialised Centre for War and Disaster Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Pascal Bonnabry
- Specialised Centre for Emergency and Disaster Pharmacy, Institute of Pharmaceutical Sciences of Western Switzerland, School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland.,Pharmacy, Geneva University Hospitals, Geneva, Switzerland
| | - Nicolas Widmer
- Specialised Centre for Emergency and Disaster Pharmacy, Institute of Pharmaceutical Sciences of Western Switzerland, School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland. .,Pharmacy of the Eastern Vaud Hospitals, Rennaz, Switzerland.
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3
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Williams BE, Kondo KK, Ayers CK, Kansagara D, Young S, Saha S. Preventing Unequal Health Outcomes in COVID-19: A Systematic Review of Past Interventions. Health Equity 2022; 5:856-871. [PMID: 35018320 PMCID: PMC8742307 DOI: 10.1089/heq.2021.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 11/12/2022] Open
Abstract
Background: We sought to identify interventions that reduced disparities in health outcomes in infectious disease outbreaks or natural disasters in the United States to understand whether these interventions could reduce health disparities in the current COVID-19 pandemic. Methods: We searched MEDLINE and other databases to May 2020 to find studies that examined interventions to mitigate health inequalities in previous infectious disease pandemics or disasters. We assessed study quality using the Newcastle-Ottawa Scale and the Critical Appraisal Skills Program (CASP) Checklist for Qualitative Studies. Results: We included 14 articles (12 studies) and 5 Centers for Disease Control (CDC) stakeholder meeting articles on pandemic influenza preparedness in marginalized populations. Studies called for intervention and engagement before pandemic or disaster onset. Several studies included interventions that could be adapted to COVID-19, including harnessing technology to reach disadvantaged populations, partnering with trusted community liaisons to deliver important messaging around disease mitigation, and using culturally specific communication methods and messages to best reach marginalized groups. Discussion: To our knowledge this is the first systematic review to examine interventions to mitigate health inequities during an infectious disease pandemic. However, given that we identified very few disparities-focused infectious disease intervention studies, we also included studies from the disaster response literature, which may not be as generalizable to the current context of COVID-19. Overall, community outreach and tailored communication are essential in disease mitigation. More research is needed to evaluate systemic interventions that target the distal determinants of poor health outcomes among marginalized populations during pandemics and natural disasters.
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Affiliation(s)
- Beth E Williams
- Primary Care, VA Portland Health Care System, Portland, Oregon, USA
| | - Karli K Kondo
- Evidence Synthesis Program, VA Portland Health Care System, Portland, Oregon, USA.,Research Integrity Office, Oregon Health and Science University, Portland, Oregon, USA
| | - Chelsea K Ayers
- Evidence Synthesis Program, VA Portland Health Care System, Portland, Oregon, USA
| | - Devan Kansagara
- Evidence Synthesis Program, VA Portland Health Care System, Portland, Oregon, USA.,Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon, USA
| | - Sarah Young
- Evidence Synthesis Program, VA Portland Health Care System, Portland, Oregon, USA
| | - Somnath Saha
- Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, Oregon, USA.,Division of General Internal Medicine, Oregon Health and Science University, Portland, Oregon, USA
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Developing Public Health Emergency Response Leaders in Incident Management: A Scoping Review of Educational Interventions. Disaster Med Public Health Prep 2021; 16:2149-2178. [PMID: 34462032 DOI: 10.1017/dmp.2021.164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
During emergency responses, public health leaders frequently serve in incident management roles that differ from their routine job functions. Leaders' familiarity with incident management principles and functions can influence response outcomes. Therefore, training and exercises in incident management are often required for public health leaders. To describe existing methods of incident management training and exercises in the literature, we queried 6 English language databases and found 786 relevant articles. Five themes emerged: (1) experiential learning as an established approach to foster engaging and interactive learning environments and optimize training design; (2) technology-aided decision support tools are increasingly common for crisis decision-making; (3) integration of leadership training in the education continuum is needed for developing public health response leaders; (4) equal emphasis on competency and character is needed for developing capable and adaptable leaders; and (5) consistent evaluation methodologies and metrics are needed to assess the effectiveness of educational interventions.These findings offer important strategic and practical considerations for improving the design and delivery of educational interventions to develop public health emergency response leaders. This review and ongoing real-world events could facilitate further exploration of current practices, emerging trends, and challenges for continuous improvements in developing public health emergency response leaders.
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Betka AA, Bergren MD, Rowen JL. Improving rural disaster response preparedness. Public Health Nurs 2021; 38:856-861. [PMID: 33999473 DOI: 10.1111/phn.12924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Disasters happen in all communities and negatively impact the health and safety of populations if not well managed. Rural health organizations face greater challenges when implementing emergency preparedness policies and need unique resources to help ensure the health of their communities. The purpose of this article is to describe the development and evaluation of an agricultural simulation scenario designed for rural health organizations. METHODS The agricultural disaster scenario was developed after determining the desired content domains. Forty students from nursing, medicine, public health, and social work participated in a functional simulation using the scenario. Outcomes were measured using a pre-post measurement with one cohort design. Data were analyzed using paired-samples t-tests. RESULTS Students reported a 30% increase in self-confidence, 38% increase in disaster competence, and 19% increase in interprofessional collaboration competence after the simulation. Statistically significant increases in student scores were noted on all surveys across professions. CONCLUSION The agricultural disaster simulation is a valid scenario to use for disaster preparation using emergency operations plans.
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Guo C, Sim T, Su G. Individual Disaster Preparedness in Drought-and-Flood-Prone Villages in Northwest China: Impact of Place, Out-Migration and Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041649. [PMID: 33572299 PMCID: PMC7916103 DOI: 10.3390/ijerph18041649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/30/2021] [Accepted: 02/04/2021] [Indexed: 11/21/2022]
Abstract
Rural communities are generally more vulnerable to natural hazards when compared to urban communities. Moreover, rural communities are diverse and unique in their place, population, agricultural production and culture, which make it challenging for different rural settings to prepare for disasters. There is a little comparison made about the individual disaster preparedness among rural communities with different geographic landforms. In this study, we examined the individual disaster preparedness of rural residents in three drought-and-flood-prone villages with different landforms (plains, loess plateau and mountains) via a cross-sectional self-report structured questionnaire survey conducted in Northwest China. We also adopted an ecological framework to examine the determinants of villagers’ individual disaster preparedness across different dimensions: place, individual sociodemographic factors, family socioeconomic status, hazard adaptations, community and neighbourhood influences. We found that place was a significant factor for disaster preparedness when controlling individual sociodemographic and family socioeconomic factors. The level of preparedness in the plains was higher than both mountains and plateau. Moreover, the villagers who had out-migrated to work reported a higher level of disaster preparedness than did local villagers. In addition, the community and neighbourhood played an important role in determining individual disaster preparedness. This research highlights the needs for tailored community-based disaster risk reduction programs to improve villagers’ knowledge and skills of disaster preparedness.
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Affiliation(s)
- Chunlan Guo
- World Health Organization Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hung Hum, Hong Kong, China
- Correspondence:
| | - Timothy Sim
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hum, Hong Kong, China;
- S R Nathan School of Human Development, Singapore University of Social Sciences, Singapore 599494, Singapore
| | - Guiwu Su
- Institute of Geology, China Earthquake Administration, Beijing 100029, China;
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Umoren RA, Gray MM, Handley S, Johnson N, Kunimura C, Mietzsch U, Billimoria Z, Lo MD. In-Hospital Telehealth Supports Care for Neonatal Patients in Strict Isolation. Am J Perinatol 2020; 37:857-860. [PMID: 32268382 PMCID: PMC7356060 DOI: 10.1055/s-0040-1709687] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study is to determine the feasibility of "in-hospital" inpatient telemedicine within a children's referral hospital to facilitate inpatient care activities such as interprofessional rounding and the provision of supportive services such as lactation consultations to pediatric patients in strict isolation. To test the feasibility of in-hospital video telemedicine, a dedicated telemedicine device was set up in the patient's room. This device and the accompanying Bluetooth stethoscope were used by the health care team located just outside the room for inpatient rounding and consultations from supportive services. Video telemedicine facilitated inpatient care and interactions with support services, reducing the number of health care providers with potential exposure to infection and decreasing personal protective equipment use. In the setting of strict isolation for highly infectious viral illness, telemedicine can be used for inpatient care activities such as interprofessional rounding and provision of supportive services. KEY POINTS: · Telehealth supports patient care in isolation.. · Telehealth reduced health care provider exposures.. · Telehealth conserves personal protective equipment..
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Affiliation(s)
- Rachel A. Umoren
- Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington,Department of Pediatrics, University of Washington, Seattle, Washington,Address for correspondence Rachel A. Umoren, MBBCh, MS Department of Pediatrics, Division of Neonatology1959 NE Pacific Street, Box 356320, Seattle, WA 98195
| | - Megan M. Gray
- Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington,Department of Pediatrics, University of Washington, Seattle, Washington
| | - Sarah Handley
- Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington,Department of Pediatrics, University of Washington, Seattle, Washington
| | - Nathaniel Johnson
- Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington
| | - Christina Kunimura
- Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington,Digital Health Innovation, Seattle Children's Hospital, Seattle, Washington
| | - Ulrike Mietzsch
- Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington,Department of Pediatrics, University of Washington, Seattle, Washington
| | - Zeenia Billimoria
- Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington,Department of Pediatrics, University of Washington, Seattle, Washington
| | - Mark D. Lo
- Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington,Department of Pediatrics, University of Washington, Seattle, Washington
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8
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Chou WK, Lin CH, Cheng MT, Chen YC, Shih FY. The Value of Functional Exercise in Pediatric Mass- Casualty Incident Training. J Acute Med 2019; 9:118-127. [PMID: 32995240 PMCID: PMC7440371 DOI: 10.6705/j.jacme.201909_9(3).0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Hospital staff in Taiwan practice mass casualty incident (MCI) management through full-scale exercise (FSE). However, FSE is generally resource-intensive and time-consuming. As an alternative, functional exercise (FE) may be more cost-effective with a similar effect in certain aspects. Hence, we aimed to evaluate the FE value in MCI training. We investigated whether FE can increase the familiarity of pediatric MCI response and the effect in different groups. METHODS A new emergency operation plan (EOP) of nontraumatic pediatric MCI was developed in 2018 for our Children's Hospital. An FE was conducted to assess the plan. In addition to the emergency department staff, head nurses, supervisors, and physicians of Children's Hospital also participated in the exercise. Pre- and post-exercise questionnaires were designed, and participants were asked to evaluate their familiarity with pediatric MCI response pre- and post-exercise. Participants' reading experience of the new EOP, previous training level, occupation position, and whether they were using a computer during the exercise were also noted in the questionnaires. Data were analyzed using paired t-test and Fisher's exact test. RESULTS Among 49 participants, 16 participants completed the pre- and post-exercise questionnaires. The post-exercise familiarity score was found to be significantly higher than that of pre-exercise (p < 0.05). There were no significant differences among the relationships between familiarity increase and participants' reading experience of the new EOP, previous training level, occupation position, and whether they were using a computer during the exercise. CONCLUSIONS FE can significantly increase the familiarity of the hospital staff with pediatric MCI response and may be applied as a new training method of hospital disaster preparedness.
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Affiliation(s)
- Wei-Kuo Chou
- National Taiwan University Hospital Department of Emergency Medicine No.7, Zhongshan S. Rd., Zhongzheng Dist. Taipei 100 Taiwan
| | - Chien-Hao Lin
- National Taiwan University Hospital Department of Emergency Medicine No.7, Zhongshan S. Rd., Zhongzheng Dist. Taipei 100 Taiwan
| | - Ming-Tai Cheng
- National Taiwan University Hospital Department of Emergency Medicine No.7, Zhongshan S. Rd., Zhongzheng Dist. Taipei 100 Taiwan
| | - Yun-Chang Chen
- National Taiwan University Hospital Department of Emergency Medicine No.7, Zhongshan S. Rd., Zhongzheng Dist. Taipei 100 Taiwan
| | - Fuh-Yuan Shih
- National Taiwan University Hospital Department of Emergency Medicine No.7, Zhongshan S. Rd., Zhongzheng Dist. Taipei 100 Taiwan
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Brandrud AS, Bretthauer M, Brattebø G, Pedersen MJ, Håpnes K, Møller K, Bjorge T, Nyen B, Strauman L, Schreiner A, Haldorsen GS, Bergli M, Nelson E, Morgan TS, Hjortdahl P. Local emergency medical response after a terrorist attack in Norway: a qualitative study. BMJ Qual Saf 2017; 26:806-816. [PMID: 28676492 DOI: 10.1136/bmjqs-2017-006517] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 04/24/2017] [Accepted: 04/30/2017] [Indexed: 11/03/2022]
Abstract
INTRODUCTION On 22 July 2011, Norway suffered a devastating terrorist attack targeting a political youth camp on a remote island. Within a few hours, 35 injured terrorist victims were admitted to the local Ringerike community hospital. All victims survived. The local emergency medical service (EMS), despite limited resources, was evaluated by three external bodies as successful in handling this crisis. This study investigates the determinants for the success of that EMS as a model for quality improvement in healthcare. METHODS We performed focus group interviews using the critical incident technique with 30 healthcare professionals involved in the care of the attack victims to establish determinants of the EMS' success. Two independent teams of professional experts classified and validated the identified determinants. RESULTS Our findings suggest a combination of four elements essential for the success of the EMS: (1) major emergency preparedness and competence based on continuous planning, training and learning; (2) crisis management based on knowledge, trust and data collection; (3) empowerment through multiprofessional networks; and (4) the ability to improvise based on acquired structure and competence. The informants reported the successful response was specifically based on multiprofessional trauma education, team training, and prehospital and in-hospital networking including mental healthcare. The powerful combination of preparedness, competence and crisis management built on empowerment enabled the healthcare workers to trust themselves and each other to make professional decisions and creative improvisations in an unpredictable situation. CONCLUSION The determinants for success derived from this qualitative study (preparedness, management, networking, ability to improvise) may be universally applicable to understanding the conditions for resilient and safe healthcare services, and of general interest for quality improvement in healthcare.
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Affiliation(s)
- Aleidis S Brandrud
- Quality Department, Vestre Viken HF, Drammen, Buskerud, Norway.,Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Michael Bretthauer
- Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Transplantation Medicine and K G Jebsen Center for Colorectal Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Guttorm Brattebø
- Norwegian National Advisory Unit on Trauma, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Department of Anaesthesia & Intensive Care, Haukeland University Hospital, Bergen, Norway
| | - May Jb Pedersen
- Department of General and Orthopedic Surgery, Obstetrics, Anaesthesia and Intensive Care, Ringerike Hospital, Vestre Viken HF, Drammen, Buskerud, Norway
| | - Kent Håpnes
- Division of Mental Health and Addiction, Ringerike DPS, Vestre Viken HF, Drammen, Buskerud, Norway
| | - Karin Møller
- Department of Medicine, Municipality of Ringerike, Honefoss, Buskerud, Norway
| | - Trond Bjorge
- Department of Pulmonary Diseases, Ostfold Hospital, Kalnes, Ostfold, Norway
| | - Bjørnar Nyen
- Department of Medicine, Municipality of Porsgrunn, Porsgrunn, Norway
| | - Lars Strauman
- Department of Medicine, Nordland Hospital, Lofoten, Nordland, Norway
| | - Ada Schreiner
- Norwegian Federation of Organizations of Disabled People, Oslo, Norway
| | - Gro S Haldorsen
- Department of Quality, Medicine and Patient Safety, South-Eastern Norway Regional Health Authority, Hamar, Norway
| | - Maria Bergli
- Quality Department, Vestre Viken HF, Drammen, Buskerud, Norway
| | - Eugene Nelson
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Tamara S Morgan
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Per Hjortdahl
- Department of Family Medicine, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
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Utilization of Functional Exercises to Build Regional Emergency Preparedness among Rural Health Organizations in the US. Prehosp Disaster Med 2017; 32:224-230. [DOI: 10.1017/s1049023x16001527] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractRural communities face barriers to disaster preparedness and considerable risk of disasters. Emergency preparedness among rural communities has improved with funding from federal programs and implementation of a National Incident Management System. The objective of this project was to design and implement disaster exercises to test decision making by rural response partners to improve regional planning, collaboration, and readiness. Six functional exercises were developed and conducted among three rural Nebraska (USA) regions by the Center for Preparedness Education (CPE) at the University of Nebraska Medical Center (Omaha, Nebraska USA). A total of 83 command centers participated. Six functional exercises were designed to test regional response and command-level decision making, and each 3-hour exercise was followed by a 3-hour regional after action conference. Participant feedback, single agency debriefing feedback, and regional After Action Reports were analyzed. Functional exercises were able to test command-level decision making and operations at multiple agencies simultaneously with limited funding. Observations included emergency management jurisdiction barriers to utilization of unified command and establishment of joint information centers, limited utilization of documentation necessary for reimbursement, and the need to develop coordinated public messaging. Functional exercises are a key tool for testing command-level decision making and response at a higher level than what is typically achieved in tabletop or short, full-scale exercises. Functional exercises enable evaluation of command staff, identification of areas for improvement, and advancing regional collaboration among diverse response partners.ObaidJM, BaileyG, WheelerH, MeyersL, MedcalfSJ, HansenKF, SangerKK, LoweJJ. Utilization of functional exercises to build regional emergency preparedness among rural health organizations in the US. Prehosp Disaster Med. 2017;32(2):224–230.
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