Precision Augmentation of Medical Surge Capacity for Disaster Response

Design and validation of a preparedness evaluation tool of pre-hospital emergency medical services for terrorist attacks: a mixed method study

INTRODUCTION

Terrorist attacks are one of the human problems that affect many countries, leaving behind a huge toll of disabilities and deaths. The aim of this study was to use a mixed-method analysis to design and validate an evaluation tool for pre-hospital emergency medical services for terrorist attacks.

METHODS

The present study is a mixed-method (qualitative and quantitative) study that was conducted in two phases. In the qualitative phase (item generation), semi-structured interviews were conducted with 34 Iranian emergency medical technicians who were selected through a purposive sampling method and a scoping literature review was conducted to generate an item pool for the preparedness evaluation of Emergency Medical Services (EMS) in terrorist attacks. In the quantitative phase (item reduction), for validity of tool face, content and construct validity, were performed; for tool reliability, the test and retest and intra-class correlation coefficient were evaluated.

RESULTS

At the first stage, 7 main categories and 16 subcategories were extracted from the data, the main categories including "Policy and Planning", "Education and Exercise "," Surge Capacity", "Safety and Security", "Command, Control and Coordination", "Information and Communication Management "and "Response Operations Management". The initial item pool included 160 items that were reduced to 110 after assessment of validity (face, content and construct). intra-class correlation coefficient (ICC = 0.71) examination and Pearson correlation test (r = 0.81) indicated that the tool was also reliable.

CONCLUSION

The research findings provide a new perspective to understand the preparedness of pre-hospital emergency medical services for terrorist attacks. The existing 110-item tool can evaluate preparedness of pre-hospital emergency medical services for terrorist attacks through collecting data with appropriate validity and reliability.

Evaluating Nursing Staff Perception of Hospital Readiness for Continuity of Essential Health Care Services and Surge Capacity in Line With COVID-19

OBJECTIVE

To evaluate nursing staff' perception of hospital readiness for continuity of essential health care services and surge capacity in line with COVID-19.

METHODS

A total of 300 nurses were recruited from one hospital in Saudi Arabia. They completed self-administered, online questionnaires. The questionnaire assessed participants' socio-demographic data and their perceptions regarding hospital readiness for continuity of essential health care services and surge capacity in line with COVID-19.

RESULTS

The findings revealed that nursing staff had a moderate mean score regarding hospital readiness for continuity of health care services (3.89 ± 0.61) and an average mean value regarding surge capacity of 3.83 ± 0.63. Also, the value of R2 of surge capacity in healthcare can predict 82.9% of the variance in hospital readiness for continuity of health care services in terms of surge capacity.

CONCLUSION

Hospital administrators could propose hospital regulations and protocols for the management of confirmed and suspected COVID-19 patients in addition to designing a continuing education program for health professionals at all levels related to prevention, control, and management of COVID-19 suspected and confirmed patients.

The Energy of Finance in Refining of Medical Surge Capacity

The availability of resources and their concentration in the place of greatest need, will not allow us to successfully overcome a medical surge without the energy required to activate these resources and activities, and increase their quantities if necessary, that is why the staff and management of healthcare institutions are forced to making ethical crisis decisions about who wins and who loses. This study highlights the versatility of the concept of ‘energy’ by attributing it to money or financial resources, which are highly essential in dealing with surges as the healthcare system adopts the appropriate capacity level. This study considers the means (space, staff, supplies, and specific resources) at the disposal of healthcare institutions for the control of diseases as economic resources to identify ways for enhancing their capacity, especially during periods of medical surges such as that caused by the coronavirus disease (COVID-19). The medical resources are dependent on ‘energy’, albeit not in the strictest sense of the term. The article, thus, points out that while limited resources are the norm in economic theory, a medical surge provides an opportunity to sufficiently extend the resources within the health system capacity through increased funding.