Collaboration Exercises in Emergency Work : Outcomes in Terms of Learning and Usefulness (original) (raw)
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Outcome of collaborative emergency exercises: Differences between full‐scale and tabletop exercises
Journal of Contingencies and Crisis Management, 2020
The degree to which exercises improve the collaboration among different organisations during an emergency is under debate. This study aims to contribute to the scarce research on this topic by giving insight into the perceived effects of exercises on collaboration, learning, usefulness, and interorganisational trust. In particular, this quantitative study looked into the differences between the effects of tabletop and full-scale exercises. A questionnaire assessing collaboration, learning, usefulness, and trust-the CLUT instrument-was developed. Data were collected from 173 fulltime emergency management personnel in Norway and Canada. Usefulness, learning, and collaboration outcomes were perceived to be high for both types of exercises, but full-scale exercises were perceived to have greater learning and usefulness outcomes than tabletop exercises. Stronger relationships were identified between the perceived effects on learning and usefulness, collaboration, and trust in tabletop compared to full-scale exercise, whereas the relationship between the perceived effects upon collaboration and trust was stronger in full-scale exercises. Multiple regression analysis showed that the variables used to measure exercise usefulness can better predict tabletop exercise outcomes.
Collaboration Exercises—The Lack of Collaborative Benefits
International Journal of Disaster Risk Science, 2014
The purpose of this article is to analyze what professional emergency personnel learn during collaboration exercises and the benefits of what they have learned. Observations (n = 19) and semistructured interviews (n = 32) were carried out in conjunction with major exercises held in Sweden (2007-2012). The results show that exercises tend to be based on their own logic, which differs from actual events. Exercise participants believe that they mainly learn single-track, parallel, and pathdependent behavior. The exercises do not facilitate the use of cross-boundary activities. This means that learning, as well as benefits from the exercises for actual events, is limited. The exercises would be more appropriate if those participating had the opportunity to identify weaknesses, try alternative ways, and engage in comprehensive organizational analyses at the conclusion of the exercises. Based on the results of the study, alternative models for collaboration exercises are suggested, with elements that would better develop collaboration and contribute to learning.
When it matters most: Collaboration between first responders in incidents and exercises
Journal of Contingencies and Crisis Management
Inter-organizational collaboration is increasingly a topic for studies into accidents and disasters as well as exercises. In this study, which is based on interviews with first responders, we compared perceived collaboration during an exercise with crisis work. The three organizations included in this study-fire department, police and ambulance services-perceived the investigated tunnel exercise completely different, ranging from harmonious interaction to power struggles between commanding officers, fragmented decision-making and ambiguity. When comparing the exercise with an incident, we found that collaboration was more evident during incidents than in exercises. However, collaboration exercises appear to improve inter-organizational collaboration by stimulating informal structures, practicing listening and delegating, getting to know one another and learning a common language.
Disaster Collaborative Exercises for Healthcare Teamwork in a Saudi Context
International Journal of Disaster Risk Science
This study aimed to evaluate the development of healthcare teamwork during and after the collaboration tabletop exercises, through observation and interview methods. Integration and maturity theoretical models were employed to explain the collaborative challenges in teams that may suffer from unequally distributed power, hierarchies, and fragmentation. Using three-level collaboration tabletop exercises and the Command and control, Safety, Communication, Assessment, Treatment, Triage, Transport (CSCATTT) instrument, 100 healthcare workers were observed during each step in the implementation of the CSCATTT instrument using two simulated scenarios. The results show a lack of integration and team maturity among participants in the first scenario, leading to the delayed start of the activity, task distribution, and decision making. These shortcomings were improved in the second scenario. In-depth interviews with 20 participants in the second phase of the study revealed improved knowledge...
New collaborations in daily emergency response
International Journal of Emergency Services, 2015
Purpose – The purpose of this paper is to analyse costs and benefits from new collaborations in daily emergency response and to demonstrate how cost-benefit analysis (CBA) can be used for evaluating effects from these kinds of collaborations. Design/methodology/approach – CBA is used to evaluate two collaborations. The cases are: security officers that respond to fire and rescue service (FRS) calls; and home care nurses that assist the FRSs when they respond to urgent medical calls. Interviews, public documents and incident reports have been used as sources of data. Findings – Most costs are relatively straightforward to estimate. More difficult to estimate are the turn-out costs, including the services that cannot be performed when the new actors take on new assignments. One important benefit from these kinds of collaborations is reduced response time. Other benefits include increased situational awareness and improved preventive work in Case 1, as well as improved working conditio...
Health Services Research, 2002
Objective. To evaluate the effectiveness of training and institutionalizing teamwork behaviors, drawn from aviation crew resource management (CRM) programs, on emergency department (ED) staff organized into caregiver teams. Study Setting. Nine teaching and community hospital EDs. Study Design. A prospective multicenter evaluation using a quasi-experimental, untreated control group design with one pretest and two posttests of the Emergency Team Coordination Course TM (ETCC). The experimental group, comprised of 684 physicians, nurses, and technicians, received the ETCC and implemented formal teamwork structures and processes. Assessments occurred prior to training, and at intervals of four and eight months after training. Three outcome constructs were evaluated: team behavior, ED performance, and attitudes and opinions. Trained observers rated ED staff team behaviors and made observations of clinical errors, a measure of ED performance. Staff and patients in the EDs completed surveys measuring attitudes and opinions. Data Collection. Hospital EDs were the units of analysis for the seven outcome measures. Prior to aggregating data at the hospital level, scale properties of surveys and event-related observations were evaluated at the respondent or case level. Principal Findings. A statistically significant improvement in quality of team behaviors was shown between the experimental and control groups following training (p 5 .012). Subjective workload was not affected by the intervention (p 5 .668). The clinical error rate significantly decreased from 30.9 percent to 4.4 percent in the experimental group (p 5 .039). In the experimental group, the ED staffs' attitudes toward teamwork increased (p 5 .047) and staff assessments of institutional support showed a significant increase (p 5 .040). Conclusion. Our findings point to the effectiveness of formal teamwork training for improving team behaviors, reducing errors, and improving staff attitudes among the ETCC-trained hospitals.
Assessment of interprofessional collaboration before and after a simulated disaster drill experience
Nurse Education Today, 2019
Introduction: With increasing acuity, patient care requires a collaborative approach by a team of providers. Recent literature indicates healthcare professionals lack the ability to work in collaboration with other healthcare professionals resulting from communication and collaborative practice gaps. Background/Literature: Disasters require a rich collaboration of teams in order to be effective. As a result, interprofessional collaboration is a foundational underpinning of disaster preparedness. The overall purpose of this study was to assess perceptions of interprofessional collaboration before and after participating in an interprofessional simulated disaster drill as part of a Community Health Nursing course. Methods: This pre-test, post-test descriptive research design assessed communication, collaboration, roles/responsibilities, patient focus, team functioning and conflict management of nursing students who participated in a simulated disaster drill. Data/Results: Participants were nursing majors and primarily Caucasian females (n = 50, 89% and n = 56, 97% respectively), representative of the school of nursing population at the University. Wilcoxon Signed-Ranks test indicated that scores for the total ICAR post-test were significantly lower than the Total ICAR pre-test (Z = −2.006, p = .045, r = −0.19). While each of the individual sections of the ICAR had a lower mean score on the ICAR post-test as compared to the pre-test, collaborative patient/client-family centered approach was statistically significant (p = 0,0.002). Discussion: Following the simulated disaster drill experience, nursing students identified gaps in communication, collaboration, roles and responsibilities, collaborative patient/client-family centered approach, team functioning, conflict management/resolution. Conclusions: The study assessed the perceptions of interprofessional collaboration among undergraduate nursing students before and after a simulated disaster drill. The assessment identified the need to integrate interprofessional competencies in disaster preparedness education.
Emergency Medicine Journal, 2007
To identify collaborative instances and hindrances and to produce a model of collaborative practice. Methods: A 12 month (2005-6) mixed methods clinical case study in a large UK ambulance trust. Collaboration was measured through direct observational ratings of communication skills, teamwork and leadership with 24 multiprofessional emergency care practitioners (ECPs); interviews with 45 ECPs and stakeholders; and an audit of 611 patients. Results: Quantitative observational ratings indicated that the higher the leadership rating the greater the communication ability (p(0.001) and teamwork (p(0.001), and the higher grade ECPs were rated more highly on their leadership performance. From the patient audit, influences and outputs of collaborative practice are revealed: mean time on scene was 47 mins; 62% were not conveyed; 38% were referred, mainly to accident and emergency; ECPs claimed to make the referral decision in 87% of cases with a successful referral in 96% of cases; and in 66% of cases ECPs claimed that their intervention prevented an acute trust admission. The qualitative interview findings, final collaborative model and recommendations are reported in another paper. Conclusions: The collaborative performance of ECPs varies, but the ECPs' role does appear to have an impact on collaborative practices and patient care. Final recommendations are reported with the qualitative results elsewhere.