Hospital incident command groups’ disaster medicine performance. A prospective study concerning decision-making and staff procedure skills during major incident simulations (original) (raw)
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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2020
Background Hospital incident command groups’ (HICG) performance may have a profound impact on hospital response to major incidents. Previous research has assessed hospital incident command group capacity as opposed to performance and factors associated to performance. The objective was to assess associations between decision-making and staff procedure skills of the hospital incident command group. Methods This was a prospective observational study using performance indicators to assess hospital incident command groups’ decision-making and performance. A total of six hospitals in Stockholm, Sweden, with their respective HICGs participated. Associations between decision-making skills and staff procedure skills during major incident simulations were assessed using measurable performance indicators. Results Decision-making skills are correlated to staff procedure skills and overall HICG performance. Proactive decision-making skills had significantly lower means than reactive decision-ma...
Hospital incident command system (HICS) performance in Iran; decision making during disasters
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2012
Background: Hospitals are cornerstones for health care in a community and must continue to function in the face of a disaster. The Hospital Incident Command System (HICS) is a method by which the hospital operates when an emergency is declared. Hospitals are often ill equipped to evaluate the strengths and vulnerabilities of their own management systems before the occurrence of an actual disaster. The main objective of this study was to measure the decision making performance according to HICS job actions sheets using tabletop exercises. Methods: This observational study was conducted between May 1st 2008 and August 31st 2009. Twenty three Iranian hospitals were included. A tabletop exercise was developed for each hospital which in turn was based on the highest probable risk. The job action sheets of the HICS were used as measurements of performance. Each indicator was considered as 1, 2 or 3 in accordance with the HICS. Fair performance was determined as < 40%; intermediate as 41-70%; high as 71-100% of the maximum score of 192. Descriptive statistics, T-test, and Univariate Analysis of Variance were used. Results: None of the participating hospitals had a hospital disaster management plan. The performance according to HICS was intermediate for 83% (n = 19) of the participating hospitals. No hospital had a high level of performance. The performance level for the individual sections was intermediate or fair, except for the logistic and finance sections which demonstrated a higher level of performance. The public hospitals had overall higher performances than university hospitals (P = 0.04). Conclusions: The decision making performance in the Iranian hospitals, as measured during table top exercises and using the indicators proposed by HICS was intermediate to poor. In addition, this study demonstrates that the HICS job action sheets can be used as a template for measuring the hospital response. Simulations can be used to assess preparedness, but the correlation with outcome remains to be studied.
Assessment of a Military Hospital’s Disaster Preparedness Using a Health Incident Command System
Trauma Monthly, 2016
Background: A hospital emergency incident command system is one of the most reliable and popular organizational methods for disaster and emergency management. Objectives: The aim of the present study was to assess the level of disaster preparedness in the emergency department and other selected units of a military hospital in Tehran. Methods: This cross-sectional study was conducted in 2013 and involved 97 medical staff members from various departments: emergency, management, discharge and transport, camp (security and staff), information and communication technology, training, reception, and human resources. Three instruments were used for data collection: a self-reported questionnaire, unit evaluation checklist, and maneuver evaluation checklist. Results: The overall mean score for the maneuver checklist was 55.5%. The mean (± standard deviation) score for the questionnaire was 42.02 ± 8.62. The unit evaluation checklist had a score of 165 from a total of 244 possible points and a mean percentage of 67.62%. After conducting the maneuver, the hospital staff was reported to have weak performance in evaluating and prioritizing patients for quick release and tracking their conditions. Conclusions: The present study shows that the selected hospital had a moderate level of preparedness, which is in line with the previous studies. It is recommended that future studies evaluate the effect of education on the disaster preparedness of hospital units.
Background: Hospitals as the essential health service providers should manage their performance during incidents and disasters. The Hospital Incident Command System (HICS) is helpful in this regard. The establishment of this system assists the hospital disaster risk management committee to get prepared in emergency situations. This study aimed to assess the effect of HICS establishment on preparedness of Police Hospitals in Tehran, Iran during disasters, under simulated conditions. Materials and Methods: This was a quasi-experimental interventional study. The study participants were 55 managers of Imam Sajjad and Vali Asr hospitals in Tehran selected by census method (23 from Imam Sajjad Hospital as the control group, and 32 from Vali Asr Hospital as the experimental group). The preparedness of hospitals was measured before the intervention using Hospital Preparedness Scale (HPS) designed by Khankeh (2012). After establishment of HICS in Vali Asr Hospital, the hospital managers received a 3-day training through incident scenario. After one month, their preparedness was measured again by HPS instrument. The collected data were analyzed in SPSS (Version 18) using descriptive statistics, Independent t test and Chi-square test. Results: Establishment of HICS significantly increased preparedness of hospitals in communications, continuity of vital services, manpower, and procurement and logistics areas. Conclusion: Establishment of HICS can improve the hospitals' preparedness at times of disasters in many aspects. It is suggested that similar studies be conducted in private and public hospitals with longer follow-up time.
Health in Emergencies & Disasters Quarterly
Background: Hospitals as the essential health service providers should manage their performance during incidents and disasters. The Hospital Incident Command System (HICS) is helpful in this regard. The establishment of this system assists the hospital disaster risk management committee to get prepared in emergency situations. This study aimed to assess the effect of HICS establishment on preparedness of Police Hospitals in Tehran, Iran during disasters, under simulated conditions. Materials and Methods: This was a quasi-experimental interventional study. The study participants were 55 managers of Imam Sajjad and Vali Asr hospitals in Tehran selected by census method (23 from Imam Sajjad Hospital as the control group, and 32 from Vali Asr Hospital as the experimental group). The preparedness of hospitals was measured before the intervention using Hospital Preparedness Scale (HPS) designed by Khankeh (2012). After establishment of HICS in Vali Asr Hospital, the hospital managers received a 3-day training through incident scenario. After one month, their preparedness was measured again by HPS instrument. The collected data were analyzed in SPSS (Version 18) using descriptive statistics, Independent t test and Chi-square test. Results: Establishment of HICS significantly increased preparedness of hospitals in communications, continuity of vital services, manpower, and procurement and logistics areas. Conclusion: Establishment of HICS can improve the hospitals' preparedness at times of disasters in many aspects. It is suggested that similar studies be conducted in private and public hospitals with longer follow-up time.
Principles of hospital disaster management: an integrated and multidisciplinary approach
B-ENT, 2016
Principles of hospital disaster management: an integrated and multidisciplinary approach. Hospitals play an important role during a disaster response, and are also at risk for internal incidents. We propose an integrated and multidisciplinary approach towards hospital disaster management and preparedness. In addition to response strategies, much attention is given to risk assessment and preparedness in the pre-incident phase and to business continuity planning (BCP) in the post-incident phase. It is essential to train key players and all personnel to understand the Hospital Incident Management System (HIMS) and to perform specific emergency procedures. All emergency procedures should be grounded in evidence-based practice resulting from essential disaster response research.
Abstract. Principles of hospital disaster management: an integrated and multidisciplinary approach. Hospitals play an important role during a disaster response, and are also at risk for internal incidents. We propose an integrated and multidisciplinary approach towards hospital disaster management and preparedness. In addition to response strategies, much attention is given to risk assessment and preparedness in the pre-incident phase and to business continuity planning (BCP) in the post-incident phase. It is essential to train key players and all personnel to understand the Hospital Incident Management System (HIMS) and to perform specific emergency procedures. All emergency procedures should be grounded in evidence-based practice resulting from essential disaster response research
The Incident Command System in Disasters: Evaluation Methods for a Hospital-based Exercise
Prehospital and Disaster Medicine, 2005
Objectives:No universally accepted methods for objective evaluation of the function of the Incident Command System (ICS) in disaster exercises currently exist. An ICS evaluation method for disaster simulations was derived and piloted.Methods:A comprehensive variable list for ICS function was created and four distinct ICS evaluation methods (quantitative and qualitative) were derived and piloted prospectively during an exercise. Delay times for key provider-victim interactions were recorded through a system of data collection using participant and observer-based instruments. Two different post exercise surveys (commanders, other participants) were used to assess knowledge and perceptions of assigned roles, organization, and communications. Direct observation by trained observers and a structured debriefing session also were employed.Results:A total of 45 volunteers participated in the exercise that included 20 mock victims. First, mean, and last victim delay times (from exercise init...
Strategies to Manage Disaster in the Emergency Department of A Multispeciality Hospital-A Study
Background of the study: A disaster may be a serious disruption ,occurring over a comparatively short time ,of the functioning of a community or a society involving widespread human ,material ,economic or environmental loss and impacts, which exceeds the power of the affected community or society to cope using its own resources. In a hospital there are two type of disaster can occur, external disaster and internal disaster, it can be natural as well as manmade disaster. When a disaster occur in a community, emergency department of each hospital plays a significant role on command and control, safe and security, surge capacity, continuity of essential services, human resources, logistics and supply management, post disaster recovery. Emergency preparedness program is the first step in preparing the hospital to respond effectively and quickly to emergencies that occur within the community or within the h ospital. Objective of the study: • To assess the disaster management plan in emergency department of selected hospital in related to National Disaster Management Authority • To analyze the preparedness about handling disaster among the staff in emergency department. • To report the gap and suggest corrective and preventive action for the analysis. Methodology: Cross sectional study was conducted in the Emergency department of a multi-speciality hospital in Mangalore, where a universal sampling technique was used to select the respondents. Predetermined questionnaire which was prepared with the guideline of NDMA, for managing disaster was administered to draw the information from all the staff working in the emergency department. The data analysis was descriptive, where demographic details of the respondents was collected in order to understand the profile of the respondents who presented the data. Result: Firstly, the awareness about the disaster management among the respondents was analysed. All of them also responded that there were standards, protocols, guidelines for the disaster preparedness and response. Conclusion: The present study was conducted in only one hospital, which showed the moderate preparedness to handle the mass disaster.