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Making Disaster Care Count: Consensus Formulation of Measures of Effectiveness for Natural Disaster Acute Phase Medical Response

  • Rajesh K. Daftary (a1) (a2), Andrea T. Cruz (a1), Erik J. Reaves (a3), Frederick M. Burkle (a4), Michael D. Christian (a5) (a6) (a7), Daniel B. Fagbuyi (a2), Andrew L. Garrett (a8), G. Bobby Kapur (a9) and Paul E. Sirbaugh (a1) (a10)...

Abstract

Introduction

No standard exists for provision of care following catastrophic natural disasters. Host nations, funders, and overseeing agencies need a method to identify the most effective interventions when allocating finite resources. Measures of effectiveness are real-time indicators that can be used to link early action with downstream impact.

Hypothesis

Group consensus methods can be used to develop measures of effectiveness detailing the major functions of post natural disaster acute phase medical response.

Methods

A review of peer-reviewed disaster response publications (2001-2011) identified potential measures describing domestic and international medical response. A steering committee comprised of six persons with publications pertaining to disaster response, and those serving in leadership capacity for a disaster response organization, was assembled. The committee determined which measures identified in the literature review had the best potential to gauge effectiveness during post-disaster acute-phase medical response. Using a modified Delphi technique, a second, larger group (Expert Panel) evaluated these measures and novel measures suggested (or “free-texted”) by participants for importance, validity, usability, and feasibility. After three iterations, the highest rated measures were selected.

Results

The literature review identified 397 measures. The steering committee approved 116 (29.2%) of these measures for advancement to the Delphi process. In Round 1, 25 (22%) measures attained >75% approval and, accompanied by 77 free-text measures, graduated to Round 2. There, 56 (50%) measures achieved >75% approval. In Round 3, 37 (66%) measures achieved median scores of 4 or higher (on a 5-point ordinal scale). These selected measures describe major aspects of disaster response, including: Evaluation, Treatment, Disposition, Public Health, and Team Logistics. Of participants from the Expert Panel, 24/39 (63%) completed all rounds. Thirty-three percent of these experts represented international agencies; 42% represented US government agencies.

Conclusion

Experts identified response measures that reflect major functions of an acute medical response. Measures of effectiveness facilitate real-time assessment of performance and can signal where practices should be improved to better aid community preparedness and response. These measures can promote unification of medical assistance, allow for comparison of responses, and bring accountability to post-disaster acute-phase medical care. This is the first consensus-developed reporting tool constructed using objective measures to describe the functions of acute phase disaster medical response. It should be evaluated by agencies providing medical response during the next major natural disaster.

DaftaryRK, CruzAT, ReavesEJ, BurkleFMJr, ChristianMD, FagbuyiDB, GarrettAL, KapurGB, SirbaughPE. Making Disaster Care Count: Consensus Formulation of Measures of Effectiveness for Natural Disaster Acute Phase Medical Response. Prehosp Disaster Med. 2014;29(5):1-7.

Copyright

Corresponding author

Correspondence: Rajesh K. Daftary, MD George Washington University School of Medicine Department of Pediatrics Division of Emergency Medicine 111 Michigan Ave, NW Washington, DC 20010 USA E-mail rajdaftary@gmail.com

References

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1. Poyzner M. World Disasters Timeline. 2013. www.mapreport.com/subtopics/d.html. Accessed August 21, 2012.
2.James, JJ, Subbarao, I, Lanier, WL. Improving the art and science of disaster medicine and public health preparedness. Mayo Clin Proc. 2008;83(5):559-562.
3.Rosborough, S. A tale of two responses: Haiti earthquake highlights the need for training in international disaster response. Disaster Med Public Health Prep. 2010;4(1):21-23.
4. Pavignani E, Colombo S. Analysing Disrupted Health Sectors: A Modular Manual. France: World Health Organization: Department of Recovery and Transition Programmes, Health Action in Crisis; 2009.
5.Reaves, EJ, Schor, KW, Burkle, FM Jr. Implementation of evidence-based humanitarian programs in military-led missions: part II. The impact assessment model. Disaster Med Public Health Prep. 2008;2(4):237-244.
6.Bradt, DA. Evidence-based decision-making (part II): applications in disaster relief operations. Prehosp Disaster Med. 2009;24(6):479-492.
7.Waller, SG, Ward, JB, Montalvo, M, Cunliffe, C, Beadling, C, Riley, K. A new paradigm for military humanitarian medical operations: mission-generic metrics. Mil Med. 2011;176(8):845-851.
8.Stratton, SJ. The Utstein-style template for uniform data reporting of acute medical response in disasters. Prehosp Disaster Med. 2012;27(3):219.
9.Bradt, DA, Aitken, P. Disaster medicine reporting: the need for new guidelines and the CONFIDE statement. Emerg Med Australas. 2010;22(6):483-487.
10.Ciottone, G (ed). Disaster Medicine. 3rd ed. Philadelphia, Pennsylvania USA: Elsevier; 2006.
11.The Sphere Project. Humanitarian Charter and Minimum Standards in Humanitarian Response. 3rd ed. Northampton, United Kingdom: The Sphere Project; 2011.
12.Bradt, DA, Drummond, CM. Rapid epidemiological assessment of health status in displaced populations--an evolution toward standardized minimum, essential data sets. Prehosp Disaster Med. 2003;18(1):178-185.
13.Debacker, M, Hubloue, I, Dhondt, E, et al. Utstein-style template for uniform data reporting of acute medical response in disasters. PLoS Curr. 2012;4:e4f6cf3e8df15a.
14.Leiba, A, Schwartz, D, Eran, T, et al. DISAST-CIR: disastrous incidents systematic analysis through components, interactions and results: application to a large-scale train accident. J Emerg Med. 2009;37(1):46-50.
15.Fink, A, Kosecoff, J, Chassin, M, Brook, RH. Consensus methods: characteristics and guidelines for use. Am J Public Health. 1984;74(9):979-983.
16.Chan, JL, Burkle, FM Jr. A framework and methodology for navigating disaster and global health in crisis literature. PLoS Curr. 2013;5:10.1371/currents.dis.9af6948e381dafdd3e877c441527cba0.
17.Kelen, G, Sauer, LM. Trend analysis of disaster health articles in peer-reviewed publications pre- and post-9/11. Am J Disaster Med. 2008;3(6):369-376.
18.Hsu, C, Sandford, B. The Delphi technique: making sense of consensus. PARE. 2007;12(10):1.
19.Powell, C. The Delphi technique: myths and realities. J Adv Nurs. 2003;41(4):376-382.
20. National Quality Forum. Measure Evaluation Criteria. 2012. http://www.qualityforum.org/docs/measure_evaluation_criteria.aspx. Accessed May 28, 2013.
21.Williams, PL, Webb, C. The Delphi technique: a methodological discussion. J Adv Nurs. 1994;19(1):180-186.
22.Jones, J, Hunter, D. Consensus methods for medical and health services research. BMJ. 1995;311(7001):376-380.

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Making Disaster Care Count: Consensus Formulation of Measures of Effectiveness for Natural Disaster Acute Phase Medical Response

  • Rajesh K. Daftary (a1) (a2), Andrea T. Cruz (a1), Erik J. Reaves (a3), Frederick M. Burkle (a4), Michael D. Christian (a5) (a6) (a7), Daniel B. Fagbuyi (a2), Andrew L. Garrett (a8), G. Bobby Kapur (a9) and Paul E. Sirbaugh (a1) (a10)...

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