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RCHIS is an Electronic Medical Record (EMR) and Health Information System (HIS) that has been purpose built for use by Red Cross Red Crescent (RCRC) Emergency Response Units (ERUs), which are the equivalent of Type 1 (fixed and mobile) and Type 2 facilities in the Emergency Medical Teams (EMT) classification.
Objectives:
To share the main lessons learned from the pilot to inform development and implementation of similar systems in other EMTs.
Method/Description:
A three-day, in-person super user training was held with 13 participants: nine first aid volunteers, two nurses, and two medical doctors; seven delegates had experience using an EMR. These super users served as trainers for staff at the pilot.
The pilot occurred with the Portuguese Red Cross (PRC) for the Peregrinação de Fátima, where 200,000 people were in attendance. The PRC was part of a wider coordination cell with the civil defense authority, who required live reporting from the three clinics PRC had set up.
Results/Outcomes:
77 user accounts and 243 patient files were created during the four-day pilot.
The delegates shared feedback directly and through a survey. 88% stated that RCHIS was very easy to use with the majority of delegates requiring less than 30 minutes of training. 95% of delegates stated that they had sufficient training to use RCHIS to its full extent.
The civil defense authority was able to utilize the real-time reporting to assist in their operational response.
Conclusion:
The first RCHIS pilot was very successful from both a technical and organizational perspective.
Health emergencies such as the COVID-19 pandemic strain health systems and emergency response mechanisms. Identifying critical points during the response cycle where emergency workforce and operational capacity can be improved can help break the protracted nature of responses. Global health emergency workforce, or health emergency and alert response teams such as multidisciplinary Public Health Rapid Response Teams (RRTs) and Emergency Medical Teams (EMTs), play critical roles in the response to public health emergencies.
Objectives:
The project aims to explore and understand how countries manage and operationalize their RRT and EMT programs. With anecdotal evidence of countries integrating the two historically disparate groups, we propose to examine how countries are jointly or separately addressing legal frameworks and policies; management practices; reporting processes and protocols; training; as well as program operations and standards.
Method/Description:
Through existing global partnerships and networks, a convenience sample of national focal points responsible for the management of their RRT and EMT program are sent an online survey followed by participating in a one-on-one interview. Quantitative and qualitative analyses will be conducted.
Results/Outcomes:
Twelve countries representing all six World Health Organization regions with both RRT and EMT programs have been selected for engagement.
Conclusion:
Factors contributing to or against countries integration of RRT and EMT programs will be identified. Areas of divergence or synergy of plans and standard operating procedures will be mapped. Recommendations for strengthening global health emergency alert and response teams will be generated.
Thailand Emergency Medical Team (Thailand EMT) was verified by the WHO in 2019 as a Type 1 fixed EMT. The second wave of COVID-19 hit the country in December 2020. Samut Sakhon province was the center of the spread with many migrant workers infected. Several field hospitals were set up, one being situated in the compound of a Buddhist Temple, Wat Krok Krak. Thailand EMT was tasked in setting up and running the operation here in the initial phase.
Objectives:
To describe Thailand EMT’s experience in operating a COVID-19 field hospital.
Method/Description:
On December 30, 2020, 16 members of the Thailand EMT were deployed to the Wat Krok Krak Field Hospital. The team comprised of doctors, nurses, pharmacists, and emergency medical technicians who also functioned as logistic officers. Patients were admitted in groups every day. Physicians communicated with patients by using a telemedicine system to monitor patients clinically.
Results/Outcomes:
From December 31, 2020 through January 6, 2021, 143 COVID-19 patients were admitted. There were 104 female and 39 male patients. Patients were between 16 and 54 years of age, with a mean of 31.5 years. All were foreigner workers from nearby countries. Three patients had to be referred to a tertiary hospital. The rest of the patients were eventually discharged.
Conclusion:
Thailand EMT was able to adapt and deployed to operate a COVID-19 field hospital. Collaboration with relevant agencies and local authorities played a key role. This deployment, although within Thailand, was a good learning opportunity for the team to prepare for future operations.
The WHO EMT Minimum Data Set (EMT-MDS) was designed for data collection in sudden-onset disasters. Using EMT-MDS in the context of primary health care (PHC) generated large quantities of low granularity data that threatened the successful delivery of UK-Med’s clinical programs in Ukraine. Accordingly, UK-Med developed, piloted, and implemented a new coding tool (PHC-CT) tailored to PHC presentations prevalent in humanitarian settings.
Objectives:
To assess the performance of EMT-MDS and PHC-CT in the generation of programmatically-useful diagnostic codes from data collected in mobile PHC clinics in Ukraine during active conflict.
To compare the performance of EMT-MDS and PHC-CT in this setting and to suggest recommendations for data collection tool improvements.
Method/Description:
After multiple iterations, the final version of PHC-CT was used to collect clinical data from all UK-Med clinical encounters in Ukraine from March 28, 2022-May 13, 2022. Clinical data using EMT-MDS were collected simultaneously. The prevalence of each diagnostic code was calculated using both EMT-MDS and PHC-CT, expressed as a proportion of the total diagnoses, and compared between the two coding tools.
Results/Outcomes:
1,390 clinical encounters took place during the study. Data coded using EMT-MDS generated 1,756 diagnoses (86.8% of total diagnoses) categorized as “Other Diagnosis” while the same data coded using PHC-CT generated 37 diagnoses (1.8% of total diagnoses) categorized as “Other Diagnosis.” Only seven of the available 25 diagnostic codes in EMT-MDS were used, while 48 of the 67 available diagnostic codes in PHC-CT were used.
Conclusion:
PHC-CT offers substantial benefits beyond those provided by EMT-MDS when utilized in mobile PHC clinics in humanitarian settings.
Tables and Figures (optional)
Table 1.
Number of Clinical Encounters, Unique Diagnoses, and Frequency of Selected Diagnostic Codes for EMT-MDS and PHC-CT. (Note: % refers to proportion of diagnoses made)
WHO EMTs play an important role in providing assistance and health care services to countries hit by an emergency or a natural disaster. Therefore, EMTs are subjected to vastly different cultures from various countries, meaning they require training to cultural awareness, an understanding and acceptance of the languages, beliefs, cultures, and morals of those receiving care. The World Health Organization (WHO) has published minimum standards for Emergency Medical Teams (EMTs), which briefly mention that the senior EMT team member must have some knowledge of cultural awareness. However, there is no requirement for cultural awareness training for EMTs prior to responding to disasters.
Objectives:
The goal of this study is to determine the presence of cultural awareness training, and if present, what are the competencies covered by the training for the WHO EMTs.
Method/Description:
A survey will be distributed to Accredited WHO EMTs to capture the presence for cultural awareness training and the core competencies of the existing training.
Results/Outcomes:
Data expected to be collected and analyzed by October 1, 2022.
Conclusion:
Cultural awareness training is a crucial and beneficial skill for EMTs while deploying internationally. For WHO EMTs, it is essential to respond internationally in an accepted and ethical manner; cultural awareness training should be a requirement for all teams deploying to a foreign country. A cultural awareness curriculum will create more efficient EMTs that provide effective aid to countries in need.
Pacific Island Countries and Areas (PICs) represent some of the most logistically challenging locations, covering vast ocean territory and remote islands. Light, mobile clinical response capability is critical in the disaster-prone Pacific. Beginning in January 2021, WHO researched, tailored, and procured EMT cache “kits” specifically for Pacific Island contexts, based on the core standards of the global EMT initiative.
Objectives:
To research, tailor, and procure cache “kits” to ensure self-sufficiency and high-quality out-patient mobile medical care for national EMTs in PICs.
Method/Description:
WHO facilitated the development of national cache kits for 10 PICs EMTs. A need for specialized equipment and supplies or “cache” for team self-reliance is critical. Through a consultative process, including Pacific EMT leadership and team members, EMT mentors, and regional partners, WHO curated and procured cache kits for 10 PICs EMTs.
Results/Outcomes:
The Pacific EMT cache kit is designed for four-to-six-person teams with the capacity to deploy for a minimum of three days, with full self-sufficiency. Because of the complex and remote access to many Pacific Islands, EMT cache must be practical for transport on small aircrafts and maritime vessels. A consultative process resulted in a curated cache list for Pacific national EMTs of over 125 items, estimated to weigh approximately 440 kilograms per kit. By the end of 2022, a total 31 kits will be delivered to EMTs in ten countries.
Conclusion:
The design, development, and procurement of Pacific EMT cache for national response operations will allow for increased speed and agility for response to disasters and public health emergencies.
Moral distress is a well-described phenomenon in medical providers. It has been linked to mental health deterioration, decreased job satisfaction, and early retirement. No study has been done on the level of moral distress associated with treating patients in simultaneous disasters.
Objectives:
1. To learn what is known about the experience of moral distress in frontline health care providers during the COVID-19 pandemic and the concurrent conflict in Armenia during 2020.
2. To determine how WHO EMTs can support their frontline staff experiencing moral distress.
Method/Description:
A survey was designed to test the moral distress felt by Armenian EMS providers who had cared for both COVID-19 and war casualty patients. This was adapted from the Moral Distress Scale Revised (MDS-R).
Results/Outcomes:
Of the questions asked, respondents most often responded that they were disturbed by: “Continuing to participate in care for a hopelessly ill or injured person who is being sustained on a ventilator when no one will make a decision to withdraw support” (Mean 2.68/Median 3/Mode 4); and “Initiated extensive life-saving actions when I think they only prolong death” (2.47/3/3), which caused the next most distress to subjects.
Conclusion:
It is expected that some health care workers in Armenia are likely facing on-going consequences of the moral distress they faced during this unprecedented period of global pandemic and war. Clinics and teams who are more likely to encounter potentially morally distressing events, such as disaster medicine workers, need to address their moral distress mitigation plan by identifying strategies across the continuum of disaster management.
The COVID-19 pandemic resulted in multiple requests for EMT assistance in the Pacific Region. AUSMAT responded in six countries, sometimes simultaneously. The needs of the pandemic and the pressures on available resources to respond required development of innovative methods. One example is the “POP-O-MOP” tool.
Objectives:
Describe the evolution and utility of “POP-O-MOP” tool in building local capacity in Pacific health care systems facing COVID-19 outbreaks.
Method/Description:
The initial aim of the tool was to assist in maximizing the response by providing a concise, one-page teaching tool to assist in training of local nursing staff. As the tool evolved over successive COVID-19 deployments in the Pacific Region, the scope grew to include medical and allied health staff, and the content was refined.
While the “POP-O-MOP” mnemonic provides an aide-memoir for steps of COVID-19 care at the bedside; it also provided a structure for facilitating training and interdisciplinary discussion amongst clinicians.
Results/Outcomes:
By utilizing this structured training face-to-face, video, and online formats, the number of staff able to treat COVID-19 patients was increased, drawing on novices and staff from non-critical care backgrounds.
Of significance, it was observed that while the technical skills included improved health response, the confidence gained by local staff in the brief training increased their desire to contribute to the COVID-19 response by overcoming stigma, fear, and the sense of futility.
Conclusion:
The POP-O-MOP tool proved to be an effective tool to leverage in-country resources by providing effective just-in-time training for local health care workers.
A roundtable was hosted by the World Association for Disaster and Emergency Medicine (WADEM) World Congress to explore prehospital spinal immobilization (SI). The participants queried prehospital SI in resource-scarce environments (RSE), whether the disaster or humanitarian setting was applicable to the then recently released ILCOR statement, and identified challenges in maintaining appropriate application of SI in the prehospital RSE. A specific call was requested as an output of the roundtable for WADEM to provide guidance in this area of practice.
Objectives:
This systematic review informed a subsequent Delphi study to develop prehospital guidelines for SI in disaster and humanitarian settings.
Method/Description:
A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The review included English language papers published from January 2000 through July 2019.
Results/Outcomes:
The search strategy yielded a total of 1,029 references. After exclusion of duplicates, 919 titles were identified for further screening. After applying exclusion criteria, a total of 14 references underwent evaluation. The reviewed articles comprised six types of studies and represented research from institutions in ten different countries.
Conclusion:
There is a lack of high-level evidence on the utility or effect of spinal motion restriction or immobilization on patient outcomes in disasters. There is a need for robust research to determine the clinical benefit of spinal restriction or immobilization in disasters and across disaster types. This systematic review informed a subsequent Delphi study to develop recommendations and guidance for practice related to prehospital SI in disaster and humanitarian settings.
The Korea Disaster Relief Team (KDRT) was established in 2008 to systemize Korea’s overseas medical emergency response. Following multiple international deployments since 2008, KDRT embarked on its journey to achieve WHO Emergency Medical Team (EMT) Global Classification in 2017.
Objectives:
To outline the key success factors in KDRT’s work to reach classification as a Type 1 Fixed EMT.
Method/Description:
As the Korean government dispatches KDRT, a multi-agency collaboration is essential to respond to overseas disasters. To this end, KDRT leveraged a formal collaborative approach, assigning specific roles for EMT development and deployment to several national agencies: The Republic of Korea Ministry of Foreign Affairs, the Ministry of Health and Welfare, the Ministry of National Defense, the Korea International Cooperation Agency, Korea’s National Medical Center, and the Korea Foundation for International Healthcare. This network prepared KDRT for WHO EMT Verification and developing Standard Operation Procedures for the EMT Type 1. Based on this SOP, KDRT repeated simulations for each element to strengthening capabilities and enable deployment ensuring strong coordination with national and international partners in response.
Results/Outcomes:
After initiating KDRT’s journey towards EMT classification 2017, KDRT formalized cooperation with multiple agencies, and codified these roles and responsibilities in formal/published SOPs. Finally, the KDRT was verified by WHO in June 2022.
Conclusion:
This study provides a process within the operating system limited to the Republic of Korea, the country of the KDRT. However, it also can be used as a collaborative reference case in the EMT development and verification process.
Following a quarantine breach in April 2021, Fiji went from no cases of COVID-19 to having the highest number per capita in the world. Fiji was relatively well-prepared to respond to COVID-19 as it has strong emergency management response systems. Nevertheless, due to the rapid increase, the public health system was quickly overwhelmed. The problem was particularly acute at the main tertiary hospital in Suva.
Objectives:
To describe the effects of an overwhelming COVID-19 outbreak on nurses working in the Emergency Department of Colonial War Memorial Hospital in Fiji, in 2021.
To describe the lessons learned and recommendations for the future.
Method/Description:
Focus Group Discussion with two groups of nurses: (1) ED nurse and (2) nurses seconded to provide a surge workforce in the most acute phase.
Results/Outcomes:
Preliminary findings show that nurses were lacking in confidence and frightened about the growing epidemic. Resources, material and human, were initially in short supply. The agency of the nurses as result of their post-graduate study and due to the collegial environment in ED resulted in increased supplies of PPE and changes to nursing practice (eg, web-based handover). Final results pending.
Conclusion:
The preliminary findings of this research illustrate that even in low-resource settings, with the right support and effective nursing leadership, nurses can provide safe and effective care to patients. The research illustrates the benefits of sound, relevant education, the crucial importance of teamwork, the importance of networks, the important benefits of early deployment of the MET, and the need for effective nursing leadership.
The WHO has recommended the inclusion of rehabilitation capabilities in EMTs responding to disasters and health emergencies since 2013. Likewise, the importance of rehabilitation input across the continuum of care for patients experiencing COVID-19 illness has been highlighted since the onset of the global COVID-19 pandemic. Despite recognition of the role and value of rehabilitation, both in EMTs and the management of COVID-19, evidence that EMTs activated in response to COVID-19 have deployed rehabilitation professionals remains limited.
Objectives:
This paper will describe the experiences of the Australian Medical Assistance Team (AUSMAT) in deploying rehabilitation professionals as an integrated capability of multi-disciplinary EMTs responding to COVID-19 health emergencies.
Method/Description:
In response to COVID-19 emergencies in Papua New Guinea, Fiji, Timor-Leste, and the Solomon Islands, AUSMAT deployed rehabilitation professionals alongside multi-disciplinary EMTs on four occasions in 2021-2022. The rehabilitation professionals engaged in direct clinical care and capacity-building activities.
Results/Outcomes:
The work of the deployed AUSMAT rehabilitation professionals facilitated important capacity building and support for local rehabilitation staff and services, enhanced the time critical multi-disciplinary training of local nursing and medical staff, and improved the quality of clinical care of COVID-19 patients.
Conclusion:
AUSMAT’s experience has demonstrated that the deployment of rehabilitation professionals as part of a multi-disciplinary team adds significant value to the work of EMTs responding to COVID-19 health emergencies. Nursing and medical staff cannot readily replicate the knowledge, skills, and perspectives of rehabilitation professionals. Appropriately skilled rehabilitation professionals should be deployed to support national rehabilitation staff when EMTs respond to health emergencies.
Japan is a country with many disasters. Japan’s disaster medical system has improved significantly over the past 30 years by gaining experience in various disasters. Japan is implementing one of the unique disaster medical teams raised from experience and needs.
Objectives:
Introducing the Japan Disaster Medical Assistance Team (DMAT) system and discussing how the domestic disaster medical team should be.
Method/Description:
Referring to the actual response to domestic disasters and the development of disaster medical teams in Japan.
Results/Outcomes:
The National Emergency Medical Teams (National-EMT), Japan DMAT, was established in 2005. Currently, DMAT is 1,754 teams and over 15,862 members were registered. The team usually consists of five to six personnel, including two doctors, two nurses, and two logisticians. Each team carries standardized equipment. Japan DMAT will not set up a field hospital in the disaster area. Japan DMAT will bring a team to the Disaster Base Hospitals (DBHs) and start supporting the affected hospital operation first. Then, if there are other affected patients within DBH’s medical jurisdiction, then the team will mobile and support each hospital and clinic for further medical assistance.
Conclusion:
Having National-EMT in your own country is necessary for disaster-prone countries. Still, it is also required to consider what type of EMT needs to be established, referring already existing emergency medical system of your country.
The COVID-19 pandemic, especially in Africa, has increased the need for EMTs for surge management, clinical care, and capacity-building support for establishing national EMTs.
Objectives:
To analyze the implementation of EMTs deployments in the AFRO Region during the COVID-19 pandemic.
Method/Description:
This is a retrospective policy analysis done from the perspective of the EMT policy implementor using Walt and Gilson’s policy triangle1 (capturing processes, the actors, the context, and the content). Data were collected through document reviews, key informant interviews, semi-structured in-depth interviews, and focus-group discussions. Analysis was done through a priori framework analysis.
Results/Outcomes:
Overall, 22 countries benefited from international EMT deployments since the onset of COVID-19, with deployment periods varying between six to 24 weeks. Development partners, governments, and local authorities supported deployments. Some deployments were hampered by inadequate knowledge of EMTs processes, bureaucratic and administrative barriers, and slow mobilization of resources. Other challenges were the lack of critical care equipment and teams facing resistance due to cultural differences. Some teams only worked in big cities rather than local regions with low capacity and high morbidities from COVID-19. Collaboration between international and national teams resulted in enhanced capacity building, optimistic volunteerism and resilience, and provision of clinical care in constraint settings to save lives.
Conclusion:
The deployments were critical in saving lives in under-resourced settings despite the challenges. COVID-19 has provided an impetus to strengthen national public health response by providing training opportunities, twinning or exchange programs, building health infrastructure, and prepositioning supplies and equipment to ensure national reliance and sustainability.
While there are accepted triage and treatment guidelines for the entrapped and mangled extremity in civilian and military resource rich environments, there are none for resource-scarce environments.
Objectives:
A PRISMA systematic literature review was performed to elucidate the current triage and treatment of the entrapped and mangled extremity to understand the factors that contribute to the decision to amputate, or not amputate, and to extract data to develop clinical guidelines.
Method/Description:
A lead researcher followed the PRISMA systematic literature review search strategy inclusion and exclusion criteria.
A first reviewer was randomly assigned sources. One of the two lead researchers was the second reviewer. Each determined the Level of Evidence (LOE) and Quality of Evidence (QE) from each source.
Results/Outcomes:
Five-hundred ninety-seven (597) records were screened. Fifty-eight (58) articles were entered into the final study. There was one study determined to be LOE-1, 29 LOE-2, and 28 LOE-3 with 15 determined to achieve QE-1, 37 QE-2, and six QE-3.
Data extracted included relevant information to develop clinical guidelines to include physiologic parameters, injury patterns or procedures, imaging, rehabilitation, ethics, and the informed consent process.
Conclusion:
This systematic literature review showed that there is a lack of studies producing strong evidence to support the triage and treatment of an entrapped or mangled extremity in resource-scarce environments. A Delphi method study is suggested to adapt and modify available evidence extracted to create clinical guidelines in the resource-scarce environment.
Health staff in South Sudan and Nigeria face extreme risks while providing services: in 2021, at least 18 health care workers were killed in South Sudan and Nigeria, while 32 were kidnapped. Reporting of such incidents takes place via the WHO coordinated SS. However, such event reporting is not designed to capture “lower scale” security incidents, nor does it capture possible solutions. As such, the IRC in coordination with the Health Cluster and national organizations are conducting a survey to complement the existing analysis with insights of frontline health care workers, to support program design, funding requests, and advocacy activities. Research questions include:
What are the most common incidents of violence against health care workers?
What has been the impact of these incidents on staff well-being, on the health system/sector, and on access to health care for the wider community?
What are the priorities in preventing such incidents and reducing their impact?
Objectives:
To identify incidents of violence against health care as experienced by health care staff in 2022.
To identify health workers perspective on causes, impact, and what works in terms of prevention and response.
Method/Description:
A self-administered, online survey targeting all health staff working for the humanitarian community in South Sudan and Northeastern Nigeria.
Results/Outcomes:
This study is on-going with results expected by early September.
Conclusion:
This study is on-going with results expected by early September.
One of the most severe outcomes of the Ukraine war has been the systematic destruction of communities resulting in mass migration of people to Poland. Millions of affected people have arrived in Poland as war refugees requiring medical attention from a fragile health care system overburdened by the COVID-19 pandemic. This study assesses ED utilization in Polish hospitals by Ukrainian refugees.
Objectives:
To assess the impact of Ukrainian refugees on ED utilization in Poland.
Method/Description:
Demographic data, chief presenting complaints, diagnosis, and the level of care needed were registered. Bivariate and multivariate logistic regression analysis were performed to yield odds ratios (OR) with a 95% confidence interval.
Results/Outcomes:
At the time of investigation, there were 4,000 Ukrainian refugees admitted to Polish hospitals, of which more than half were children. Results are forthcoming.
Conclusion:
Although COVID-19 pandemic highlighted the insufficiency of the Polish health care system, resulting in delayed treatment for many patients, the current mass migration from Ukraine emphasizes the lack of a proper organization for crisis management in Poland. Facing an unprecedented and historic challenge, the Polish health care system, operating at the limit of its capacity, is stretched beyond capacity resulting in excess mortality, which exceeded 200,000 deaths during the pandemic. The impact was directly due to the pandemic or the delay in treating other diseases such as cardiovascular diseases and cancer. Inconsistency in medical decision making, lack of proper recommendations from the authorities, and organizational insufficiency requires a renewed focus on adaptive capacity and long-term solutions that promote systems resiliency.
Over the last decade, a global increase in the number of armed conflicts has been recorded and Mobile Health Units (MHU) are deployed to provide aid to people with limited access to health care. However, the service modality has received criticism related to irregular service provision and logistical difficulties. Although MHUs may be of value in conflicts and insecure environments, there is a significant knowledge gap regarding their usefulness to address dominating health needs.
Objectives:
To elucidate the use of MHUs in conflict settings in adherence to WHO Classification for Emergency Medical Teams.
Method/Description:
A scoping review was conducted following the framework by Arksey and O’Malley. Twenty-six bibliographic databases and websites were searched for white and grey literature published between 2000-2021 reporting on the use of MHUs in conflict settings.
Results/Outcomes:
Fourteen publications were included in the final analysis, highlighting seven themes: site of operation and mobility, key characteristics, services, benchmark indicators, staff, community engagement, and safety and security. The mobile approach was reported to increase access to health services. Challenges described primarily concerned access and availability, limited coverage, and logistics. Several studies highlighted the need for more sustainable interventions and a more clearly defined exit strategy.
Conclusion:
There is a paucity of publications reporting on the use of MHUs in conflict settings and inconsistencies in the reported data. The literature adhered to previous research and WHO guidelines to some extent. Further research is needed evaluating the interventions and outcomes of MHUs in conflict settings.
Rapid Response Mobile Laboratories (RRML) are a crucial component of preparedness and response to health emergencies, both as a stand-alone asset and in conjunction with other rapid response capacities. The development of an RRML classification system in 20191 both defines laboratory structure and provides a foundation for the development of RRML minimum standards under the umbrella of the WHO Global Outbreak Alert and Response Network (GOARN).
Objectives:
These minimum standards define the requirements for RRMLs/GOARN in the field and facilitate their interoperability with other important operational assets of WHO, including Emergency Medical Teams (EMTs), contributing to the overall response and to enhanced collaboration among national and international health partners.
Method/Description:
The development of minimum standards brought together over 30 technical experts in various disciplines from European GOARN partner institutions to conduct a systematic applied literature review and consolidate field experiences and lessons learned from infectious disease outbreaks globally, as well as addressing the complete RRML deployment life cycle2 and for each RRML type.
The RRML minimum standards focus on four workstreams: Operational Support & Logistics; Laboratory Information Management System; Biosafety & Biosecurity; and Quality Management Systems.
Results/Outcomes:
This standardization will ensure predictable response in the field and is the first step in strengthening RRML interoperability with other capacities and members of the global health emergency workforce, such as EMTs and Rapid Response Teams, as well as national-level counterparts.
Conclusion:
The standards contribute to strengthening of National Laboratory capacities, provide the basis for a forthcoming monitoring and evaluation Framework, and WHO RRML recognition process.
In Canada, access to health care is considered a universal right, however, many Indigenous communities exist in austere settings and the major health care provided is through a nursing station. As a result, they are vulnerable to developing acute staff shortages during COVID-19 outbreaks.
Objectives:
Trial the effectiveness of a Nomadic Medical Assistance Team (NoMAT) to mitigate sudden staff shortages caused by a COVID-19 outbreak in a remote Indigenous community served only by a nursing station.
Method/Description:
Indigenous Services Canada funded a pilot and NoMAT was deployed from March 13 through April 2, 2022 to a small Indigenous community in remote Northern Ontario, Canada.
The team consisted of up to seven personnel: MD, Nurse, Nurse Practitioner, Physician Assistant, Paramedic, Data Support, and Logistics. Individuals served from one-to-two weeks of a three-week deployment. If there was a shortage, the MD could be virtual. Local health resources were used and the team resided at the local school.
Results/Outcomes:
The NoMAT rapidly: (1) worked with the local team to co-develop outbreak management; (2) identified high-risk patients for treatment; (3) supported non-COVID-19 patient care; and (4) reduced a backlog of care.
Conclusion:
The NoMAT strategy is highly effective and efficient in mitigating the impact of both COVID-19 surges and reducing backlogs of care. The next step is developing a proposal for full-time teams.