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A crucial component of a hospital’s disaster plan is an efficient staff recall communication method. Many hospitals use a “calling tree” protocol to contact staff members and recall them to work. Alternative staff recall methods have been proposed and explored.
An unannounced, multidisciplinary, randomized emergency department (ED) staff recall drill was conducted at night - when there is the greatest need for back-up personnel and staff is most difficult to reach. The drill was performed on December 14, 2017 at 4:00am and involved ED staff members from three hospitals which are all part of the McGill University Health Centre (MUHC; Montreal, Quebec, Canada). Three tools were compared: manual phone tree, instant messaging application (IMA), and custom-made hospital Short Message Service (SMS) system. The key outcome measures were proportion of responses at 45 minutes and median response time.
One-hundred thirty-two participants were recruited. There were 44 participants in each group after randomization. In the manual phone tree group, 18 (41%) responded within 45 minutes. In the IMA group, 11 participants (25%) responded in the first 45 minutes. In the SMS group, seven participants responded in the first 45 minutes (16%). Manual phone tree was significantly better than SMS with an effect size of 25% (95% confidence interval for effect: 4.6% to 45.0%; P=.018). Conversely, there was no significant difference between manual phone tree and IMA with an effect size of 16% (95% confidence interval for effect: −5.7% to 38.0%; P=.17) There was a statistically significant difference in the median response time between the three groups with the phone tree group presenting the lowest median response time (8.5 minutes; range: 2.0 to 8.5 minutes; P=.000006).
Both the phone tree and IMA groups had a significantly higher response rate than the SMS group. There was no significant difference between the proportion of responses at 45 minutes in the phone tree and the IMA arms. This study suggests that an IMA may be a viable alternative to the traditional phone tree method. Limitations of the study include volunteer bias and the fact that there was only one communication drill, which did not allow staff members randomized to the IMA and SMS groups to fully get familiar with the new staff recall methods.
HomierV, HamadR, LarocqueJ, ChasséP, KhalilE, FrancJM.A Randomized Trial Comparing Telephone Tree, Text Messaging, and Instant Messaging App for Emergency Department Staff Recall for Disaster Response. Prehosp Disaster Med. 2018;33(5):471–477.
Pediatric hospital disaster responders must be well-trained and prepared to manage children in a mass-casualty incident. Simulations of various types have been the traditional way of testing hospital disaster plans and training hospital staff in skills that are used in rare circumstances. The objective of this longitudinal, survey-based, observational study was to assess the effect of disaster response and management-based experiential learning on the knowledge and confidence of advanced learners.
A simulation-based workshop was created for practicing Pediatric Emergency Medicine (PEM) physicians, senior PEM physicians, and critical care and pediatric surgery residents to learn how to manage a disaster response. Given that this particular group of learners had never been exposed to such a disaster simulation, its educational value was assessed with the goal of improving the quality of the hospital pediatric medical response to a disaster by increasing the responders’ knowledge and confidence. Objective and subjective measures were analyzed using both a retrospective, pre-post survey, as well as case-based evaluation grids.
The simulation workshop improved the learners’ perceived ability to manage patients in a disaster context and identified strengths and areas needing improvement for patient care within the disaster context.
Advanced learners exposed to an experiential learning activity believed that it improved their ability to manage patients in a disaster situation and felt that it was valuable to their learning. Their confidence was preserved six months later.
BankI, KhalilE. Are Pediatric Emergency Physicians More Knowledgeable and Confident to Respond to a Pediatric Disaster after an Experiential Learning Experience?Prehosp Disaster Med. 2016;31(5):551–556.
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