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Disaster Exercises to Prepare Hospitals for Mass-Casualty Incidents: Does it Contribute to Preparedness or is it Ritualism?

Published online by Cambridge University Press:  17 July 2018

Marlous LMI Verheul ,
Michel LA Dückers ,
Bea B Visser ,
Ralf JJ Beerens  and
Joost JLM Bierens
Marlous LMI Verheul*
Affiliation:
University Medical Centre of Utrecht, Utrecht, The Netherlands
Michel LA Dückers
Affiliation:
Impact – National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Diemen, The Netherlands NIVEL – Netherlands Institute for Health Services Research, Utrecht, The Netherlands
Bea B Visser
Affiliation:
University Medical Centre of Groningen, Groningen, The Netherlands
Ralf JJ Beerens
Affiliation:
Netherlands Institute for Safety (NIFV), Arnhem, The Netherlands Lund University Centre for Risk Assessment and Management (LUCRAM), Lund, Sweden
Joost JLM Bierens
Affiliation:
Research Group Emergency and Disaster Medicine, Vrije Universiteit, Brussels, Belgium
*
Correspondence: Marlous Verheul UMC Utrecht| Huispostnummer G 04.228 Postbus 85500 3508 GA UTRECHT The Netherlands E-mail: m.l.m.verheul@umcutrecht.nl
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Abstract

Introduction

The central question this study sought to answer was whether the team members of Strategic Crisis Teams (SCTs) participating in mass-casualty incident (MCI) exercises in the Netherlands learn from their participation.

Methods

Evaluation reports of exercises that took place at two different times were collected and analyzed against a theoretical model with several dimensions, looking at both the quality of the evaluation methodology (three criteria: objectives described, link between objective and items for improvement, and data-collection method) and the learning effect of the exercise (one criterion: the change in number of items for improvement).

Results

Of all 32 evaluation reports, 81% described exercise objectives; 30% of the items for improvement in the reports were linked to these objectives, and 22% of the 32 evaluation reports used a structured template to describe the items for improvement. In six evaluation categories, the number of items for improvement increased between the first (T1) and the last (T2) evaluation report submitted by hospitals. The number of items remained equal for two evaluation categories and decreased in six evaluation categories.

Conclusion

The evaluation reports do not support the ideal-typical disaster exercise process. The authors could not establish that team members participating in MCI exercises in the Netherlands learn from their participation. More time and effort must be spent on the development of a validated evaluation system for these simulations, and more research into the role of the evaluator is needed.

Verheul MLMI, Dückers MLA, Visser BB, Beerens RJJ, Bierens JJLM. Disaster exercises to prepare hospitals for mass-casualty incidents: does it contribute to preparedness or is it ritualism? Prehosp Disaster Med. 2018;33(4):387–393

Keywords

hospital staff preparednessmass-casualty incidentsprofessional educationsimulation exercises
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 33 , Issue 4 , August 2018 , pp. 387 - 393
Copyright
© World Association for Disaster and Emergency Medicine 2018 

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Footnotes

Conflicts of interest: This material is the result of a thesis submitted in partial fulfilment of the requirements for the degree of Master of Science in Disaster Medicine (European Master in Disaster Medicine). The authors have no conflicts of interest to declare.

References

1. United Nations Office for Disaster Risk Reduction web site. 2015 disasters in numbers. http://www.unisdr.org/files/47804_2015disastertrendsinfographic.pdf. Published 2016. Accessed September 12, 2017.Google Scholar
2. National Association of State EMS Officials. Extended Definition Document NEMSIS/NHTSA 2.2.1 Data Dictionary. https://nemsis.org/media/nemsis_v2/documents/ Data_Managers_Council_-_Data_Definitions_Project_Final_Ve.pdf. Accessed November 22, 2017.Google Scholar
3. Wet toelating zorginstellingen. http://wetten.overheid.nl/BWBR0018906/2016-08-01. Accessed September 12, 2017.Google Scholar
4. Kwaliteitswet zorginstellingen. http://wetten.overheid.nl/BWBR0007850/2015-01-01. Accessed September 12, 2017.Google Scholar
5. Landelijke convenant Opleiden Trainen Oefenen 2008. https://www.rijksoverheid.nl/documenten/convenanten/2008/10/16/convenant-inzake-opleiden-trainen-en-oefenen-ter-voorbereiding-op-rampen-en-crises. Accessed September 12, 2017.Google Scholar
6. Tur-Kaspa, I. Preparing hospitals for toxicological mass-casualties events. Crit Care Med. 1999;27(5):1004-1008.Google Scholar
7. Reinertsen, JL. Physicians as leaders in the improvement of health care systems. Physicians as Leaders in Improving Health Care Series. Berwick DM, Nolan TW, (series eds). Ann Intern Med. 1998;128(10):651-656.Google Scholar
8. FEMA - HSEEP Glossary, 2013. https://www.fema.gov/media-library-data/20130726-1914-25045-8890/hseep_apr13_.pdf. Accessed September 12, 2017.Google Scholar
9. Taylor, MJ, McNicholas, C, Nicolay, C, Darzi, A, Bell, D, Reed, JE. Systematic review of the application of the plan–do–study–act method to improve quality in healthcare. BMJ Qual Saf. 2014;23(4):290-298.Google Scholar
10. Dückers, MLA, Wagner, C, Vos, L, Groenewegen, PP. Understanding organizational development, sustainability, and diffusion of innovations within hospitals participating in a multi-level quality collaborative. Imp Sci. 2011;6(18).Google Scholar
11. Beerens, R, Abraham, P, Glerum, P, Kolen, B. Flood preparedness training and exercises. In: Bierens J, (ed). Handbook on Drowning. Berlin, Germany: Springer; 2013: 1009-1016.Google Scholar
12. St. Leger, AS, Walsworth-Bell, JP. Change Promoting Research for Health Services. Buckingham: Open University Press; 1999.Google Scholar
13. Dausey, DJ, Moore, M. Using exercises to improve public health preparedness in Asia, the Middle East, and Africa. BMC Res Notes. 2014;7(1):474.Google Scholar
14. Huber, GP. Organizational learning: the contributing processes and the literatures. Organ Sci. 1991;2(1):88-115.Google Scholar
15. Alexander, PA, Schallert, DL, Reynolds, RE. What is learning anyway? A topographical perspective considered. Educ Psychol. 2009;44(3):176-192.Google Scholar
16. Stufflebeam, DL, Coryn, CLS. Evaluation Theory, Models, and Applications. 2nd ed. San Francisco, California USA: Jossey-Bass; 2007.Google Scholar
17. Calidoni-lundberg, F. Evaluation: Definitions, Methods, and Models. Östersund, Sweden.Google Scholar
18. Lagadec, P. Learning processes for crisis management in complex organizations. J Contingencies Cris Manag. 1997;5(1):24.Google Scholar
19. Hsu, EB, Jenckes, MW, Catlett, CL, et al. Effectiveness of hospital staff mass-casualty incident training methods: a systematic literature review. Prehosp Disaster Med. 2004;19(3):191-199.Google Scholar
20. Beerens, R, Tehler, H. Scoping the field of disaster exercise evaluation - a literature overview and analysis. Int J Disaster Risk Reduct. 2016;19(May):413-446.Google Scholar
21. Juffermans, J, Bierens, JJLM. Recurrent medical response problems during five recent disasters in the Netherlands. Prehosp Disaster Med. 2010;25(2):127-136.Google Scholar
22. Savoia, E, Preston, J, Biddinger, PD. A consensus process on the use of exercises and after-action reports to assess and improve public health emergency preparedness and response. Prehosp Disaster Med. 2013;28(3):305-308.Google Scholar
23. Savoia, E, Agboola, F, Biddinger, PD. Use of after action reports (AARs) to promote organizational and systems learning in emergency preparedness. Int J Environ Res Public Health. 2012;9(8):2949-2963.Google Scholar
24. Lundberg, J, Rollenhagen, C, Hollnagel, E. What-You-Look-For-Is-What-You-Find - The consequences of underlying accident models in eight accident investigation manuals. Saf Sci. 2009;47(10):1297-1311.Google Scholar
25. Borodzicz, E, van Haperen, K. Individual and group learning in crisis simulations. J Contingencies Cris Manag. 2002;10(3):139-147.Google Scholar
26. Birkland, TA. Disasters, lessons learned, and fantasy documents. J Contingencies Cris Manag. 2009;17(3):146-156.Google Scholar