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Factors That May Influence the Preparation of Standards of Procedures for Dealing with Mass-Casualty Incidents

Published online by Cambridge University Press:  28 June 2012

Bruria Adini*
Affiliation:
Emergency and Disaster Management Division, Ministry of Health, Israel Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
Avishay Goldberg
Affiliation:
Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
Danny Laor
Affiliation:
Emergency and Disaster Management Division, Ministry of Health, Israel
Robert Cohen
Affiliation:
Center for Medical Education, Hebrew University, Jerusalem, Israel
Yaron Bar-Dayan
Affiliation:
Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel Israel Defense Forces Home Front Command
*
Col. Dr. Y. Bar-Dayan MD MHA 16 Dolev St. Neve Savion, Or-Yehuda, Israel E-mail: [email protected]

Abstract

Introduction:

General hospitals in Israel are required to develop standards of procedures (SOPs) to facilitate the management of mass-casualty incidents (MCIs). These SOPs represent the initial step in a continuous process, providing guidelines for hospitals to manage MCIs in an organized and efficient manner. Evaluation of the preparedness levels of hospitals in dealing with MCIs is required in order to promote an effective response, and to identify factors that might impact the quality of SOPs. The aim of this study was to identify the characteristics of hospitals that have an impact on the preparation of SOPs.

Methods:

An evaluation tool was developed to assess the SOPs from 22 hospitals during the management of a MCI. The results of the evaluations were analyzed, in relation to the size, trauma capabilities, ownership, geographic location, urban versus rural status of the hospitals, the proximity to other hospitals, participation in drills during the year prior to the evaluation, and number of actual MCIs the hospital managed in the past three years.

Results:

The evaluation scores of the SOPs of 11 of the 22 hospitals (50%) were very high, so their SOPs did not require modifications.The SOPs of four hospitals (18%) were rated highly, requiring only minor modifications. The SOPs of four hospitals (18%) received poor ratings, requiring major modifications, and three hospitals (14%) were found to have incomplete SOPs and received very poor ratings.No significant differences were found between the ratings of SOPs in relation to the different characteristics of the hospitals analyzed. A low correlation between the level of SOPs and the number of MCIs that the hospital managed was found (r = 0.266, NS).

Conclusions:

The tool developed to evaluate the quality of the SOPs of hospitals to manage MCIs was logistically feasible and capable of differentiating between hospital SOPs. The comprehensiveness and completeness of the SOPs appears to be unrelated to the characteristics of the hospitals included in this study. Of particular note was the lack of a significant correlation between the SOP rating and the number of actual MCIs managed by a hospital.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2007

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References

1.Joint Commission on the Accreditation of Healthcare Organization: Joint Commission Perspectives. 2001 Special issue; 21(12):121. Available at: http://www.jcrinc.com/subscribers/perspectives.asp?durki=1122. Accessed 15 October 2005.Google Scholar
2.Simon, R, Teperman, S: The World Trade Center attack: Lessons for disaster management. Crit Care 2001;5(6):318320.CrossRefGoogle ScholarPubMed
3.Institute of Medicine: Chemical and Biological Terrorism: Research and Development to Improve Civilian Medical Response. Washington, DC: National Academy Press; 1999.Google Scholar
4.Quarentelli, EL: Organizational Behavior in Disasters and Implications for Disaster Planning. Newark: Disaster Research Center, University of Delaware, 1985.Google Scholar
5.Shugarman, LR, Eiseman, E, Jain, A, Nicosia, N, Stern, S, Wasserman, J: Enhancing Public Health Preparedness: Exercises, Exemplary Practices, and Lessons Learned. California: Rand Corporation, 2005;1023.Google Scholar
6.Agency for Healthcare Research and Quality: Disaster Planning Drills and Readiness Assessment.Bioterrorism and Health System Preparedness, Issue Brief No. 2.AHRQ Publication No. 04-P007. Rockville, MD: Agency for Healthcare Research and Quality, 2004.Google Scholar
7.Clark County Multi-Jurisdictional Mass Casualty Plan. 2005. Available at: http://www.accessclarkcounty.com/Administrative_services/OEM/MCI_P LAN.pdf. Accessed 24 October 2005.Google Scholar
8.Green, GB, Modi, S, Lunney, K, Thomas, TL: Generic evaluation methods for disaster exercises in developing countries. Ann Emerg Med 2003;41:689699.CrossRefGoogle Scholar
9.Quarentelli, EL: Research Based Criteria For Evaluating Disaster Planning and Managing. International Seminar on Chernobyl and Beyond: Humanitarian Assistance to Victims of Technological Disasters. Moscow, Russia: Department of Humanitarian Affairs of the United Nations, 1997.Google Scholar
10.De Grace, M, Ericson, D, Folz, H, Greene, W, Ho, K, Pearce, L: Proceedings for the 5th Asia-Pacific Conference on Disaster Medicine: Creating an agenda for action. Prehosp Disast Med 2001;16(1):1821.CrossRefGoogle ScholarPubMed
11.Rosen, B: Health Care Systems in Transition: Israel. Thomson, S, Mossialos, E (eds). Copenhagen: European Observatory on Health Care Systems; 2003.Google Scholar
12.Romm, FJ, Hulka, BS: Developing criteria for quality of assessment: Effect of the Delphi technique. Health Serv Res 1979;14(4):309312.Google ScholarPubMed
13.Einav, S, Feigenberg, Z, Weissman, C, et al. : Evacuation priorities in mass casualty terror-related events: Implications for contingency planning. Ann Surg 2004;239(3):304310.CrossRefGoogle ScholarPubMed