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Leadership and Use of Standards by Australian Disaster Medical Assistance Teams: Results of a National Survey of Team Members

Published online by Cambridge University Press:  17 May 2012

Peter Aitken
Affiliation:
James Cook University, Townsville, Queensland, Australia The Townsville Hospital, Townsville, Queensland, Australia
Peter A. Leggat*
Affiliation:
The Townsville Hospital, Townsville, Queensland, Australia
Andrew G. Robertson
Affiliation:
James Cook University, Townsville, Queensland, Australia Department of Health, Perth, Western Australia, Australia
Hazel Harley
Affiliation:
James Cook University, Townsville, Queensland, Australia Consultant, Perth, Western Australia, Australia, and formerly Department of Health, Perth, Western Australia, Australia
Richard Speare
Affiliation:
James Cook University, Townsville, Queensland, Australia
Muriel G. Leclercq
Affiliation:
James Cook University, Townsville, Queensland, Australia Department of Health, Perth, Western Australia, Australia
*
Correspondence: Peter A. Leggat, MD School of Public Health Tropical Medicine and Rehabilitation Sciences James Cook University Townsville, Queensland 4811, Australia E-mail [email protected]

Abstract

Introduction

It is likely that calls for disaster medical assistance teams (DMATs) will continue in response to international disasters.

Objective

As part of a national survey, the present study was designed to evaluate leadership issues and use of standards in Australian DMATs.

Methods

Data was collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 Asian Tsunami disaster.

Results

The response rate for this survey was estimated to be approximately 50% (59/118). Most of the personnel had deployed to the Asian Tsunami affected areas. The DMAT members were quite experienced, with 53% (31/59) of personnel in the 45-55 years of age group. Seventy-five percent (44/59) of the respondents were male. Fifty-eight percent (34/59) of the survey participants had significant experience in international disasters, although few felt they had previous experience in disaster management (5%, 3/59). There was unanimous support for a clear command structure (100%, 59/59), with strong support for leadership training for DMAT commanders (85%, 50/59). However only 34% (20/59) felt that their roles were clearly defined pre-deployment, and 59% (35/59) felt that team members could be identified easily. Leadership was identified by two team members as one of the biggest personal hardships faced during their deployment. While no respondents disagreed with the need for meaningful, evidence-based standards to be developed, only 51% (30/59) stated that indicators of effectiveness were used for the deployment.

Conclusions

In this study of Australian DMAT members, there was unanimous support for a clear command structure in future deployments, with clearly defined team roles and reporting structures. This should be supported by clear identification of team leaders to assist inter-agency coordination, and by leadership training for DMAT commanders. Members of Australian DMATs would also support the development and implementation of meaningful, evidence-based standards. More work is needed to identify or develop actual standards and the measures of effectiveness to be used, as well as the contents and nature of leadership training.

Aitken P, Leggat PA, Robertson AG, Harley H, Speare R, Leclercq MG. Leadership and use of standards by Australian disaster medical assistance teams: results of a national survey of team members. Prehosp Disaster Med. 2012;27(2):1-6.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2012

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References

1. Aitken, P, Leggat, PA, Robertson, A, Harley, H, Speare, R, Leclerq, M. Education and training of Australian Disaster Medical Assistance Team members: results of a national survey. Prehosp Disaster Med. 2011;26:41-48.CrossRefGoogle ScholarPubMed
2. South Australian Department of Health: Australian Medical Assistance Team (AusMAT). http://www.health.sa.gov.au/Default.aspx?tabid=128. Accessed March 30, 2011.Google Scholar
3. CRED (Centre for Research on the Epidemiology of Disasters). World Disaster Report 2000. http://www.cred.be. Accessed March 30, 2011.Google Scholar
4. International Federation of Red Cross and Red Crescent Societies (IFRC). World Disasters Report 2000. Geneva: International Federation of Red Cross and Red Crescent Societies; 2001.Google Scholar
5. Haddow, GD, Bullock, JA. International disaster management. In: Haddow GD, Bullock JA, eds, Introduction to Emergency Management. Boston: Butterworth Heinemann; 2008:251-302.Google Scholar
6. Gunn, SWA. The humanitarian imperative in disaster management — a memorial tribute to Professor Peter Safar. Prehosp Disaster Med. 2005;20:89-92.CrossRefGoogle ScholarPubMed
7. Steketee M. Rudd leads from the front on overseas aid. The Australian. http://www.theaustralian.com.au/national-affairs/rudd-leads-from-the-front-on-overseas-aid/story-fn59niix-1225942097850. Published October 23, 2010. Accessed April 6, 2011.Google Scholar
8. Russbach, R. International assistance operations in disaster situations. Prehosp Disaster Med. 1990;5(3):247-249.CrossRefGoogle Scholar
9. McEntire, DA. Balancing international approaches to disaster: rethinking prevention instead of relief. Aust J Emerg Management. 1998;13:50-55.Google Scholar
10. Dara, SI, Ashton, RW, Farmer, JC, Carlton, PK. Worldwide disaster medical response: an historical perspective. Crit Care Med. 2005;33(Suppl):s2-s6.CrossRefGoogle ScholarPubMed
11. Aghababian, R. Lessons learned of international importance from recent disasters. Prehosp Disaster Med. 2000;15(3):79s.CrossRefGoogle Scholar
12. Bridgewater, FH, Aspinall, ET, Booth, JP, et al. Team Echo: observations and lessons learned in the recovery phase of the 2004 Asian tsunami. Prehosp Disaster Med. 2006;21:s20-s25.CrossRefGoogle ScholarPubMed
13. Byleveld, PM, Kent, MI, McCall, BJ. Operation Sumatra Assist: post-tsunami environmental and public health response in Banda Aceh. ADF Health. 2006;6:48-53.Google Scholar
14. Cooper, DM. “Operation tsunami assist” — Australian civilian medical team deployment. Prehosp Disaster Med. 2005;20:s113-s114.CrossRefGoogle Scholar
15. Garner, A, Harrison, K. Early post tsunami disaster medical assistance to Banda Aceh: a personal account. Emerg Med Australas. 2006;18:93-96.CrossRefGoogle Scholar
16. Grantham, H. Southeast Asian tsunami — Australian ECHO team response. Prehosp Disaster Med. 2005;20:s114.CrossRefGoogle Scholar
17. Jackson, A, Little, M. On the ground in Nias in response to an earthquake — an emergency team's experience. Emerg Med Australas. 2006;18:199-202.CrossRefGoogle Scholar
18. Pearce, A, Mark, P, Gray, N, Curry, C. Responding to the Boxing Day tsunami disaster in Aceh, Indonesia: Western and South Australian contributions. Emerg Med Australas. 2006;18:86-92.CrossRefGoogle Scholar
19. Robertson, AG, Dwyer, DE, Leclercq, MG. Operation South East Asia Tsunami Assist: an Australian team in the Maldives. Med J Aust. 2005;182:340-342.CrossRefGoogle ScholarPubMed
20. VanRooyen, MJ, Hansch, S, Curtis, D, Burnham, G. Emerging issues and future needs in humanitarian assistance. Prehosp Disaster Med. 2001;16(4):216-222.CrossRefGoogle ScholarPubMed
21. Wallace, AG. National disaster medical system: disaster medical assistance teams. In: Hogan DE, Burstein JL, eds, Disaster Medicine. Philadelphia: Lippincott Williams and Wilkins; 2002:133-142.Google Scholar
22. Bar-Dayan, Y, Rami, P, Issac, A, et al. Support factors of the healthcare teams in affected areas of Thailand during the disaster medical response — lessons learned from the 26th December 2004 tsunami. Prehosp Disaster Med. 2005;20:s119-s120.CrossRefGoogle Scholar
23. Timboe, HL. Project Hope volunteers and the Navy Hospital Ship Mercy. Mil Med. 2006;171:s34-s36.CrossRefGoogle ScholarPubMed
24. Burkle, FM, Isaac-Renton, J, Beck, A, et al. 5th Asia-Pacific conference on disaster medicine. Theme 5. Application of international standards to disasters: Summary and action plan. Prehosp Disaster Med. 2001;16:36-38.CrossRefGoogle Scholar
25. Birch, M, Miller, S. Humanitarian assistance: standards, skills, training and experience. BMJ. 2005;330:1199-1201.CrossRefGoogle Scholar
26. Kizer, KW. Lessons learned in public health emergency management: personal reflections. Prehosp Disaster Med. 2000;15(4):209-214.CrossRefGoogle ScholarPubMed
27. Briggs, SM. Disaster management teams. Current Opin Crit Care. 2005;11:585-589.CrossRefGoogle ScholarPubMed
28. Yamada, S, Gunatialke, RP, Roytman, TM, Gunatilake, S, Fernando, T, Fernando, L. The Sri Lankan tsunami experience. Disast Management Response. 2006;4:38-48.CrossRefGoogle Scholar
29. Cook, S, Smart, T, Stephenson, J. Learning the hard way: Australian Defence Force health responses to terrorist attacks in Bali, 2002 and 2005. ADF Health. 2006;7:51-55.Google Scholar
30. Abolghasemi, H, Radfar, MH, Khatami, M, Nia, MS, Amid, A, Briggs, SM. International medical response to a natural disaster: lessons learned from the Bam earthquake experience. Prehosp Disaster Med. 2006;21(3):141-147.CrossRefGoogle ScholarPubMed
31. Bradt, DA, Drummond, CM. From complex emergencies to terrorism — new tools for health sector coordination in conflict associated disasters. Prehosp Disast Med. 2003;18:263-271.CrossRefGoogle ScholarPubMed
32. Noji, EK, Gunn, SWA, Aziz, AA, et al. 5th Asia-Pacific conference on disaster medicine. Theme 4. Effective models for medical ad health response coordination. Summary and action plan. Prehosp Disaster Med.. 2001;16:33-35.CrossRefGoogle Scholar
33. Anderson, P, Ho, K, Braham, S, et al. 5th Asia-Pacific conference on disaster medicine. Theme 2. Telehealth and communication technologies in health: Summary and action plan. Prehosp Disaster Med. 2001;16:26-28.CrossRefGoogle Scholar
34. Hickson, C, Schull, M, Arias, EH, et al. 5th Asia-Pacific conference on disaster medicine. Theme 3. Sharing Pacific rim experiences in disasters: summary and action plan. Prehosp Disaster Med. 2001;16:29-32.CrossRefGoogle Scholar
35. Zoraster, RM. Barriers to disaster coordination: health sector coordination in Banda Aceh following the South Asia tsunami. Prehosp Disaster Med. 2006;21:s13-s18.CrossRefGoogle ScholarPubMed
36. Nocera, A. Prior planning to avoid responders becoming “victims” during disasters. Prehosp Disaster Med. 2000;15:46-48.CrossRefGoogle Scholar
37. Scott-Findlay, J. Darwin and the natural disasters organization. Med J Aust. 1975;1:644-646.CrossRefGoogle ScholarPubMed
38. Holland, J, Wooster, P. International rescue team: selection and training. Crisis Resp J. 2004;1:51-54.Google Scholar
39. Moore, S, Blasser, E. A new look at disaster medical assistance teams. Mil Med. 1991;156:543-546.CrossRefGoogle Scholar
40. Cuny, FC. Principles of disaster management lesson 7: management leadership styles and methods. Prehosp Disaster Med. 2000;15(1):70-78.Google ScholarPubMed
41. McCormick, S, Wardrope, J. Major incidents, leadership, and series summary and review. Emerg Med J. 2003;20:70-74.CrossRefGoogle ScholarPubMed
42. Anderson, EW. Approaches to conflict resolution. BMJ. 2005;331:344-346.CrossRefGoogle ScholarPubMed
43. Hickson, C, Schull, M, Arias, EH, et al. 5th Asia-Pacific conference on disaster medicine. Theme 3. Sharing Pacific rim experiences in disasters: summary and action plan. Prehosp Disaster Med. 2001;16:29-32.CrossRefGoogle Scholar
44. Relief and Rehabilitation Network. Joint Evaluation of Emergency Assistance to Rwanda, Study 3: Humanitarian Aid and Effects. http://www.odihpn.org/documents/networkpaper016.pdf. Overseas Development Institute. Published 1996. Accessed April 30, 2011.Google Scholar
45. Salama, P, Buzard, N, Spiegel, P. Improving standards in international humanitarian response: the SPHERE project and beyond. JAMA. 2001;286:531-532.CrossRefGoogle ScholarPubMed
46. VanRooyen, M, Leaning, J. After the tsunami — facing the public health challenges. NEJM. 2005;352:435-438.CrossRefGoogle ScholarPubMed
47. Sondorp, E, Kaiser, T, Zwi, A. Editorial: Beyond emergency care: challenges to health planning in complex emergencies. Trop Med Int Health. 2001;6:965-970.CrossRefGoogle ScholarPubMed
48. Birnbaum, ML. Professionalization and credentialing. Prehosp Disaster Med. 2005;20(4):210-211.CrossRefGoogle ScholarPubMed
49. Nabarro, D. Putting it together: stronger public health capacity within disaster management systems. Prehosp Disaster Med. 2005;20(6):483-485.CrossRefGoogle ScholarPubMed
50. Bradt, DA, Drummond, CM. From complex emergencies to terrorism — new tools for health sector coordination in conflict associated disasters. Prehosp Disast Med. 2003;18:263-271.CrossRefGoogle ScholarPubMed
51. Burkle, FM. Complex emergencies: an introduction. Prehosp Disaster Med. 2001;16:182-183.CrossRefGoogle ScholarPubMed
52. Rubin, M, Heuvelmans, JHA, Tomic-Cica, A, Birnbaum, ML. Health related relief in the former Yugoslavia: needs, demands and supplies. Prehosp Disaster Med. 2000;15(1):1-11.CrossRefGoogle ScholarPubMed
53. The Sphere Project. Humanitarian Charter and Minimum Standards in Disaster Response. http://www.sphereproject.org/. Published 2004. Accessed March 31, 2011.CrossRefGoogle Scholar
54. Brennan, RJ, Nandy, R. Complex humanitarian emergencies: a major global health challenge. Emerg Med. 2001;3:147-156.CrossRefGoogle Scholar
55. Griekspoor, A, Sondorp, E. Enhancing the quality of humanitarian assistance: taking stock and future initiatives. Prehosp Disaster Med. 2001;16:209-215.CrossRefGoogle ScholarPubMed
56. Dufour, C, Geoffrey, V, Maury, H, Grunewald, F. Rights, standards and quality in a complex humanitarian space: is SPHERE the right tool? Disasters. 2004;28:124-141.CrossRefGoogle Scholar
57. Libman, IM, LaPorte, RE, Akawaza, S, et al. The need for a global health disaster network. Prehosp Disaster Med. 1997;12(1):11-12.CrossRefGoogle ScholarPubMed
58. Abolghasemi, H, Radfar, MH, Khatami, M, Nia, MS, Amid, A, Briggs, SM. International medical response to a natural disaster: lessons learned from the Bam earthquake experience. Prehosp Disaster Med. 2006;21(3):141-147.CrossRefGoogle ScholarPubMed
59. Maury, H, Russbach, R. The Quality Compass — a new tool to manage and evaluate humanitarian assistance. Int J Disast Med. 2004;2:106-110.CrossRefGoogle Scholar
60. Leus, XR. The road ahead. Prehosp Disaster Med. 2000;15(4):136-143.CrossRefGoogle ScholarPubMed
61. Nates, JL, Moyer, VA. Lessons from Hurricane Katrina, tsunamis, and other disasters. Lancet. 2005;366:1144-1146.CrossRefGoogle ScholarPubMed
62. World Health Organization/Pan-American Health Organization. Guidelines for the use of foreign field hospitals in the aftermath of sudden impact disasters. Prehosp Disaster Med. 2003;18(4):278-290.CrossRefGoogle Scholar
63. von Schreeb, J, Riddez, L, Samnegård, H, Rosling, H. Foreign field hospitals and the recent sudden-impact disasters in Iran, Haiti, Indonesia, and Pakistan. Prehosp Disaster Med. 2008;23:144-151.CrossRefGoogle Scholar
64. Telford J, Cosgrove J, Houghton R. Joint evaluation of the international response to the Indian Ocean tsunami: synthesis report. http://www.preventionweb.net/english/professional/publications/v.php?id=2097 London: Tsunami Evaluation Coalition. Published 2006. Accessed April 8, 2011.Google Scholar
65. Redmond, AD, O'Dempsey, TJ, Taithe, B. Disasters and a register for foreign medical teams. Lancet. 2011;377:1054-1055.CrossRefGoogle Scholar
66. Hoffman, MH. Hercules versus the methane monster: separating law from mythology for practical use in disasters and emergencies. Prehosp Disaster Med. 2003;18(1):4-5.CrossRefGoogle ScholarPubMed
67. Sharp, TW, Wightman, JM, Davis, MJ, Sherman, SS, Burkle, FM. Military assistance in complex emergencies: what have we learned since the Kurdish relief effort? Prehosp Disaster Med. 2001;16(4):197-208.CrossRefGoogle ScholarPubMed
68. Pan American Health Organization/World Health Organization. Evaluation of preparedness and response to hurricanes Georges and Mitch: conclusions and recommendations. http://www.paho.org/english/dd/ped/concleng.htm. Accessed March 30, 2011.Google Scholar
69. Burkle, FM, McGrady, KAW, Newett, SL, et al. Complex humanitarian emergencies III. Measures of effectiveness. Prehosp Disaster Med. 1995;10(1):48-56.CrossRefGoogle ScholarPubMed
70. United Nations Office for Coordination of Humanitarian Affairs (OCHA). INSARAG—International Search and Rescue Advisory Group: overview. http://www.unocha.org/what-we-do/coordination-tools/insarag/overview. Accessed April 6, 2011.Google Scholar