Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-22T17:07:38.388Z Has data issue: false hasContentIssue false
  • English
  • Français

Quality Management Tool for Mass Casualty Emergency Responses and Disasters

Published online by Cambridge University Press:  28 June 2012

Marcus S. Villarreal
Marcus S. Villarreal*
Affiliation:
Occupational Health Centers, Houston, Texas
*
FACEP Occupational Health Centers8505 Gulf Freeway, Suite F Houston, Texas 77017USA
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction and background:

Quality management (QM) principles generally have not been applied to multi-casualty and disaster situations. Quality management incorporates quality assurance (QA) and quality improvement (QI) supported by a management information system (MIS). Since responders to disasters and multi-casualty incidents generally operate on standing orders and/or protocols, the character of the responses lends itself to quality management methods. Standards and indicators of performance readily can be developed for these situations.

Objectives:

1) to format disaster medical records as data collection instruments; 2) to develop appropriate tools that are easy to use for rapid assessments; 3) to develop a mechanism for determination of causes of injuries; and 4) to develop methods to: a) track patients; b) document response and recovery; andc) document the circumstances associated with the event.

Methods:

Model tools using checklists and short, fill-in answers are provided. These tools are designed to be incorporated into the trauma or EMS registries. Emergency medical technicians, nurses, physicians, and medical students scored the same disaster scenario for the functional areas of calling the state of the disaster, triage, and field stabilization.

Results:

Testing indicated that the checklists are completed in less than one minute, and produce objective data per patient in each functional area evaluated. In one instance, data were compiled for 38 patients from one bus accident in less than 10 minutes. The same data were reproduced, without variation, in the same amount of time, by three different providers of varied professional backgrounds.

Keywords

causes of injurychecklistscommunicationsdata collectiondisastersdisaster earthquakeoperationsdisaster statusE-codesemergency medical servicesemergency medical techniciansmanagement information systemnursesphysiciansquality assurancequality improvementquality managementsearch and rescuescreeningstandardstriage
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 12 , Issue 3 , September 1997 , pp. 27 - 36
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Palafox, J: The 1989 Loma Prieta Earthquake: Issues in medical control. Prehospital and Disaster Medicine 1993;8:291–297.CrossRefGoogle ScholarPubMed
2. QA Manual for Emergency Medicine, Dallas, Texas, American College of Emergency Physicians, 1987, p 5.Google Scholar
3. Johnson, J: Continuous Quality Improvement in EMS, Dallas, Texas, American College of Emergency Physicians, 1992, pp 1–21.Google Scholar
4. Shouldice, G: Introduction to Managed Care, Arlington, Virginia, 1993, p 300.Google Scholar
5. Stratton, S: Martchenke, J: Hospital disaster operations during the 1989 Loma Prieta Earthquake: Editorial Comments. Prehospital and Disaster Medicine 1994;9:153.CrossRefGoogle Scholar
6. Polsky, SS, Weigand, JV: Quality assurance in emergency medical service systems. Emergency Clinics of North America 1990;8:75–85.CrossRefGoogle ScholarPubMed
7. Holroyd, B, Knopp, R, Kallsen, G: Medical control: Quality assurance in prehospital care. JAMA 1986;256:1027–1031.CrossRefGoogle ScholarPubMed
8. Salerno, S, Wrenn, K, Slovis, C: Monitoring EMS protocol deviations: A useful quality assurance tool. Ann Emerg Med 1991;20:1319–1324.Google Scholar
9. Boyel, M: Objectives to direct the training of emergency medicine residents on off-service rotations: emergency medical services. Journal of Emergency Medicine 1990;8:791–795Google Scholar
10. Guha-Sapir, D: Rapid assessment of health needs in mass emergencies: review of current concepts and methods. World Health Stat Q 1991; 44:171–181.Google Scholar
11. Centers for Disease Control: Rapid health needs assessment following Hurricane Andrew-Florida and Louisiana, 1992. Morbidity and Mortality Weekly Report 1992; 41:685–688.Google Scholar
12. Lillibridge, SR, Noji, EK, Burkle, FM Jr: Disaster assessment: The emergency health evaluation of a population affected by a disaster. Ann Emerg Med 1993;22:1715–1720.CrossRefGoogle ScholarPubMed
13. Ribbeck, B: Injury surveillance: A method for recording E-codes for emergency department patients. Ann Emerg Med 1992; 21:37–40.Google Scholar
14. Martchenke, J, Pointer, JE: Hospital Disaster Operations During the 1989 Loma Prieta Earthquake. Prehospital and Disaster Medicine 1994;9:146–153.Google Scholar
15. Onsite Triage Patient Tracking Program, Baltimore, Maryland, Maryland Institute for Emergency Medical Services, 1989.Google Scholar
16. Keaton, B: Continuous Quality Improvement in EMS, Dallas, Texas, American College of Emergency Physicians, 1992, pp 133–144.Google Scholar
17. Resources for Optimal Care of the Injured Patient, Chicago, Illinois, American College of Surgeons, 1990, p 72.Google Scholar
18. Resources for Optimal Care of the Injured Patient, Chicago, Illinois, American College of Surgeons, 1990, p 41.Google Scholar
19. Alson, R, Alexander, D, Leonard, RB, Stringer, LW: Analysis of medical treatment at a field hospital following Hurricane Andrew. Ann Emerg Med 1993;22:1727.CrossRefGoogle Scholar
20. Flick, G: Medical Malpractice, Handling Emergency Medicine Cases, Colorado Springs, Colorado, 1991, pp 278–279.Google Scholar
21. Roush, W: Continuous Quality Improvement in EMS, Dallas, Texas, American College of Emergency Physicians, 1992, p 34.Google Scholar
22. Bern, A: Emergency Medicine Risk Management, Dallas, Texas, American College of Emergency Physicians, 1991, p 107.Google Scholar
23. Texas Pattern Jury Charges, Austin, Texas, Committee on Pattern Jury Charges of the State Bar of Texas, 1990, pp 50.3–50.4.Google Scholar
24. Auf der Heide, E: Disaster Response: Principles of Preparation and Coordination. St. Louis: C.V. Mosby Co., 1989, pp 50–52.Google Scholar
25. The Hospital Emergency Incident Command System, 2d ed., Santa Ana California, Orange County Health Care Agency, Emergency Medical Services, 1993.Google Scholar