The underground mining industry has one of the most hazardous industrial occupations, and requires an increased level of preparedness for injury incidents. The most important outcome for seriously injured victims is the reduction in morbidity and mortality. Receiving effective and timely care may mean the difference between life and death. However, mines are usually located in a rural area and the incident site may be deep underground which makes it an extraordinary challenge for the rescue services. A successful rescue response in an extraordinary milieu demands a high level of inter-organizational cooperation skills at the incident site.

To analyze statements of collaborate activities during a major incident exercise in the underground mine industry, essentially for patient outcome.

A Delphi technique was performed, asking opinions from experts in iterative rounds to generate, understand, and form consensus on group opinion around this complex issue. The experts were personnel from disaster medicine (n=3), emergency and prehospital medicine (n=10), rescue service (n=16), and mine industry (n=9), all with operative command positions.

Three iterative rounds were performed. The first round was conducted as a workshop to collect opinions about the most important inter-organization cooperation activities to optimize patient outcome from an injury incident in an underground mine. This resulted in 63 statements. The statements included information about: early alarm routines, collaborative support and efforts of early life-saving interventions, relevant resources and equipment, command and control room, and functions. In round two participants shared and communicated decisions about safety, situation awareness, and guidelines for response. All statements reached consensus among the experts in round three.

These inter-organizational statements are considered important by experts, and could be used to evaluate collaboration in major incident exercises. Hence, the statements can also be quality indicators for reporting results from major incident management.