The decision-making (DM) process in public administration is the subject of research from different perspectives and disciplines. Evidence-based policies, such as health technology assessment (HTA), are not the only support on which public policies are designed. During the COVID-19 pandemic WHO, national and subnational institutions developed HTA reports to guide DM. Despite this, inadequate variability was observed in the health technologies recommended and reimbursed by different provincial Health Ministries in a federally organized developing country like Argentina. The processes and results of DM on health technologies for COVID-19 in Health Ministries of Argentina were inquired.

A retrospective research design was developed, with triangulation of quantitative and qualitative methods. We retrieved information for the years 2020–2021 through document review of official webpages, surveys, and interviews with decision-makers of the 25 Argentinian Ministries of Health. We analyzed the recommendations and reimbursement policies of seven health technologies.

In contradiction with WHO’s policies, ivermectine, inhaled ibuprofen, convalescent plasma and equine serum were widely recommended by most of Argentina’s health ministries outside a clinical trial context, with risks for patients and a huge opportunity cost.

Despite an important HTA institutional capacity, the impact of HTA organizations and their technical reports was limited. Health Ministries with institutionalized HTA units had more adherence to WHO recommendations, but the influence of different technical and political criteria was identified. Power relations within and outside the administration, the pharmaceutical industry and academics, the media, social pressure, the judicial and legislative powers, and the political context strongly influenced DM.

To achieve resilience in the response of a major incident, it is essential to coordinate major processes and resources with the aim to manage expected and unexpected changes. The coordination is partly done through timely, adequate, and resilience-oriented decisions. Accordingly, the aim of the present paper is to describe factors that affected decision-making in a medical command and control team during the early COVID-19 pandemic.

This study used a qualitative method in which 13 individuals from a regional public healthcare system involved in COVID-19 related command and control were interviewed. Data was collected through semi-structured interviews and analyzed using qualitative content analysis.

The factors affecting decision-making in medical command and control during early COVID-19 pandemic were grouped into 5 themes: organization, adaptation, making decisions, and analysis, as well as common operational picture.

The present study indicated that decision-making in medical command and control faces many challenges in the response to pandemics. The results may provide knowledge about disaster resilience and can be utilized in educational and training settings for medical command and control.

The COVID-19 pandemic negatively impacted healthcare worker well-being, leading to increased burnout and decreased workplace engagement. To combat expected stressors from the pandemic, our mid-sized academic health center implemented numerous institutional support, such as town halls, and virtual support groups. This study aimed to evaluate faculty utilization of institutional support, its association with perceived organizational support, received organizational support, and burnout.

A retrospective, cross-sectional survey was distributed to 630 faculty employed at our institution in September 2020, assessing participant demographics, institutional support utilized, perceived organizational support, and burnout, through a combination of self-report measures and qualitative responses.

A total of 79 (12.5%) faculty provided complete responses and were included in the analysis. Qualitative analysis identified 4 primary themes: (1) flexibility and adjusted expectations, (2) direct communication, (3) sense of community, and (4) no support felt, with additional subthemes within each larger theme. Increased utilization of institutional support was associated with decreased odds of experiencing burnout.

Flexibility, communication, and sense of community emerged as important strategies for maintaining faculty well-being and engagement during the early stages of the COVID-19 pandemic. This study suggests that utilization of workplace support is protective against burnout. Perceived support was not beneficial.

In the event of a disaster, the chain of command and communication of each relevant agency is important. In this study, a chronological record creation system using voice AI (V-CRS) was developed, and an experiment was conducted to determine whether the obtained information could be quickly and easily summarized in chronological order.

After a lecture by Japanese Disaster Medical Assistant (DMAT) Team members and 8 medical clerks on how to use the developed tool, a comparison experiment was conducted between manual input and V-CRS utilization of the time to compile disaster information.

Results proved that V-CRS can collect information gathered at headquarters more quickly than handwriting. It was also suggested that even medical clerks who have never been trained to record information during disasters could record information at the same speed as trained DMAT personnel.

V-CRS can transcribe audio information even in situations where technical terms and physical units must be recorded, such as radiation disasters. It has been proven that anyone can quickly organize information using this method, to some extent.

While patient participation in individual health technology assessments (HTAs) has been frequently described in the literature, patient and citizen participation at the organizational level is less described and may be less understood and practiced in HTA bodies. We aimed to better understand its use by describing current practice.

To elicit descriptive case studies and insights we conducted semi-structured interviews and open-ended questionnaires with HTA body staff and patients and citizens participating at the organizational level in Belgium, France, Quebec, Scotland, and Wales.

We identified examples of organizational participation in managerial aspects: governance, defining patient involvement processes, evaluation processes and methods, and capacity building. Mechanisms included consultation, collaboration, and membership of standing (permanent) groups. These were sometimes combined. Participants were usually from umbrella patient organizations and patient associations, as well as individual patients and citizens.

Although the concept, participation at the organizational level, is not well-established, we observed a trend toward growth in each jurisdiction. Some goals were shared for this participation, but HTA bodies focused more on instrumental goals, especially improving participation in HTAs, while patients and citizens were more likely to offer democratic and developmental goals beyond improving participation processes.

Our findings provide rationales for organizational-level participation from the perspectives of HTA bodies and patients. The case studies provide insights into how to involve participants and who may be seen as legitimate participants. These findings may be useful to HTA bodies, the patient sector, and communities when devising an organizational-level participation framework.

Disaster management (DM) is becoming increasingly complex because of technological advancement and the multi-organization and international contexts. Effective interoperability and adequate collaboration in DM have the potential to spare the human life and to control the economic burden. For those reasons, it’s becoming important to find a way for systems and organizations that exploit, at the same time, the technological interoperability and team’s interoperability.

This study aims to provide an overview of the multi-organizational problems and solutions reflecting on achieving interoperability in multi-organizational DM.

The article is structured as a scoping review based on the Joanna Briggs Institute’s (JBI) methodology for scoping reviews. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist was used to report the results. The selected papers were assessed using the Critical Appraisal Skills Program (CASP) checklists to screen their methodological quality.

The scoping review was conducted systematically searching the databases PubMed, Google Scholar, and Web of Science. The search algorithm was developed using the three key concepts “interoperability; multi-organizational; disaster medicine” translated into different possible search and Medical Subject Headings (MeSH) terms. Studies of all research design types were considered.

The included literature is reporting experiences on interoperability and how it has been applied to health care systems and organizations interacting during a disaster event. Twelve articles were included. Specific problems and solutions were identified regarding the technological and personnel interoperability, such as ineffective integration, technical problems, lack of an interoperability language, and data filtering network. The suggested approach might involve a focus on both the technological as well the human and personnel interoperability with the aim to create a culture of interoperability through compatible technological solutions and joint trainings.

This study identified two main approaches during disasters: technology versus personnel interoperability. The suggested approach is to develop a hybrid culture of interoperability through compatible technological solutions combined to joint and multi-disciplinary trainings to achieve the development of a common language.

Further research will need a solution-focused approach on the culture and language of interoperability as thematic gathering training, socio-technical networks, and policies/procedural guidelines.

We sought to determine who is involved in the care of a trauma patient.

We recorded hospital personnel involved in 24 adult Priority 1 trauma patient admissions for 12 h or until patient demise. Hospital personnel were delineated by professional background and role.

We cataloged 19 males and 5 females with a median age of 50-y-old (interquartile range [IQR], 35.5-67.5). The average number of hospital personnel involved was 79.71 (standard deviation, 17.62; standard error 3.6). A median of 51.2% (IQR, 43.4%-59.8%) of personnel were first involved within hour 1. More personnel were involved in direct versus indirect care (median 54.5 [IQR, 47.5-67.0] vs 25.0 [IQR, 22.0-30.5]; P < 0.0001). Median number of health-care professionals and auxiliary staff were 74.5 (IQR, 63.5-90.5) and 6.0 (IQR, 5.0-7.0), respectively. More personnel were first involved in hospital locations external to the emergency department (median, 53.0 [IQR, 41.5-63.0] vs 27.5 [IQR, 24.0-30.0]; P < 0.0001). No differences existed in total personnel by Injury Severity Score (P = 0.1266), day (P = 0.7270), or time of admission (P = 0.2098).

A large number of hospital personnel with varying job responsibilities respond to severe trauma. These data may guide hospital staffing and disaster preparedness policies.

Disasters can have impact on the demand and supply of blood, with such a difficult perspective, planning of an appropriate response to counterbalance the need for blood is of paramount importance. The primary objective of this study was to evaluate how the impact of blood imbalances may be absorbed by inert recruitment of donors during 2 life-threatening earthquakes that shook Taiwan on the same date in 2016 and 2018.

A retrospective database search from blood bank registries was developed.

Despite the public efforts to restrain the flow, a 3- to 4-fold increase in volunteers responded to the earthquakes. This surge alleviated after a day and did not contribute to sub-par collections. Those who donated more than usual immediately after the event were identified as first-time, younger, and female populations. The hospitals providing inpatient care to the injured transfused a slightly decreased amount of packed red cells, whereas the use of whole blood, platelets, and plasma remained stable. The inert recruiting was effective in reducing the duration of donor overabundance.

Compared with other examples, the inert recruiting approach was effective in reducing the duration of donor overabundance to 1 day and may be useful for disaster preparedness of transfusion supplies.

The key to resilience after disasters is the provision of coordinated care and resource distribution to the affected community. Past research indicates that the general public lacks an understanding regarding agencies’ roles and responsibilities during disaster response.

This study’s purpose was to explore the general public’s beliefs regarding agencies or organizations’ responsibilities related to resource management during disasters. In addition, the public’s attitudes towards the management and use of community disaster assistance centers were explored.

Qualitative interviews were conducted with members of the general public. Interviews were audio-recorded and transcribed verbatim. Content analysis was used to analyze the data and identify themes that describe the public’s expectations of disaster response agencies and the use of community disaster assistance centers.

A total of 28 interviews were conducted. Half of the participants (n=14) were black, 57% (n=16) were female, and the mean age was 49 years. The general public has developed trust and distrust toward response organizations and governmental agencies based on past experiences during disasters. The public wishes to have local agencies to help lead disaster response, but expects a collaboration between all response organizations, including the government. The managing agency overseeing community disaster assistance centers was not perceived as important, but the proximity of these centers to community members was considered critical.

The general public prefers that local agencies and leaders manage disaster response, and they expect collaboration among response agencies. Community assistance centers need to be located close to those in need, and be managed by agencies trusted by the general public. (Disaster Med Public Health Preparedness. 2018;12:446–449)

The goal of this study was to gain insights into the decision-making processes used by California public health officials during real-time crises. The decision-making processes used by California public health officials during the 2009 H1N1 influenza pandemic were examined by a survey research team from the University of California Berkeley.

The survey was administered to local public health officials in California. Guidelines published by the Centers for Disease Control and Prevention had recommended school closure, and local public health officials had to decide whether to follow these recommendations. Chi-squared tests were used to make comparisons in the descriptive statistics.

The response rate from local public health departments was 79%. A total of 73% of respondents were involved in the decision-making process. Respondents stated whether they used or did not use 15 ethical, logistical, and political preselected criteria. They expressed interest in receiving checklists and additional training in decision-making.

Public health decision-makers do not appear to have a standard process for crisis decision-making and would benefit from having an organized decision-making model. The survey showed that ethical, logistical, and political criteria were considered but were not prioritized in any meaningful way. A new decision-making tool kit for public health decision-makers plus implementation training is warranted. (Disaster Med Public Health Preparedness. 2015;9:464–471)

From January 29 through February 5, 2013, a school district outside metropolitan Denver, Colorado, was closed because of absenteeism related to influenza-like illness (ILI) among students and staff. We evaluated the consequences and acceptability of the closure among affected households.

We conducted a household survey regarding parent or guardian employment and income interruptions, alternative child care arrangements, interruption of noneducational school services, ILI symptoms, student re-congregation, and communication preferences during the closure.

Of the 35 (31%) of 113 households surveyed, the majority (28 [80%]) reported that the closure was not challenging. Seven (20%) households reported challenges: 5 (14%) reported that 1 or more adults missed work, 3 (9%) reported lost pay, and 1 (3%) reported challenges because of missed subsidized school meals. The majority (22 [63%]) of households reported that a hypothetical 1-month closure would not represent a problem; 6 of 8 households that did anticipate challenges reported that all adults worked outside the home. The majority (58%) of students visited at least 1 outside venue during the closure.

A brief school closure did not pose a major problem for the majority of the affected households surveyed. School and public health officials should consider the needs of families in which all adults work outside the home when creating school closure contingency plans. (Disaster Med Public Health Preparedness. 2015;9:4-8)