Using a Logic Model to Enable and Evaluate Long-Term Outcomes of a Mass Casualty Training Program: A Single Center Case Study

2021 ◽  
pp. 1-7
Author(s):  
Nicholas B Dadario ◽  
Simon Bellido ◽  
Andrew Restivo ◽  
Miriam Kulkarni ◽  
Maninder Singh ◽  
...  
Keyword(s):  
New York ◽  
Training Program ◽  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
Mass Casualty ◽  
Logic Model ◽  
Self Directed Learning ◽  
Academic Center ◽  
Mass Casualty Event

Abstract Purpose: Global health disasters are on the rise and can occur at any time with little advance warning, necessitating preparation. The authors created a comprehensive evidence-based Emergency Preparedness Training Program focused on long-term retention and sustained learner engagement. Method: A prospective observational study was conducted of a simulation-based mass casualty event training program designed using an outcomes-based logic model. A total of 25 frontline healthcare workers from multiple hospital sites in the New York metropolitan area participated in an 8-hour immersive workshop. Data was collected from assessments, and surveys provided to participants 3 weeks prior to the workshop, immediately following the workshop, and 3 months after completion of the workshop. Results: The mean percentage of total knowledge scores improved across pre-workshop, post-workshop and retention (3 months post-workshop) assessments (53.2% vs. 64.8% vs. 67.6%, P < 0.05). Average comfort scores in the core MCI competencies increased across pre-workshop, post-workshop and retention self-assessments (P < 0.01). Of the participants assessed at 3 months retention (n = 14, 56%), 50.0% (n = 7) assisted in updating their hospital’s emergency operations plan and 50.0% (n = 7) pursued further self-directed learning in disaster preparedness medicine. Conclusions: The use of the logic model provided a transparent framework for the design, implementation, and evaluation of a competency-based EPT program at a single academic center.

Utilizing a Pediatric Disaster Coalition Model to Increase Pediatric Critical Care Surge Capacity in New York City

2017 ◽  
Vol 11 (4) ◽  
pp. 473-478 ◽  
Author(s):  
Michael Frogel ◽  
Avram Flamm ◽  
Mayer Sagy ◽  
Katharine Uraneck ◽  
Edward Conway ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Critical Care ◽  
York City ◽  
Emergency Preparedness ◽  
Mass Casualty ◽  
Surge Capacity ◽  
Pediatric Critical Care ◽  
Mass Casualty Event ◽  
Care Surgery

AbstractA mass casualty event can result in an overwhelming number of critically injured pediatric victims that exceeds the available capacity of pediatric critical care (PCC) units, both locally and regionally. To address these gaps, the New York City (NYC) Pediatric Disaster Coalition (PDC) was established. The PDC includes experts in emergency preparedness, critical care, surgery, and emergency medicine from 18 of 25 major NYC PCC-capable hospitals. A PCC surge committee created recommendations for making additional PCC beds available with an emphasis on space, staff, stuff (equipment), and systems. The PDC assisted 15 hospitals in creating PCC surge plans by utilizing template plans and site visits. These plans created an additional 153 potential PCC surge beds. Seven hospitals tested their plans through drills. The purpose of this article was to demonstrate the need for planning for disasters involving children and to provide a stepwise, replicable model for establishing a PDC, with one of its primary goals focused on facilitating PCC surge planning. The process we describe for developing a PDC can be replicated to communities of any size, setting, or location. We offer our model as an example for other cities. (Disaster Med Public Health Preparedness. 2017;11:473–478)

scholarly journals (A47) Pediatric Mass-Casualty Triage: The New York City Approach

2011 ◽  
Vol 26 (S1) ◽  
pp. s16-s16
Author(s):  
A. Cooper ◽  
D. Gonzalez ◽  
M. Frogel ◽  
A. Flamm ◽  
D. Prezant ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Critically Ill ◽  
York City ◽  
Emergency Preparedness ◽  
Early Recognition ◽  
Trauma Surgery ◽  
Mass Casualty ◽  
Infants And Children ◽  
Mass Casualty Event

IntroductionA Mass-Casualty Event (MCE) involving pediatric victims could overwhelm existing pediatric resources. Therefore, early recognition of critically ill infants and children is essential for proper distribution among pediatric capable hospitals. However, emergency medical services (EMS) personnel have limited experience with pediatric assessments, and less with pediatric mass-casualty triage (MCT). To address these gaps, the New York City (NYC) Pediatric Disaster Coalition (PDC) in collaboration with the Fire Department (FDNY) and Office of Emergency Management, made simple alterations to the START-based NYC-MCT Algorithm that can be rapidly and accurately applied by EMS personnel in the field with minimal additional education and preparation, obviating the requirement for extensive and expensive retraining.MethodsThe PDC includes experts in pediatric emergency preparedness, emergency medicine, critical care, and trauma surgery in NYC, as well as DOHMH, FDNY-OMA, and OEM. Its Triage Subcommittee determined the minimum essential pediatric alterations to the Algorithm, which then was tested by FDNY-EMS.ResultsAfter focused literature review and multiple draft revisions aimed to maximize pediatric benefit yet minimize unnecessary complexity, the Algorithm was modified to ensure that: (1) five rescue breaths will be provided to infants or children prior to being categorized as Dead or Expectant; (2) infants under 12 months old will be categorized as Critical and receive priority transport, and (3) children initially categorized as Delayed or Minor will be uptriaged to a new Urgent (Orange) category to receive such care in a rapid manner. To date, > 3,000 FDNY personnel have been trained in its use, and tested its accuracy using tabletop scenarios. Mean accuracy is 80–90%.ConclusionsThe model is an effective, multidisciplinary approach to planning. Minimum alterations to the Algorithm were adopted by the regional EMS system. The Modified Algorithm improves identification of critically ill infants and children. This approach could be adopted by other large urban centers.

Medical Society's Blueprint for a Successful Community Response to Emergency Preparedness

2009 ◽  
Vol 24 (1) ◽  
pp. 73-75 ◽  
Author(s):  
John Maese
Keyword(s):  
New York ◽  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
Common Good ◽  
Community Response ◽  
Medical Society ◽  
Physician Leadership ◽  
Staten Island ◽  
Community Needs ◽  
Hospital Systems

AbstractIt is clear from disaster evaluations that communities must be prepared to act independently before government agencies can cope with the early ramifications of disasters. In response to devastation to the borough of Staten Island, New York in the wake of 11 September 2001, the Richmond County Medical Society established a structure to incorporate community needs and institutions to work together for the common good. A program that brings together two hospital systems, nursing homes, emergency medical services, and the Office of Emergency Management physician leadership in a meaningful way now is in place. This approach has improved the disaster preparedness of Staten Island and demonstrated how the Medical Society can provide leadership in disaster preparedness and serve as a conduit for communication amongst entities that normally do not communicate.

scholarly journals (A284) Improving Hospital Mass Casualty Preparedness through Ongoing Readiness Evaluation

2011 ◽  
Vol 26 (S1) ◽  
pp. s79-s79
Author(s):  
B. Adini ◽  
D. Laor ◽  
T. Hornik-Luria ◽  
A. Goldberg ◽  
D. Schwartz ◽  
...  
Keyword(s):  
Acute Care ◽  
Emergency Preparedness ◽  
Life Experience ◽  
Real Life ◽  
High Standard ◽  
Acute Care Hospitals ◽  
Mass Casualty ◽  
Evaluation Tool ◽  
Effective Response ◽  
Mass Casualty Event

BackgroundIsraeli Hospitals are required to maintain a high level of emergency preparedness.ObjectivesTo investigate the effect of on-going use of an evaluation tool on acute-care hospitals' emergency preparedness for mass casualty events (MCE).MethodsEvaluation of emergency preparedness for MCE was carried out in all acute-care hospitals, based on an evaluation tool consisting of 306 objective and measurable parameters. Two cycles of evaluations were conducted in 2005 to 2009 and the scores were calculated to detect differences.ResultsA significant increase was found in the mean total scores of emergency preparedness between the two cycles of evaluations (from 77.1 to 88.5). An increase was found in scores for standard operating procedures, training and equipment, but the change was significant only in the training category. The relative increase was highest in hospitals that did not experience real MCE.DiscussionThis study offers a structured and practical approach for ongoing improvement of emergency preparedness, based on validated measurable benchmarks. An ongoing assessment of the level of emergency preparedness motivates hospitals' management and staff to improve their capabilities and thus results in a more effective response mechanism for emergency scenarios.ConclusionsUtilization of predetermined and measurable benchmarks allows the institutions being assessed to improve their level of performance in the evaluated areas. The expectation is that these benchmarks will allow for a better response to actual MCEs. The study further demonstrated that even hospitals without “real-life” experience can gear up using preset benchmarks and reach a high standard of mass casualty event preparedness.

scholarly journals An Evaluation of the Literacy Demands of Online Natural Disaster Preparedness Materials for Families

2019 ◽  
Vol 14 (4) ◽  
pp. 449-458
Author(s):  
Marvin So ◽  
Jessica L. Franks ◽  
Robyn A. Cree ◽  
Rebecca T. Leeb
Keyword(s):  
Natural Disasters ◽  
Risk Communication ◽  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
Information Source ◽  
Assessment Tools ◽  
Literacy Assessment ◽  
Self Directed Learning ◽  
Care Needs ◽  
Assessment Scores

AbstractObjective:Natural disasters are becoming increasingly common, but it is unclear whether families can comprehend and use available resources to prepare for such emergencies. The objective of this study was to evaluate the literacy demands of risk communication materials on natural disasters for US families with children.Methods:In January 2018, we assessed 386 online self-directed learning resources related to emergency preparedness for natural disasters using 5 literacy assessment tools. Assessment scores were compared by information source, audience type, and disaster type.Results:One-in-three websites represented government institutions, and 3/4 were written for a general audience. Nearly 1-in-5 websites did not specify a disaster type. Assessment scores suggest a mismatch between the general population’s literacy levels and literacy demands of materials in the areas of readability, complexity, suitability, web usability, and overall audience appropriateness. Materials required more years of education beyond the grade level recommended by prominent health organizations. Resources for caregivers of children generally and children with special health care needs possessed lower literacy demands than materials overall, for most assessment tools.Conclusions:Risk communication and public health agencies could better align the literacy demands of emergency preparedness materials with the literacy capabilities of the general public.

A Comparison of Emergency Preparedness Policies by Long-Term Care Setting Type in Ohio: Assisted Living Settings Lag Behind Nursing Homes in Key Areas

2020 ◽  
pp. 073346482090201
Author(s):  
Katherine A. Kennedy ◽  
Cassandra L. Hua ◽  
Ian Nelson
Keyword(s):  
Assisted Living ◽  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
Long Term Care ◽  
Nursing Facilities ◽  
Community Based ◽  
Term Care ◽  
Skilled Nursing ◽  
Care Facilities

Skilled nursing facilities (SNFs) have received regulatory attention in relation to their emergency preparedness. Yet, assisted living settings (ALs) have not experienced such interest due to their classification as a state-regulated, home- and community-based service. However, the growth in the number of ALs and increased resident acuity levels suggest that existing disaster preparedness policies, and therefore, plans, lag behind those of SNFs. We examined differences in emergency preparedness policies between Ohio’s SNFs and ALs. Data were drawn from the 2015 wave of the Ohio Biennial Survey of Long-Term Care Facilities. Across setting types, most aspects of preparedness were similar, such as written plans, specifications for evacuation, emergency drills, communication procedures, and preparations for expected hazards. Despite these similarities, we found SNFs were more prepared than large ALs in some key areas, most notably being more likely to have a backup generator and 7 days of pharmacy stocks and generator fuel.

Disaster Olympics: A Model for Resident Education

2016 ◽  
Vol 31 (3) ◽  
pp. 237-241 ◽  
Author(s):  
P. Daniel ◽  
R. Gist ◽  
A. Grock ◽  
S. Kohlhoff ◽  
P. Roblin ◽  
...  
Keyword(s):  
New York ◽  
Emergency Preparedness ◽  
Test Scores ◽  
Resident Education ◽  
Olympic Games ◽  
Disaster Medicine ◽  
Publication Type ◽  
Educational Method ◽  
Academic Center ◽  
Post Test

AbstractObjectivesThe aim of this study was to describe an educational method teaching Disaster Medicine to American Emergency Medicine (EM) physicians and to evaluate knowledge attainment using this method.MethodsThis was an observational study using a pre-test and a post-test. A full-scale disaster exercise (FSE) was conducted at a large academic center with two hospitals in Brooklyn, New York (USA). Eighty-two EM residents (physicians in training, post medical school) participated in the study. Inclusion criteria for study participation was all EM residents training at the State University of New York (SUNY) Downstate at the time of the study. There were no exclusion criteria. The exercise was a disaster drill designed as “Olympic Games.” Participants in the exercise took a pre-test and a post-test. The primary outcome of the study was the mean difference between pre-test and post-test scores of the study participants using independent sample t-tests. Secondary outcomes of the study were percent of critical actions met by the residents and the hospitals as measured by direct observation of trained study personnel during the exercise.ResultsMean resident post-test scores were higher than pre-test scores to a degree that was statistically significant (62% versus 53%; P =.002). The residents’ performances ranged from 48% to 63% of objectives met. The hospitals’ performances met 50% to 100% of their objectives.ConclusionThe use of an Olympic Games format was an effective model for disaster education for physicians. The model allowed for evaluation of performance and protocols of participants and hospital systems, respectively, and may be used objectively to evaluate for areas of improvement. The Disaster Olympics drill was found to improve emergency preparedness knowledge in the population studied and may constitute a novel and efficacious methodology in disaster training.DanielP, GistR, GrockA, KohlhoffS, RoblinP, ArquillaB. Disaster Olympics: a model for resident education. Prehosp Disaster Med. 2016;31(3):237–241.

Playing Politics with Natural Disaster

2020 ◽  
Author(s):  
Timothy W. Kneeland
Keyword(s):  
New York ◽  
Emergency Management ◽  
Emergency Preparedness ◽  
The United States ◽  
Local State ◽  
Disaster Victims ◽  
Disaster Policy ◽  
Disaster Preparation ◽  
The Impact

Hurricane Agnes struck the United States in June of 1972, just months before a pivotal election and at the dawn of the deindustrialization period across the Northeast. The response by local, state, and national officials had long-term consequences for all Americans. President Richard Nixon used the tragedy for political gain by delivering a generous relief package to the key states of New York and Pennsylvania in a bid to win over voters. After his landslide reelection in 1972, Nixon cut benefits for disaster victims and then passed legislation to push responsibility for disaster preparation and mitigation onto states and localities. The impact led to the rise of emergency management and inspired the development of the Federal Emergency Management Agency (FEMA). With a particular focus on events in New York and Pennsylvania, this book narrates how local, state, and federal authorities responded to the immediate crisis of Hurricane Agnes and managed the long-term recovery. The impact of Agnes was horrific, as the storm left 122 people dead, forced tens of thousands into homelessness, and caused billions of dollars in damage from Florida to New York. In its aftermath, local officials and leaders directed disaster relief funds to rebuild their shattered cities and reshaped future disaster policies. The book explains how the political decisions by local, state, and federal officials shaped state and national disaster policy and continues to influence emergency preparedness and response to this day.

scholarly journals Hospitals preparedness using WHO guideline: A systematic review and meta-analysis

2018 ◽  
Vol 25 (4) ◽  
pp. 211-222 ◽  
Author(s):  
Fatemeh Rezaei ◽  
Mohammad Reza Maracy ◽  
Mohammad H Yarmohammadian ◽  
Hojat Sheikhbardsiri
Keyword(s):  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
Meta Analysis ◽  
Scientific Information ◽  
Critical Role ◽  
Mass Casualty ◽  
World Health ◽  
Bibliographic Databases ◽  
Hospital Emergency ◽  
Hospital Emergency Preparedness

Background: Hospitals play a critical role in providing communities with essential medical care during disasters. Objectives: In this article, the key components and recommended actions of WHO (World Health Organization) Hospital emergency response checklist have been considered to identify current practices in disaster/emergency hospital preparedness in actual or potential incidents. Methods: Articles were obtained through bibliographic databases, including ISI Web of Science, PubMed, Science Direct, Scopus, Google Scholar, and SID: Scientific information database. Keywords were “Disaster,” “Preparedness,” “Emergency Preparedness,” “Disaster Planning,” “Mass Casualty Incidents,” “Hospital Emergency Preparedness,” “Health Emergency Preparedness,” “Preparedness Response,” and “Emergency Readiness.” Independent reviewers (F.R. and M.H.Y.) screened abstracts and titles for eligibility. STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) checklist was used to qualifying the studies for this review. Results: Of 1545 identified studies, 26 articles were implied inclusion criteria. They accounted for nine key components and 92 recommended actions. The majority of principles that had been rigorously recommended at any level of the hospital emergency preparedness were command and control and post-disaster recovery. Surge capacity was considered less frequently. Conclusion: We recommend considering the proposed disaster categories by FEMA (Federal Emergency Management Agency). In this framework, different weights for nine components can be considered based on disaster categories. Thus, a more valid and reliable preparedness checklist could be developed.

Factors Influencing the Prioritization of Injured Patients for Transfer to a Burn or Trauma Center Following a Mass Casualty Event

2020 ◽  
pp. 1-8
Author(s):  
Elizabeth A. Lancet ◽  
Wei Wei Zhang ◽  
Patricia Roblin ◽  
Bonnie Arquilla ◽  
Rachel Zeig-Owens ◽  
...  
Keyword(s):  
New York ◽  
Large Scale ◽  
Local Community ◽  
Injury Severity ◽  
Community Hospital ◽  
Clinical Information ◽  
Mass Casualty ◽  
Patient Profile ◽  
Mass Casualty Event ◽  
Consultation Team

ABSTRACT Objectives: In New York City, a multi-disciplinary Mass Casualty Consultation team is proposed to support prioritization of patients for coordinated inter-facility transfer after a large-scale mass casualty event. This study examines factors that influence consultation team prioritization decisions. Methods: As part of a multi-hospital functional exercise, 2 teams prioritized the same set of 69 patient profiles. Prioritization decisions were compared between teams. Agreement between teams was assessed based on patient profile demographics and injury severity. An investigator interviewed team leaders to determine reasons for discordant transfer decisions. Results: The 2 teams differed significantly in the total number of transfers recommended (49 vs 36; P = 0.003). However, there was substantial agreement when recommending transfer to burn centers, with 85.5% agreement and inter-rater reliability of 0.67 (confidence interval: 0.49–0.85). There was better agreement for patients with a higher acuity of injuries. Based on interviews, the most common reason for discordance was insider knowledge of the local community hospital and its capabilities. Conclusions: A multi-disciplinary Mass Casualty Consultation team was able to rapidly prioritize patients for coordinated secondary transfer using limited clinical information. Training for consultation teams should emphasize guidelines for transfer based on existing services at sending and receiving hospitals, as knowledge of local community hospital capabilities influence physician decision-making.

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