Editorial Comments—Evaluation of Medical Command and Control Using Performance Indicators during a Full-Scale Major Aircraft Crash Exorcise

2010 ◽  
Vol 25 (2) ◽  
pp. 124-125
Author(s):  
Marvin L. Birnbaum
2010 ◽  
Vol 25 (2) ◽  
pp. 118-123 ◽  
Author(s):  
Dan Gryth ◽  
Monica Rådestad ◽  
Heléne Nilsson ◽  
Ola Nerf ◽  
Leif Svensson ◽  
...  

AbstractIntrodution:Large, functional, disaster exercises are expensive to plan and execute, and often are difficult to evaluate objectively. Command and control in disaster medicine organizations can benefit from objective results from disaster exercises to identify areas that must be improved.Objective:The objective of this pilot study was to examine if it is possible to use performance indicators for documentation and evaluation of medical command and control in a full-scale major incident exercise at two levels: (1) local level (scene of the incident and hospital); and (2) strategic level of command and control. Staff procedure skills also were evaluated.Methods:Trained observers were placed in each of the three command and control locations. These observers recorded and scored the performance of command and control using templates of performance indicators. The observers scored the level of performance by awarding 2, 1, or 0 points according to the template and evaluated content and timing of decisions. Results from 11 performance indicators were recorded at each template and scores >11 were considered as acceptable.Results:Prehospital command and control had the lowest score. This also was expressed by problems at the scene of the incident. The scores in management and staff skills were at the strategic level 15 and 17, respectively; and at the hospital level, 17 and 21, respectively.Conclusions:It is possible to use performance indicators in a full-scale, major incident exercise for evaluation of medical command and control. The results could be used to compare similar exercises and evaluate real incidents in the future.


2011 ◽  
Vol 26 (S1) ◽  
pp. s112-s112
Author(s):  
M.E.A. Rådestad ◽  
H. Nilsson ◽  
A. Rüter ◽  
M. Castren ◽  
L. Svensson ◽  
...  

IntroductionDisaster medicine is a young discipline and there is a need for the development of methods for evaluation and research. This includes full-scale disaster exercises that are quite costly. Within each organization these exercises are seldom conducted. If there was a standardized concept on how to conduct as well as evaluate these exercises, this could lead to better knowledge and cost effectiveness. The aim of this study was to increase awareness of the possibility to develop and conduct full-scale exercises in different settings using performance indicators combined with indicators related to patient outcome serving as a basis for comparison and evaluation process.MethodsTwo full-scale exercises in different organizations were studied. Identical panorama with the same number and type of casualties was used. Sets of performance indicators combined with indicators for unfavorable patient outcome, according to the Emergo Train System®, were recorded as well as all transportation times and the patient distribution to selected hospitals. Qualified observers scored the results on predetermined locations; on the scene, hospital and strategic command and control.ResultsThe lowest scored performance indicators were “first report to dispatch”, “second report from scene” and “first patient evacuated”. Due to insufficient response and evacuation times of victims to the receiving hospitals the unfavourable patient outcome, regarding preventable deaths and preventable complications were 28% (n = 18) and 41% (n = 17), respectively.ConclusionsStandardized full-scale exercises where the same type of results is recorded can be conducted. This combination of performance indicators and Emergo Train System® leads to probabilities of development and better command and control response. Future use of the same concept may demonstrate important results that will lead to new and better knowledge that can be applied during real incidents.


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