Enhancing Operational Safety Through Mechanization and Intelligent Automation of Drill Floor Operations

Our rig crews regularly work around structures that pose risks such as dropped objects and pinch points. HSE and operational performance is highly dependent on human performance. Human performance or human factors have resulted in a relatively high frequency of serious Health, Safety and Environment (HSE) incidents associated with tubular handling on ADNOC Onshore rigs. An example is the fatality on a rig in Abu Dhabi while preparing to run casing in February 2018. We believe we can prevent major incidents, enhance efficiency and reduce risk by removing our people from harm's way through mechanization and intelligent automation of drill floor activities. The objective of this work is to reduce the human factor as low as reasonably practicable through mechanization and intelligent automation of tubular handling operations on ADNOC Onshore rigs. An incident prevention workshop recommended a technology search to enable hands free operations and reduce the human to machine interaction as much as reasonably practicable. A quick market research and a "Go, See, Assess" exercise with ADNOC Shareholders revealed several potential offerings on the market. ADNOC Onshore collaborated with two major technology providers and jointly designed a mechanized set up for ADNOC Onshore land rigs. The solution involved the use of mechanized equipment such as Casing Running Tools complete with hydraulically actuated single joint elevators, hydraulic catwalk, automated power slips, remote operated tong system with supporting alignment systems, air operated elevators, remote operated stabber, etc. The solution was successfully implemented on multiple rigs. The mechanized set up reduced the number of people in the so called RED Zone by 50% (Stabber, Tong Operator, Thread Inspector and Floor man) during casing and completion running operations. Other benefits realized include: Reduced reliance on human performance Reduced risk of harm to people due to dropped objects and pinch points on the rig floor Assured consistency in executing repetitive tasks such as running casing, etc This level of mechanization and intelligent automation is a first in the ADNOC Group, represents a STEP CHANGE in operational safety and has transformed how we do our business, underpinning HSE as priority number one.

Digital Twin conceptual framework for improving critical infrastructure resilience

Critical infrastructures are the backbone of our societies with increasingly complex and networked characteristics and high availability demands. This makes them vulnerable to a wide range of threats that can lead to major incidents. Resilience is a concept that describes a system’s ability to absorb and respond to disturbances, as well as to learn from the past and anticipate new threats. In this article, we apply the Digital Twin concept to the infrastructure domain to improve the system’s resilience capabilities. We conduct a comprehensive requirements analysis related to infrastructure characteristics, crisis management and resilience measures. As a result, we propose a Digital Twin Conceptual Framework for critical infrastructures. We conclude that the Digital Twin paradigm is well suited to enhance critical infrastructure resilience.

Comparative analysis of major incident triage tools in children: a UK population-based analysis

IntroductionTriage is a key principle in the effective management of major incidents. There is currently a paucity of evidence to guide the triage of children. The aim of this study was to perform a comparative analysis of nine adult and paediatric triage tools, including the novel ‘Sheffield Paediatric Triage Tool’ (SPTT), assessing their ability in identifying patients needing life-saving interventions (LSIs).MethodsA 10-year (2008–2017) retrospective database review of the Trauma Audit Research Network (TARN) Database for paediatric patients (<16 years) was performed. Primary outcome was identification of patients receiving one or more LSIs from a previously defined list. Secondary outcomes included mortality and prediction of Injury Severity Score (ISS) >15. Primary analysis was conducted on patients with complete prehospital physiological data with planned secondary analyses using first recorded data. Performance characteristics were evaluated using sensitivity, specificity, undertriage and overtriage.Results15 133 patients met TARN inclusion criteria. 4962 (32.8%) had complete prehospital physiological data and 8255 (54.5%) had complete first recorded physiological data. The majority of patients were male (69.5%), with a median age of 11.9 years. The overwhelming majority of patients (95.4%) sustained blunt trauma, yielding a median ISS of 9 and overall, 875 patients (17.6%) received at least one LSI. The SPTT demonstrated the greatest sensitivity of all triage tools at identifying need for LSI (92.2%) but was associated with the highest rate of overtriage (75.0%). Both the Paediatric Triage Tape (sensitivity 34.1%) and JumpSTART (sensitivity 45.0%) performed less well at identifying LSI. By contrast, the adult Modified Physiological Triage Tool-24 (MPTT-24) triage tool had the second highest sensitivity (80.8%) with tolerable rates of overtriage (70.2%).ConclusionThe SPTT and MPTT-24 outperform existing paediatric triage tools at identifying those patients requiring LSIs. This may necessitate a change in recommended practice. Further work is needed to determine the optimum method of paediatric major incident triage, but consideration should be given to simplifying major incident triage by the use of one generic tool (the MPTT-24) for adults and children.

Cost-effectiveness of ‘screen-and-treat’ interventions for post-traumatic stress disorder following major incidents

ObjectivesPost-traumatic stress disorder (PTSD) is commonly experienced in the aftermath of major incidents such as terrorism and pandemics. Well-established principles of response include effective and scalable treatment for individuals affected by PTSD. In England, such responses have combined proactive outreach, screening and evidence-based interventions (a ‘screen-and-treat’ approach), but little is known about its cost-effectiveness. The objective of this paper is to report the first systematic attempt to assess the cost-effectiveness of this approach.MethodsA decision modelling analysis was undertaken to estimate the costs per quality-adjusted life-year (QALY) gained from a screen-and-treat approach compared with treatment-as-usual, the latter involving identification of PTSD by general practitioners and referral to psychological therapy services. Model input variables were drawn from relevant empirical studies in the context of terrorism and the unit costs of health and social care in England. The model was run over a 5-year time horizon for a hypothetical cohort of 1000 exposed adults from the perspective of the National Health Service and Personal Social Services in England.ResultsThe incremental cost per QALY gained was £7931. This would be considered cost-effective 88% of the time at a willingness-to-pay threshold of £20 000 per QALY gained, the threshold associated with the National Institute for Health and Care Excellence in England. Sensitivity analysis confirmed this result was robust.ConclusionsA screen-and-treat approach for identifying and treating PTSD in adults following terrorist attacks appears cost-effective in England compared with treatment-as-usual through conventional primary care routes. Although this finding was in the context of terrorism, the implications might be translatable into other major incident-related scenarios including the current COVID-19 pandemic.

A Qualitative Study on Researchers’ Experiences after Publishing Scientific Reports on Major Incidents, Mass-Casualty Incidents, and Disasters

Introduction and Objective: Scientific reporting on major incidents, mass-casualty incidents (MCIs), and disasters is challenging and made difficult by the nature of the medical response. Many obstacles might explain why there are few and primarily non-heterogenous published articles available. This study examines the process of scientific reporting through first-hand experiences from authors of published reports. It aims to identify learning points and challenges that are important to address to mitigate and improve scientific reporting after major incidents. Methods: This was a qualitative study design using semi-structured interviews. Participants were selected based on a comprehensive literature search. Ten researchers, who had published reports on major incidents, MCIs, or disasters from 2013-2018 were included, of both genders, from eight countries on three continents. The researchers reported on large fires, terrorist attacks, shootings, complex road accidents, transportation accidents, and earthquakes. Results: The interview was themed around initiation, workload, data collection, guidelines/templates, and motivation factors for reporting. The most challenging aspects of the reporting process proved to be a lack of dedicated time, difficulties concerning data collection, and structuring the report. Most researchers had no prior experience in reporting on major incidents. Guidelines and templates were often chosen based on how easily accessible and user-friendly they were. Conclusion and Relevance: There are few articles presenting first-hand experience from the process of scientific reporting on major incidents, MCIs, and disasters. This study presents motivation factors, challenges during reporting, and factors that affected the researchers’ choice of reporting tools such as guidelines and templates. This study shows that the structural tools available for gathering data and writing scientific reports need to be more widely promoted to improve systematic reporting in Emergency and Disaster Medicine. Through gathering, comparing, and analyzing data, knowledge can be acquired to strengthen and improve responses to future major incidents. This study indicates that transparency and willingness to share information are requisite for forming a successful scientific report.

Prehospital major incident management: how do training and real-life situations relate? A qualitative study

ObjectiveTo explore the relationship between preparations and real-life experiences among prehospital major incident commanders.DesignAn explorative, qualitative design was used.SettingPrehospital major incidents in Sweden. Data were collected between December 2019 and August 2020.ParticipantsPrehospital major incident commanders (n=15) with real-life experiences from major events, such as fires, bus accidents, a bridge collapse and terrorist attacks, were included. All but one had participated in 2-day training focusing on the prehospital management of major incidents. In addition, about half of the participants had participated in simulation exercises, academic courses and other training in the management of major incidents.MethodsData from two-session individual interviews were analysed using inductive thematic analysis.ResultsThe conformity between real-life major incidents and preparations was good regarding prehospital major incident commanders’ knowledge of the operational procedures applied in major incidents. However, the preparations did not allow for the complexities and endurance strategies required in real-life incidents. Personal preparations, such as mental preparedness or stress management, were not sufficiently covered in the preparations. To some extent, professional experience (such as training) could compensate for the lack of formal preparations.ConclusionsThis study identified perceived gaps between preparations and real-life experiences of being a prehospital major incident commander. To minimise the gaps between demands and expectations on perceived control and to better prepare individuals for being prehospital major incident commanders, the training and other preparations should reflect complexities of real-life incidents. Preparations should develop both technical skills required, such as principles and methodology used, and personal preparedness. Personal preparations should include improving one’s mental preparedness, self-knowledge and professional self-confidence required to successfully act as a prehospital incident commander. Since little is known about what pedagogical methods that should be used to enhance this, further research is needed.

“We Thought We Were Prepared, but We Were Not”: Experiences from the Management of the Psychosocial Support Response during the COVID-19 Pandemic in Sweden. A Mixed-Methods Study

This study aimed to describe experiences of managing mental health and psychosocial activities during the first six months of the COVID-19 pandemic in Sweden. A national survey was answered by a non-probability sample of 340 involved in the psychosocial response. The psychosocial response operations met several challenges, mainly related to the diverse actors involved, lack of competence, and lack of preparations. Less than 80% of the participants had received specific training in the provision of psychosocial support during major incidents. The interventions used varied, and no large-scale interventions were used. The psychosocial response organizations were overwhelmed by the needs of health care staff and failed to meet the needs of patients and family members. An efficient and durable psychosocial response in a long-term crisis requires to be structured, planned and well-integrated into the overall pandemic response. All personnel involved need adequate and specific competence in evidence-based individual and large-scale interventions to provide psychosocial support in significant incidents. By increasing general awareness of mental wellbeing and psychosocial support amongst health professionals and their first-line managers, a more resilient health care system, both in everyday life and during major incidents and disasters, could be facilitated.

Decision-making by medical officer in charge during major incidents: a qualitative study

Background An incident command structure is commonly used to manage responses to major incidents. In the hospital incident command structure, the medical officer in charge (MOC) is in a key position. The decision-making process is essential to effective management, but little is known about which factors influence the process. Therefore, the current study aimed to describe factors influencing decision-making of MOCs. Methods A conventional content analysis was conducted based on 16 individual interviews with medical doctors who had been deployed as MOCs at Swedish hospitals during major incidents. Results The results showed that the decision-making and re-evaluation process was a comprehensive analysis influenced by three categories of factors: event factors, including consequences from the type of event, levels of uncertainty and the circumstances; organizational factors, including the doctor’s role, information management and the response to the event; and personal factors, such as competence, personality and mental preparedness. Conclusions Reliable and timely information management structure enabling the gathering and analysis of essential information, a clear command structure and appropriate personal qualities were essential and contributed to successful MOCs decision making in major incidents.