bluuebunny/crossref_metadata_2025 huggingface dataset:
Critical Decision-making in Medical Command and Control During Early Covid-19: An Interview Study
Authors: Pettersson Jenny , Jonson Carl-Oscar , Friberg Marc , Björnqvist Anton , Berggren Peter , Frisk Jessica , Prytz Erik
Published: June 2023

Introduction:

A resilient health care system is expected to withstand disruptive events and consistently deliver high quality care by continually adapting, learning, and improving. To achieve these expectations, medical command and control teams are responsible for making relevant strategic decisions, reallocating resources, and initiating cooperation. Early during Covid-19, medical command and control teams were faced with an unforeseen increase in number of patients, as well as unknown disease mechanisms and treatment regimes. Timely and adequate decision-making to become a resilient healthcare system and maintain high quality care was necessary. The aim of the present study was to describe the challenges and strategies in a medical command and control team during the early phase of the Covid-19 pandemic.

Method:

A semi-structured retrospective in-depth interview study with phenomenological approach and inductive design was used. Thirteen experienced decision makers serving in a regional medical command and control team were interviewed using the Critical Decision Method. The interviews were analyzed using manifest conventional content analyses.

Results:

The respondents described twelve separate episodes during the Covid-19 management. The analysis resulted in five themes: organization, adaptation, common operational picture, assumptions, and analysis. Organization described how organizational challenges affected the decision-making process. Adaptation described the strategies to overcome the obstructive organizational factors. Common operational picture described how challenges in lack of available information affected decision-making and strategies used in creating situational awareness. Assumptions offered descriptions of strategies used to make decisions. Analysis emphasized descriptions and strategies affecting the decision-making process.

Conclusion:

This study enables a better understanding of how medical command and control teams can be organized and structured, while also highlighting challenges in maintaining high-quality care during unexpected events. The findings obtained in the present study provide further knowledge about disaster resilience and can be utilized in educational and training settings for medical command and control.
From Crisis to Challenges: The Use of ECMO During COVID-19 Outbreak in Israel
Authors: Goren Odeda Benin , Taub Sigal Liverant , Kassif Yigal
Published: June 2023

Introduction:

The use of ECMO devices began about 50 years ago. The purpose of the ECMO device is to enable gas exchange (oxygen and carbon dioxide) and/or hemodynamic support in situations of pulmonary or heart failure to recover or to serve as a bridge in a waiting period for heart pulmonary, heart, or artificial heart transplantation. The COVID-19 outbreak increased the need for the use of ECMO as a life-saving treatment. As a result, there was an increasing demand for qualified personnel in overloaded hospitals' ICUs to care for COVID-19 patients in general, specifically for those who required ECMO treatment. These required rapid team training and new methodology development collaboration between the Ministry of Health (MOH), multi-disciplinary teams, and a national professional committee that set the treatment protocols based on universal standards.

Method:

A professional national committee was appointed by the MoH. The committee included Physicians, Nurses, Cardiopulmonary Bypass Machine Operators/Perfusionists as well as MoH representatives. The role of the committee was to establish guidelines and standards for operating ECMO services. These guidelines were adopted by the MoH and are the basic recommendations for operating ECMO units in Israeli hospitals.

Results:

The whole process had a dual challenge. One challenge was establishing new ECMO units according to the guidelines and the universal standards created by the committee. The other challenge was to motivate the old and experienced ECMO units to adopt and work according to the official standards set by the committee.

Conclusion:

These days the committee started the evaluation of the old ECMO Units to bring all ECMO units in Israel to work by the same guidelines and standards.
Community-Based Response to Pandemic: Case Study of Home Isolation Center using Flexible Surge Capacity
Authors: Phattharapornjaroen Phatthranit , Carlström Eric , Sivarak Ornlatcha , Tansuwannarat Phantakan , Chalermdamrichai Phanorn , Sittichanbuncha Yuwares , Kongtoranin Lalana , Phattranonuthai Rabkwan , Marlow Phimonrat , Winyuchonjaroen Wiyada , Pongpasupa Nathikarn , Khorram-Manesh Amir
Published: June 2023

Introduction:

The SARS-CoV-2 virus 2019 (COVID-19) has consumed many available resources within contingency plans, necessitating new capacity surges and novel approaches. This study aimed to explore the possibility of implementing the Flexible Surge Capacity concept in relieving hospitals by focusing on the community resources to develop “Home Isolation Centers” in Bangkok, Thailand.

Method:

This is a qualitative study consisting of observational and semi-structured interview data. The development and activities of Home Isolation Centers were observed, and interviews were conducted with leaders and operational workforces. Data were deductively analyzed and categorized based on the practical elements necessary in disaster and emergency management.

Results:

The obtained data could be categorized into the seven collaborative elements of the major incident medical management and support model. The command-and-control category demonstrated four subcategories: 1) coordination and collaboration, 2) staff engagement, 3) responsibility clarification, and 4) sustainability. Safety presented two subcategories: 1) patients’ information privacy and treatment, and 2) personnel safety and privacy. Communication showed internal and external communications subcategories. Assessment, triage, treatment, and transport followed the processes of the COVID-19 treatment protocols according to the World Health Organization guidelines and hospital operations. Several supplies and patient-related challenges were identified and managed during center development.

Conclusion:

The use of community resources, based on the flexible surge capacity concept, was feasible under restricted circumstances and enabled the relief of hospitals during the pandemic. Continuous education among multidisciplinary volunteer teams facilitated their full participation and engagement. The concept of flexible surge capacity may promote an alternative community-based care opportunity, irrespective of the emergencies’ etiology.
Towards the Next Pandemic–What Have We Learned? Insights of a Large Tertiary Care Hospital
Authors: Schwartz Dagan , Hayat Michal , Nagar Dorit
Published: June 2023

Introduction:

The first cases of COVID-19 arrived in Israel in March 2020. In Israel, the first known cases were Israeli patients diagnosed with COVID-19 aboard the Diamond Princess which were repatriated.

Shortly later, additional cases were found in increasing numbers constituting the "first wave". The high number of patients put significant strain on Israeli hospitals. The initial wave was later followed by additional surges in the number of patients further straining the system. At the peak, hospitals with a total bed capacity of 800 had 135 covid-19 patients with 21 of them requiring ventilatory support.

Method:

Daily and weekly multidisciplinary meetings were held and daily reports were composed. Following each wave, lessons learned and recommendations for improved preparedness were formulated. The following results and conclusion sections summarize some of the main insights and recommendations.

Results:

The main challenges in Beilinson hospital during the "first wave" were a shortage of personal protective equipment (PPE) and how to best utilize the existing supplies, uncertainty regarding infectiveness, best management practices and uncertainty regarding the expected magnitude and duration of the pandemic. In retrospect, the major insights were the need for a flexible and divisible ED to safely care for changing loads of suspected and verified COVID-19 patients as well as COVID-19 negative patients. Increasing the in-hospital stockpile of PPE as well as the regional and national stockpile and creating local production capacities. The importance of the daily multidisciplinary managerial meeting was to improve situational awareness and allow improved decision making. Staff briefing occurred on a daily basis and during times of high uncertainty at the beginning of every shift.

Conclusion:

Performing structured and frequent debriefing and analysis to achieve clinical and operational insights is crucial for improved short-term performance as well as improving preparedness for future challenges.
A Characterization of the Burden from Mandated COVID-19 Public Health Reporting on a Small Independent Hospital in New York City
Authors: Daniel Pia , Arquilla Bonnie , Roblin Patricia , Kaufman David , Cato Kenrick , Senathirajah Yalini
Published: June 2023

Introduction:

Public health agencies’ ability to monitor outbreaks requires government mandated reporting from healthcare institutions, with consequences for noncompliance. This study aims to characterize the burden on acute care hospitals from government reporting requirements during COVID-19 pandemic.

Method:

A retrospective study over a 14-month period (April 27th, 2020 to June 10th, 2021) during the COVID-19 pandemic examining the log of changes and requirements of the Health and Human Services (HHS) Teletracking, an online system for hospital reporting. We interviewed 33 individuals including hospital leadership, clinical directors, and infection control personnel in a New York City (NYC) small independent hospital (SIH).

Results:

During the study period, reporting requirements increased from five daily reports to 29 daily reports across eleven different agencies, all with separate reporting systems. Reporting schedules varied from several times a day to intermittently. Typically, new reporting requirements were conveyed to institutional contacts at 8 AM with a required deadline of 1 PM the same day. The continuous changes reportedly made it difficult to develop stable data gathering and workflow processes. There was a reported lack of clarity around new data elements’ definitions and different agencies employed different variables for the same measure. There were hospital penalties for missing deadlines, leading to clinical staff being diverted from patient care to meet reporting needs.

Conclusion:

The study shows significant reporting barriers and diversion of resources away from the frontline to supply data collection during disasters. There is significant redundancy in reporting agencies and in reporting systems, each with different reporting frequencies, and variable definitions of data elements. The public health needs of a disaster response would be better served with a more coordinated, efficient system to share information without further straining the healthcare system.
Required Functions of Information Gathering and Processing for Health, Medical, and Welfare Coordination Headquarters for Disasters in Japan
Authors: Ojima Toshiyuki , Takasugi Tomo , Haraoka Tomoko , Tonai Shuji , Miyagawa Shoko , Ichikawa Manabu , Hattori Kiyoko , Okuda Hiroko , Yi Tai-young , Tomio Jun
Published: June 2023

Introduction:

The Ministry of Health, Labor, and Welfare of Japan have suggested local governments establish Health, Medical, and Welfare Coordination Headquarters at the time of disaster. Gathering and processing information is one of the key functions of the headquarters. The study aims to clarify the required functions of information for the headquarters.

Method:

A series of interview surveys and observations were conducted, including for local governments and experts in disaster response. The contents were analyzed and required standard functions and procedures had been extracted.

Results:

The most important aspect of information gathering is its use in decision-making in matching needs and demands with resources. Needs and demands are based on damage and situation of the casualties. Resources can be categorized into human, material, financial, and informational. Because the headquarters have to process much information, it is important to clarify the objective and strategy of disaster response. The headquarters gather various quantitative and qualitative information using information and communication technology, telephone, meeting and other methods. Qualitative information can be categorized as: expected, surprising (unexpected), and unusual (rare) contents. For expected contents, quantification or estimation of needs from information in normal time or limited information immediately after the disaster and displaying or further analyzing by geographic information systems is useful. By surprising contents or case reports, additional responses or strategies will need to be reviewed.

Conclusion:

The procedure, including information gathering and decision-making, follows the OODA (observe, orient, decide, act) loop. According to our mail survey of all 47 prefectural local governments in 2019, 89% were planning to establish the headquarters. However, only 36% had prepared a manual. Using the results of this study, a standard strategic manual for the operations of the headquarters is being developed and brushed up.
Transforming Disaster and Emergency Health Policy for Contemporary Hazard Threats–a Multi-country Review
Authors: Finnigan Gerard
Published: June 2023

Introduction:

Strengthening national disaster management legislation and policy is critical for preventing and reducing catastrophic health effects from the growing threat of natural hazard disasters. Although evaluations of the effectiveness of legal and policy instruments are rarely published, similar approaches continue to be applied universally by governments to align their response to disaster impacts. This study analyzed and contrasted the effect of disaster legislation and policy on the emergency health and medical response to six complex natural hazard disasters, including typhoon, earthquake, flood, smoke haze, thunderstorm asthma and the COVID-19 pandemic.

Method:

The study applied qualitative multi-case study methodology and used a standardized program logic model to synthesize and analyze the effect of national disaster legislation and policy on emergency health and medical responses. Events were case-bounded by date, more than 9,000 casualties, and local emergency responses provided health and medical care.

Results:

Four themes emerged critical to health system response. Where legislation and policy provided clear separation of powers, systems delineated roles and responsibilities, provided clarity and process for assessment, resource acquisition, and operational mandates. Policies that created dedicated local networks and included non-health related organizations, accelerated coordination of crucial health functions for rapid mobilization and prioritization for affected populations. In all but one case, the hazard was closely monitored, already affected communities, and catastrophic risk to life understood, before the declaration and statutory powers were invoked.

Conclusion:

Using ‘declarations’ as the legal instrument to initiate ‘whole of government’ resources in disasters requires urgent review, especially where advanced hazard monitoring systems exist. Disaster and emergency health policy should support action orientated toward exposure mitigation, inclusion of non-traditional health actors and partnership building. International policy mechanisms are required to address emerging health threats not locally prioritized and advance regional cooperation agreements when the impact of hazards harm populations outside geographic boundaries.
Descriptive Analysis of Northern Triangle Disasters in the EM-DAT Database: 1900-2022.
Authors: Dickason Robert , Hertelendy Attila , Hart Alexander , Ciottone Gregory
Published: June 2023

Introduction:

Since 1900, disasters in the Northern Triangle of Central America—Guatemala, Honduras, and El Salvador—have caused over one-hundred-thousand deaths, affected millions of people, and caused billions of dollars of damages. As climate change causes increasingly frequent severe weather events, the catastrophic effects of disasters are likely to contribute to poverty and political and economic instability in the region leading to greater levels of migration out of the Northern Triangle.

Method:

This study provides a descriptive analysis of all disasters recorded in the EM-DAT database affecting Guatemala, Honduras, and El Salvador between 1900-2022. Disasters are analyzed by frequency, severity, financial cost, distribution by country, burden of death, affected and financial cost by country, and type of disasters most prevalent in each country. These trends are then graphed over the time period of the database.

Results:

EM-DAT records 359 disasters in the Northern Triangle between 1900 and 2022. Meteorologic events (floods and storms) were the most common types of disaster (44%), followed by transport accidents (13%). Meteorologic events and earthquakes were the most severe, as measured by deaths (62% of total deaths caused by disasters), people affected (60%), and financial cost (86%). Guatemala had the greatest number of disasters (45%), deaths (68%), and affected people (52%). The financial costs of the disasters were evenly distributed between the three countries.

Conclusion:

Meteorologic disasters are the most common and most severe type of disaster in the Northern Triangle. Earthquakes and transport accidents are also common. As climate change causes more severe storms in the region, disasters are likely to increase in severity as well. Governments and aid organizations should develop disaster preparedness and mitigation strategies to lessen the catastrophic effects of these coming disasters. Missing data in the EM-DAT dataset limits the conclusions of this study to general trends
Triage at Mass Gathering Events: Not an Emergency Department, and Not (Necessarily) a Disaster
Authors: Munn Matthew , Scholliers Annelies , Gogaert Stefan , Bistaraki Angeliki
Published: June 2023

Introduction:

Triage at mass gathering events (MGEs) has no standard protocol that is widely accepted and applied uniformly across event types and locations. This investigation describes the current state of published literature as it applies specifically to the triage of patient presentations at MGEs, and identifies key roles and important limitations of triage methods in use at events.

Method:

A literature review search strategy was employed (previously published, Turris et al, 2021) to search for event case reports published for the period from 2010-2022. Included papers were reviewed and data were extracted for all references to triage; authors were contacted for any missing details. Data extraction looked specifically for the following (if available) : triage mention, triage scale used, triage categories with patient counts, triage training and any information on clinical dispositions subsequent to triage assignment.

Results:

A total of 60 papers were included (Data extraction in progress, numbers to be finalized for presentation). Of these papers, a minority even made mention of triage, very few specified the triage scale used, and almost none described any triage training. Only a handful of case reports contained counts of patient presentation by triage categories. A couple of papers mentioned triage scales that were event type specific (sports, etc).

Conclusion:

Published literature to date contains limited details and agreement on triage methods in use at MGEs. Methods are largely from the emergency and disaster domains. Triage utility appears generally to be limited to designating location and provider, and for a snapshot of acuity post event. The use of triage scale has not been solely predictive of the need for transfer to hospital.
Review of Canadian Legislation on Mass Gathering Medical Response
Authors: Pigeon Marc-Antoine , Hertelendy Attila , Hart Alexander , Hsueh Jennifer , Ciottone Gregory
Published: June 2023

Introduction:

Mass gatherings have become more frequent since the beginning of the 21st century. In Canada alone, music festival and sporting event industries will each represent yearly revenues over one billion USD by 2025. Such events require adequate medical planning, as they are associated with a greater prevalence of injuries and incidents than daily life, despite most participants having few comorbidities. Most often, the responsibility of medical planning lies with event producers. This study aims to compare the existing legislative requirements for mass gathering medical response in the ten provinces and three territories of Canada.

Method:

This study is a cross-sectional descriptive study of legislation. Lists of legislative requirements were obtained by contacting via email or phone the emergency medical services (EMS) directors and Health Ministries of all the provinces and territories of Canada, and asking about any legislation or provision within existing laws regarding mass gatherings. Simple statistics were performed to compare legislation across provinces and territories.

Results:

Data collection and analysis are planned to be completed by December 31, 2022. Initial data collection and analysis revealed that none of the seven provinces who answered our emails have provincial legislations. Two referred to specific provisions in the Public Health laws of their province, though nothing specifically refers to mass gatherings. One confirmed that mass gathering medical response was a municipal/local concern to be addressed by the event producers and the locality where the event takes place, and one referred to guidelines published in 2014.

Conclusion:

Although some provinces and territories referred to provisions contained in public health legislation, none of the provinces reached to date could list specific legislation on mass gathering medical response. If this trend continues through full data analysis, it will highlight once more the need to provide more standardized guidance to organizers and municipalities in planning medical response.
Standards of Medical Planning and Response for Emergency Medical Teams During Mass Gatherings: A Systematic Review
Authors: Spaepen Kris , Lajolo Camila , Wang Ninlang , Salio Flavio , Hubloue Ives
Published: June 2023

Introduction:

Mass gathering events (MGE), organized or unplanned, can attract sufficient attendees to strain the planning and response resources of the host community, state, or nation, thereby delaying the response to emergencies. MGEs also have the potential to cause a mass casualty incident. But MGE can also lead to improvements in the organization of local emergency medical services or public health that form the legacy of that MGE. Emergency medical teams (EMTs) could be deployed to ensure health security as a surge in MGE. But these EMTs should be built on guiding principles and core standards. However, to the best of our knowledge, there are no standards on medical planning and response during any type of MGE (e.g., sports, religious, or festivals).

Method:

A systematic review was performed in accordance with current guidelines, using six databases, namely Medline (via the PubMed interface), Scopus, Embase, Cochrane Library, ScienceDirect, and CINAHL, as well as literature sourced by Google Scholar and The Journal of Prehospital and Disaster Medicine. Studies published on minimum standards or medical planning and response during MGE from 2002-2022, written in English, were selected and assessed for eligibility by two reviewers.

Results:

From a total of 20,159 articles, 138 were screened, and 32 were assessed for eligibility. Two were only abstracts, and the others did not contain any description of minimal standards available for medical planning or response in different types of MGE.

Conclusion:

No studies were found that describe any form of standards for medical planning and the response of emergency medical teams in different types of mass gathering events (e.g., sports, religious, festivals). There is a need for minimum standards for emergency medical teams deploying as a surge in mass gathering events.
Building the Evidence Base to Update the Key Public Health Considerations for Mass Gatherings Evaluation and Legacy
Authors: Chen Gina , Endericks Tina
Published: June 2023

Introduction:

Leaving a viable public health legacy and sustainable improvements in health infrastructure and capacity should be key for mass gatherings (MGs). Legacy includes improvements in health systems, health behaviors and delivering future MGs. Legacy planning and evaluation should be considered early in planning however, they are often neglected due to lack of funding to support, embed learning and maintain a sustainable legacy, and often favored over the event running smoothly.

Building on the Public Health for Mass Gatherings: Key Considerations (KC2) (2015), an updated literature review will identify new evidence for evaluating MGs and their legacy. This review will inform the development of updated resources to reflect the changing global health landscape and learning from MGs hosted during COVID-19, which can inform ways of better embedding legacy and evaluation in planning and post-event.

Method:

A systematic literature review methodology will be used. Electronic databases will be searched for relevant publications and grey literature of a wide range of MGs globally, focusing on evaluations, MG legacies, and impacts. Searches for specific technical areas e.g., surveillance, will also take place.

Results:

The literature review undertaken to develop the KC2 chapter identified limited publications. The increased interest in this field, should lead to an improved evidence base while recognizing evidence for long-term evaluation and legacy impact may still be more restricted due to the challenges of undertaking these studies. Recent literature will likely reflect work undertaken to deliver MGs during COVID-19, which will be included to identify good practice and transferable learning.

Conclusion:

Key findings of the review will be published, and the evidence base will be used to update the evaluation and legacy chapter of the KC2. There are also plans to develop a MG evaluation and legacy tool that will be applicable beyond the major high-profile funded events.
Necessity and Feasibility of Medical Containers in Nankai Trough Mega Earthquake
Authors: Maebayashi Kiyokazu , Nakata Keiji , Tanaka Ayako , Syowa Naoki , Takada Takamitsu
Published: June 2023

Introduction:

In Japan, there is an 80% probability that the Nankai Trough Mega Earthquake will occur within 30 years, and a tsunami of more than 30 meters is expected to hit the Pacific coast, killing more than 320,000 people and devastating many towns. This study clarifies the necessity and feasibility of a high-performance medical container developed by Showa to fill the gap in medical care during a large-scale disaster, especially after the sub-acute stage.

Method:

1) Simulation of the damage to disaster center hospitals in the event of the Nankai Trough Mega Earthquake.

2) To clarify the feasibility of immediate response, a demonstration experiment was conducted by combining and installing ten units of medical containers.

Results:

1) Of the prefectures where the death toll from Nankai Trough Mega Earthquake is estimated to be 5,000 or more, 119 disaster center hospitals located in cities and towns with coastlines were examined to determine if they were in the tsunami inundation zone. The results showed that 44 hospitals, or about 37%, were inundated and their medical functions were likely to be paralyzed.

2) Ten containers of medical treatment rooms, ICUs, CTs, power supplies, and oxygen could be assembled in seven days. This is by far the shortest time compared to the more than two months it takes for a temporary hospital.

Conclusion:

It is clear that medical containers can fill the void of medical care in the event of Nankai Trough Mega Earthquake.
Considering the Use of Mobile Medical Containers in the Event of Natural Disasters
Authors: Nakata Keiji , Maebayashi Kiyokazu , Tokumaru Shuji
Published: June 2023

Introduction:

In recent years, Japan has been hit by a number of natural disasters including the Great East Japan Earthquake, the Kumamoto Earthquake, the heavy rains in western Japan, and the heavy rains in Kumamoto to name a few. In each of these events, a number of hospitals located within the disaster areas were damaged and ceased to function, leading to difficulties in providing regional medical care. This presentation examines the effectiveness of mobile medical containers in handling such situations in the future.

Method:

This study organizes lessons learned from past disasters as well as the merits of and challenges facing current mobile medical containers while looking into the future.

Results:

When the Great East Japan Earthquake occurred, assembly-and-installation type temporary health clinics were constructed, but due to the numerous Japanese laws and regulations, it took almost three months for these to be delivered. On the other hand, current mobile medical containers are already in use in countries such as Tonga and Senegal and have the following advantages: (1) High mobility and easy installation, (2) Expandability as necessary, and (3) Durability for long-term use.

Conclusion:

Despite challenges such as clarification of legal handling, electricity, water supply and drainage, we consider mobile medical containers to be effective alternative medical facilities in the event of disasters.
Conceptual Framework for the Adoption of Innovative Health Technologies In Response to Health Emergencies
Authors: Leone Ryan , Hanfling Dan
Published: June 2023

Introduction:

Rapid developments in healthcare technology can significantly improve the quality, availability, and immediacy of care in health emergency events; however, without a cohesive framework to conceptualize the interplay between emerging technologies, we risk creating silos, ignoring applications, and reducing interoperability between innovations.

Method:

This framework was developed after reviewing the current literature regarding new technologies in healthcare assessment and delivery, discussing relevant innovations with experts, and analyzing global market trends in emerging health technology capabilities.

Results:

Innovative health technologies deployed in disaster settings can be grouped by their relevance to (1) Disease and Injury Surveillance and Detection, (2) Population Protection, (3) Responder Protection, and (4) Disease and Injury Management. The first category encompasses technologies that help characterize the severity and scope of an event at its onset, utilizing a network of wearable devices, sensors, remote infectious disease sampling, and other tools. Once an incident occurs, technologies aimed at Population Protection are necessary to preserve the well-being of unaffected citizens. Scaled-up on-demand manufacturing for prophylactic medical countermeasures and needle-free delivery mechanisms for pre-treatments against CBRN threats will be paramount. Healthcare and emergency responders require additional support before and during incident response, especially just-in-time training through virtual and augmented reality, biometric monitoring, next-generation personal protective equipment, and enhanced communications capabilities. Finally, delivering care to patients in healthcare emergencies will require optimized allocation of scarce resources based upon acuity and survivability. Effective healthcare service delivery can be bolstered using Telehealth, autonomous patient transport, drone delivery, robotic and haptically guided care delivery, and decision support tools.

Conclusion:

To effectively manage the successful adoption and implementation of innovative tools applicable to health emergencies, areas of impact and utility should be comprehensively categorized. This framework guides emergency managers, policymakers, and innovators alike to understand how individual developments coalesce in the larger context of disaster prevention, response, and recovery.
Deploying the Red Cross Red Crescent Health Information System (RCHIS) into a Type-One Fixed EMT: How the Use of a Custom Built Application for Electronic Medical Records and Data Reporting Improves Patient Care and Mandatory Reporting.
Authors: Clarke Lauren , Holl Felix , Raffort Thomas , Serres Elvire
Published: June 2023

Introduction:

RCHIS is an Electronic Medical Record (EMR) and Health Information System (HIS) that has been purpose-built for use by Red Cross Red Crescent (RCRC) Emergency Response Units (ERUs), which are the equivalent of Type 1 (fixed and mobile) and Type 2 facilities in the Emergency Medical Teams (EMT) classification.

Method:

A three day in-person super user training was held with 13 participants: 9 first aid volunteers, 2 nurses and 2 medical doctors. Seven of the delegates had experience using an EMR. These super users served as trainers for staff at the pilot.

The pilot occurred with the Portuguese Red Cross (PRC) for the Peregrinação de Fátima, where 200,000 people were in attendance. The PRC was part of a wider coordination cell with the civil defense authority, who required live reporting from the three Type 1 fixed clinics PRC had set up.

Results:

In total there were 77 user accounts, of which, 243 patients were consulted with and either discharged or referred throughout the four day pilot.

The delegates shared feedback directly and through a survey. 88% stated that RCHIS was ‘very easy’ to use with the majority of delegates requiring less than 20 minutes of training to be using the application and inputting patient data related to their user role. Additionally, after their training 95% of delegates stated they had sufficient training to use RCHIS to its full extent. Informal feedback from delegates was hugely positive, indicating that it was improving patient care and also continuity of care when a patient returned the next day.

The civil defense authorities were able to utilize the real-time reporting to assist in their operational response. The application was well received by the wider civil defense authority.

Conclusion:

The first RCHIS pilot was very successful from both a technical and organizational perspective.
The Critical Role of Nurses and Midwives in Disasters
Authors: Wong Diana , Hutton Alison , Ledger Kate , Lommerse Louise , Ruler Amanda
Published: June 2023

Introduction:

The critical role that nurses and midwives undertake during disasters has received significant attention in recent years. Nurses globally have faced multiple disasters, often occurring within months of each other and even overlapping. Within the past decade, on a global scale, nurses and midwives have experienced two Public Health Emergencies of International Concern (PHEIC) (SARS-CoV-2 and Monkeypox), the devastating and ongoing conflict in Ukraine and an unprecedented number of international natural hazards that have impacted them personally and professionally.

Method:

A discussion with frontline nurses and midwives provided insight into the challenges of delivering health care during disasters.

Results:

The results revealed that while there is some information available about disaster care and the role nurses play, there is minimal information about how nurses and midwives are personally affected by disasters impacting their own communities. Disaster nursing is a relatively new area of health care practice and is rarely taught at an undergraduate or workplace level.

Three opportunities for improving/acknowledging the critical role of nurses and midwives during disasters include:

1)

Acknowledging that the involvement of nurses and midwives is critical to any disaster response

2)

Promoting the importance of a nursing voice within the emergency management sector

3)

Structural reforms be urgently adopted to address workforce sustainability including addressing gender inequality

4)

These three approaches form only a part of the reform required to address the key roles that nurses and midwives perform during disasters.

Conclusion:

The ongoing pandemic has placed severe stress on an already overstretched nursing workforce, now is the right time to empower and support our nurses. In all aspects of emergency and disaster management nurses and midwives are at the frontline. Greater acknowledgement of the value nurses bring and the sacrifices they make in serving their communities will strengthen nurses’ commitment and resolve in tackling future crises.
The Enhanced Emergency Response Plan for Augmented Quarantine Hotels During the COVID-19 Pandemic
Authors: Wang Wei-Te , Lin Chung-Yi , Chang Yu-Tung , Hsiau Ya-Wen
Published: June 2023

Introduction:

During the COVID-19 outbreak in May 2021, Taipei City has transformed many vacant hotels to augmented quarantine hotels, recruiting retired medical staff to provide medical care, in order to preserve hospitals’ medical capabilities. In an augmented quarantine hotel at Caesar Park Hotel Taipei, the complexity of COVID quarantine, quarantine status of the residents, and hotel staff working with medical staff has made the original emergency response plan inappropriate. Henceforth, a series of modifications were made to ensure the emergency response readiness of Caesar Park Hotel Taipei.

Method:

The enhancements of emergency response capability of the augmented quarantine hotel at the Caesar Park Hotel Taipei, were made in accordance with the following list: 1. Revise evacuation plan, 2. Setup emergency equipment cart, 3. Modify emergency response procedure, 4. Update staff training and resident notice, 5. Routine stock count of medical supplies and emergency equipment.

Results:

The enhanced emergency response plan has ensured the safety of all personnel, plans were made in accordance with the COVID-19 quarantine status, and the staff has a clear perception of their duty with a picture of the overall emergency response plan.

Conclusion:

The enhanced emergency response plan was completed and under implementation in June 2021, and at the end of that month there was a fire that took four lives with 22 injured at a quarantine hotel in Changhua County. A review of the enhanced emergency response plan was made by the staff and corresponding hospital; many problems that happened at the Chunghua County quarantine hotel fire had already been considered or prevented in the enhanced emergency response plan. Such a method for building an enhanced emergency response plan has the potential to be implemented in more locations, and possibly in different scenarios.
Advancing Knowledge Translations to Contribute to Resilience in Emergency Preparedness, Response and Recovery: The Role of Evidence Aid
Authors: Clarke Mike , Allen Claire , Camacho Alex , Copsey Jane , Cuervo Luis Gabriel , Khalid Firas , Lim Jiewon , Mansilla Cristián , McHugh Jane , Pizarro Ana , Saeed Yasmeen
Published: June 2023

Introduction:

Policymakers, practitioners and the public all have a role in health emergency and disaster risk management (Health EDRM). They need to access, understand and use evidence from research to take actions to reduce health risks and harm. They need the best available evidence to maximize their ability to save lives and reduce suffering. Evidence Aid seeks to meet this need through collections of specially prepared plain-language summaries of systematic reviews, freely available online in multiple languages (www.EvidenceAid.org). The summaries and webpages can be linked to reference management software and embedded in other websites.

Method:

Evidence Aid has added a substantial number of summaries to its collections since 2020, for example, adding a collection for reviews of relevance to the COVID-19 pandemic and its associated measures. From 2021, Evidence Aid built on its partnership with the Pan American Health Organization (PAHO/WHO) to identify and summarize reviews relevant to building resilience into health systems. This included enhancements enriching the content of each summary with the authors’ implications for practice and research, equity considerations and funding sources.

Results:

In November 2022, the Resilient Health Systems collection contained more than 200 summaries relevant to ensuring that health systems are resilient to emergencies, disasters and related challenges. There were also 600 summaries relevant to the COVID-19 pandemic, 150 on the health of refugees and asylum seekers, more than 100 on physical and mental health impacts of disasters and 110 on preventing and treating acute malnutrition.

Conclusion:

Evidence Aid’s 1000+ summaries of systematic reviews relevant to Health EDRM provide a unique gateway into this evidence base for policymakers, practitioners and the public wishing to ensure that disaster preparedness, response, recovery and rehabilitation are effective and efficient. It should be a key component in helping people and organizations to care, cope and overcome in an increasingly challenging world.
NGO-led Disaster Response Through the Use of Interdisciplinary Teams
Authors: Inaba Mototaka , Sakata Taizo , Nishikura Tetsuji
Published: June 2023

Introduction:

Japan is one of the most disaster-prone countries in the world. The government has traditionally taken the lead during disaster responses, but now NGOs have begun to play an active role in disaster response. Peace Winds Japan (PWJ), is the first Japanese NGOs to utilize medical teams, search-and-rescue dogs, and disaster response in conjunction with one another. The presentation will be focused on operations and lessons learned.

Method:

Initially, the NGO only supported disaster-affected areas, both domestic and abroad, by providing relief supplies. However, in 2010 they began training rescue dogs to perform life-saving search-and-rescue operations immediately after sudden onset disasters. In 2014 NGO dispatched rescue dogs and a disaster response team for the first time at the Hiroshima landslide disaster. A medical team was added in 2018, and since then has sent out teams to ten other disaster sites, including West Japan Flood in 2018 and Ukraine Crisis as an international EMT in 2022.

Results:

One of the strengths of the organization is the ability to respond quickly by using aviation and maritime transport. They operate two helicopters and one vessel and can promptly and effectively transport patients and resources. Eight critical patients were transported from the hospital by helicopter during the West Japan Flood.

Conclusion:

Furthermore, joint rescue drills were conducted with both public and private organizations, and continue to seek ways for collaboration and cooperation in disaster settings.
Assessment of Statewide Communication Interoperability Plans (SCIP) Across the United States Using the Cybersecurity & Infrastructure Security Agency (CISA) Interoperability Markers
Authors: Alshemeili Ahmed , Hertelendy Attila , Hart Alexander , Alburaidi Abdulaziz , Benmoussa Gabriel , DiGregorio David , Caneva Duane , Issa Fadi , Voskanyan Amalia , Ciottone Gregory
Published: June 2023

Introduction:

The complexity of disaster management is rising because of rapidly advancing technological changes and the challenges associated with coordinating responses among multi-organizational contexts. One of the common problems with multi-organizational disaster management is the need for an interoperability language. Therefore, by maintaining effective communication, risk can be reduced, and lives can be saved in times of crisis. The United States SCIPs represent one of the solutions used to achieve a culture of better interoperability. In 2019, The National Council of Statewide Interoperability Coordinators (NCSWIC) and CISA collaborated to create a tool that identified 25 Interoperability Markers. This tool is integrated with SCIPs to increase interoperability and serves as a national framework to describe interoperability maturity at the state levels.

Method:

This is a descriptive study documenting each state's 25 interoperability markers and analyzing common gaps and successes. Two methods were used for collecting data. First, an online search for each state's SCIP. Then, an email was sent to all state's Statewide Interoperability Coordinators (SWIC) to request the most recent update of that state’s SCIP. Data were collected from October 1-31, 2022 and exported into an Excel spreadsheet (Microsoft Corp; Redmond, Washington, USA) for descriptive statistics and analysis.

Results:

The level of interoperability maturity across the United States is 66%. The governance level in the interoperability continuum scored the highest across states with 76.4%. While the other levels of the interoperability continuum like technology, training and exercise, and interstate emergency communication scored 63.5%, 64%, and 60% respectively.

Conclusion:

This study identifies a high level of interoperability maturity across the United States at the governance level. It is essential to continue to improve interstate interoperability through compatible technological solutions and multi-agency training. Finally, further research on interoperability markers is needed to enhance multi-agency emergency response.
Region V for Kids: A Pediatric Center of Disaster Excellence–Four years of Experience Creating an Improved Network Within the Disaster Cycle for Children and Families in the USA
Authors: Grove Deanna Dahl
Published: June 2023

Introduction:

Region V for kids (originally known as Eastern Great Lakes Consortium for Disaster Response ) is one of the US-ASPR (Administration for Strategic Preparedness and Response) funded Pediatric Center of Disaster Excellence (PCOE), serving nearly 12 million children and families in a six state region of the United States.

Method:

The original goals set forth were: to develop a coordinated pediatric disaster care capability, strengthen pediatric disaster preparedness plans and coordination, enhance state and regional medical pediatric surge capacity, increase healthcare professional educational competency and enhance situational awareness of pediatric disaster care across the spectrum.

Results:

The COVID-19 pandemic occurred shortly after original funding and caused a pivot from preparation to response for the partners, enhancing the collaboration and coordination for the region. The many lessons from the COVID response have been important to creating more partnerships with federal agencies around situational awareness and considering social and physical determinants of health that effect children and families. The partnerships with state agencies and other key stakeholders have been valuable to close the gaps in the pediatric/family disaster cycle. There has been a multitude of tools and products that have been created and disseminated from this PCOE, including educational tools, behavioral health training and tools, virtual exercises and quality improvement projects. The best practices and ongoing projects highlight how to improve coordinated care for children and families within a region and is an example for the United States and beyond. There are also challenges to coordinated preparedness due to jurisdictional barriers and these are as important to highlight and create mitigation strategies.

Conclusion:

This US supported PCOE is an example of a regional disaster coordination to mitigate and prepare for response concentrating on the needs of children and families in the larger disaster cycle.