1,721,074 research outputs found
Implementation, integration and analysis of innovative training tools to improve disaster response and humanitarian assistance
Effect of timing of implementation of the lockdown on the number of deaths for COVID-19 in four European countries
Key performance indicators in pre-hospital response to disasters and mass casualty incidents: a scoping review
Purpose: The objective of this study was to offer a comprehensive synthesis of the existing Key performance indicators (KPIs) used in the evaluation of the pre-Hospital response to disasters and mass casualty incidents (MCIs). Methods: At the end of December 2022 a scoping review has been performed on PubMed, Scopus, Embase, and Medline to identify articles describing the use of KPIs to assess the performance of first responders during the prehospital phase of an MCI (real or simulated). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, fourteen articles were included in the analysis. Results: Eleven articles applied indicators in exercises and/or simulations. Two articles proposed new KPIs, and one used KPIs for developing a model for benchmarking pre-Hospital response. All articles analyzed quantitative indicators of time, whereas two studied indicators of structure, of process, and of outcome as well. Conclusion: The findings from this review emphasize the need for employing common terminology and using uniformed data collection tools, if obtaining standardized evaluation method is the goal to be achieved
SIMMED SIMulation in MEDicine, Italian Society for simulation in medicine position paper: executive summary
Key performance indicators and benchmarks in MCI prehospital response using technological tools: a qualitative study assessing the perception of practitioners and tool developers
Purpose The aim of this study is to investigate the opinions and perspectives of The Novel Integrated Toolkit for Enhanced Prehospital Life Support and Triage in Challenging and Large Emergencies (NIGHTINGALE) end-users and tool developers regarding Key Performance Indicators (KPIs) and benchmarks that assess the prehospital response to Mass Casualty Incidents (MCIs) enhanced by the NIT-MR. Methods A qualitative study employing focus group discussions was conducted to collect opinions and perspectives of end-users and tool developers regarding KPIs and benchmarks in MCI response using the NIT-MR. The criteria considered for the selection and distribution of participants within the groups was the nature of their involvement within the NIGHTINGALE project and their familiarity with the tools to be discussed. Results Thirty-one participants from different countries were included. Four themes emerged during data analysis which are: definition/explanation is the personal understanding of participants of the term KPI, process of KPI development and relationship with User Requirements is the decision process for assigning KPIs to user requirements, benchmarking is the mental process of associating a benchmark to a KPI or for developing a benchmark, and technical/medical gap is the gap of understanding between each sides' fields. Conclusion This study emphasized the need for a structured approach to using KPIs and bridging the gap between technological and medical worlds, taking the NIGHTINGALE project, funded by the European Union, which aims to develop a technological toolkit for first responders in mass casualty incidents as an example. These insights are crucial for enhancing disaster response
Non-Communicable Disease (NCD) Management During Disasters and Humanitarian Emergencies: A Review of the Experiences Reported by Emergency Medical Teams (EMTs)
Background/Objectives: Non-Communicable Diseases (NCDs) place an excessive strain on health systems in disaster-affected settings and may lead to a parallel public health emergency lasting months or years after a disaster. Although NCDs are increasingly recognized as a major challenge in disasters and humanitarian emergencies, a dedicated and standardized response plan is missing, as well as a shortage of evidence-based guidelines for NCD management in theses contexts. Over the years, Emergency Medical Teams (EMTs) have traditionally been deployed to manage acute conditions such as trauma and infectious diseases that quickly impact health systems. However, greater attention is needed to address acute exacerbation of NCDs and to ensure continuity of care for people with chronic health needs in disasters and emergencies. Methods: We conducted a scoping review exploring the EMTs’ management of chronic NCDs during disasters and humanitarian emergencies, in order to identify the strategies adopted, the challenges faced, and the recommendations provided to address this health problem. The online databases PubMed, Scopus, and EBSCO were searched to identify relevant papers. Results: After screening the papers against the eligibility criteria, 17 publications were retrieved. Five different areas of intervention concerning EMTs and NCDs management were identified: (i) EMTs pre-departure preparation, operational time, and length of stay; (ii) EMTs staff composition and training; (iii) EMTs logistics; (iv) EMTs integration with local health services; (v) EMTs clinical data record. Conclusions: The findings emerging from this study showed that NCDs significantly impact disaster response in different settings, underlining the need to implement a range of EMTs activities to guarantee assistance for chronic health needs. In view of strengthening the ability of health systems to cope with the NCDs’ burden, the EMTs’ initiatives should be considered as a bridge between the support provided during the acute phase of an emergency and the continuation of care ensured by the system in its early recovery phase
A T2 Translational Science Modified Delphi Study: Spinal Motion Restriction in a Resource-Scarce Environment
Introduction: Emerging evidence is guiding changes in prehospital management of potential spinal injuries. The majority of settings related to current recommendations are in resource-rich environments (RREs), whereas there is a lack of guidance on the provision of spinal motion restriction (SMR) in resource-scarce environments (RSEs), such as: Mass-casualty incidents (MCIs); low-middle income countries; complex humanitarian emergencies; conflict zones; and prolonged transport times. The application of Translational Science (TS) in the Disaster Medicine (DM) context was used to develop this study, leading to statements that can be used in the creation of evidence-based clinical guidelines (CGs).Objective: What is appropriate SMR in RSEs?Methods: The first round of this modified Delphi (mD) study was a structured focus group conducted at the World Association for Disaster and Emergency Medicine (WADEM) Congress in Brisbane Australia on May 9, 2019. The result of the focus group discussion of open-ended questions produced ten statements that were added to ten statements derived from Fischer (2018) to create the second mD round questionnaire. Academic researchers and educators, operational first responders, or first receivers of patients with suspected spinal injuries were identified to be mD experts. Experts rated their agreement with each statement on a seven-point linear numeric scale. Consensus amongst experts was defined as a standard deviation ≤1.0. Statements that were in agreement reaching consensus were included in the final report; those that were not in agreement but reached consensus were removed from further consideration. Those not reaching consensus advanced to the third mD round. For subsequent rounds, experts were shown the mean response and their own response for each of the remaining statements and asked to reconsider their rating. As above, those that did not reach consensus advanced to the next round until consensus was reached for each statement.Results: Twenty-two experts agreed to participate with 19 completing the second mD round and 16 completing the third mD round. Eleven statements reached consensus. Nine statements did not reach consensus.Conclusions: Experts reached consensus offering 11 statements to be incorporated into the creation of SMR CGs in RSEs. The nine statements that did not reach consensus can be further studied and potentially modified to determine if these can be considered in SMR CGs in RSEs
Primary Health Care and Disasters: Applying a “Whole-of-Health System” Approach through Reverse Triage in Mass-Casualty Management
Introduction: In 2019, the World Health Organization (WHO) published the Health Emergency and Disaster Risk Management (H-EDRM) framework detailing how effective management of disasters, including mass-casualty incidents (MCIs), can be achieved through a whole-of-health system approach where each level of the health care system is involved in all phases of the disaster cycle. In light of this, a primary health care (PHC) approach can contribute to reducing negative health outcomes of disasters, since it encompasses the critical roles that primary care services can play during crises. Hospitals can divert non-severe MCI victims to primary care services by applying reverse triage (RT), thereby preventing hospital overloading and ensuring continuity of care for those who do not require hospital services during the incident. Study Objective: This study explores the topic by reviewing the literature published on early discharge of MCI victims through RT criteria and existing referral pathways to primary care services. Methods: A scoping literature review was performed and a total of ten studies were analyzed. Results: The results showed that integrating primary care facilities into disaster management (DM) through the use of RT may be an effective strategy to create surge during MCIs, provided that clear referral protocols exist between hospitals and primary care services to ensure continuity of care. Furthermore, adequate training should be provided to primary care professionals to be prepared and be able to provide quality care to MCI victims. Conclusion: The results of this current review can serve as groundwork upon which to design further research studies or to help devise strategies and policies for the integration of PHC in MCI management
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