Adini Bruria, Goldberg Avishay, Laor Danny, Cohen Robert, Bar-Dayan Yaron
Emergency and Disaster Management Division, Ministry of Health, Israel.
Prehosp Disaster Med. 2007 May-Jun;22(3):175-80. doi: 10.1017/s1049023x00004611.
General hospitals in Israel are required to develop standards of procedures (SOPs) to facilitate the management of mass-casualty incidents (MCIs). These SOPs represent the initial step in a continuous process, providing guidelines for hospitals to manage MCIs in an organized and efficient manner. Evaluation of the preparedness levels of hospitals in dealing with MCIs is required in order to promote an effective response, and to identify factors that might impact the quality of SOPs. The aim of this study was to identify the characteristics of hospitals that have an impact on the preparation of SOPs.
An evaluation tool was developed to assess the SOPs from 22 hospitals during the management of a MCI. The results of the evaluations were analyzed, in relation to the size, trauma capabilities, ownership, geographic location, urban versus rural status of the hospitals, the proximity to other hospitals, participation in drills during the year prior to the evaluation, and number of actual MCIs the hospital managed in the past three years.
The evaluation scores of the SOPs of 11 of the 22 hospitals (50%) were very high, so their SOPs did not require modifications. The SOPs of four hospitals (18%) were rated highly, requiring only minor modifications. The SOPs of four hospitals (18%) received poor ratings, requiring major modifications, and three hospitals (14%) were found to have incomplete SOPs and received very poor ratings. No significant differences were found between the ratings of SOPs in relation to the different characteristics of the hospitals analyzed. A low correlation between the level of SOPs and the number of MCIs that the hospital managed was found (r = 0.266, NS).
The tool developed to evaluate the quality of the SOPs of hospitals to manage MCIs was logistically feasible and capable of differentiating between hospital SOPs. The comprehensiveness and completeness of the SOPs appears to be unrelated to the characteristics of the hospitals included in this study. Of particular note was the lack of a significant correlation between the SOP rating and the number of actual MCIs managed by a hospital.
以色列的综合医院需要制定程序标准（SOP），以促进对大规模伤亡事件（MCI）的管理。这些SOP是一个持续过程的初始步骤，为医院以有组织、高效的方式管理MCI提供指导方针。为促进有效应对并识别可能影响SOP质量的因素，需要对医院应对MCI的准备水平进行评估。本研究的目的是确定对SOP制定有影响的医院特征。
开发了一种评估工具，用于评估22家医院在管理MCI期间的SOP。分析评估结果，涉及医院的规模、创伤处理能力、所有权、地理位置、城市与农村状况、与其他医院的距离、评估前一年参与演练的情况以及医院在过去三年中管理的实际MCI数量。
22家医院中有11家（50%）的SOP评估得分非常高，因此其SOP无需修改。4家医院（18%）的SOP评级较高，仅需进行 minor 修改。4家医院（18%）的SOP评级较差，需要进行 major 修改，3家医院（14%）的SOP不完整，评级非常差。在所分析的医院不同特征方面，SOP评级之间未发现显著差异。发现SOP水平与医院管理的MCI数量之间的相关性较低（r = 0.266，无显著性差异）。
开发的用于评估医院管理MCI的SOP质量的工具在后勤方面是可行的，并且能够区分医院的SOP。SOP的全面性和完整性似乎与本研究中所纳入医院的特征无关。特别值得注意的是，SOP评级与医院管理的实际MCI数量之间缺乏显著相关性。
