Nilsson Heléne, Vikström Tore, Rüter Anders
Department of Clinical and Experimental Medicine, Faculty of Health Science, Centre for Teaching and Research in Disaster Medicine and Traumatology, Linköping University, Linköping, Sweden.
Am J Disaster Med. 2010 Jan-Feb;5(1):35-40. doi: 10.5055/ajdm.2010.0004.
The aim of this study was to show the possibility to identify what decisions in the initial regional medical command and control (IRMCC) that have to be improved.
This was a prospective, observational study conducted during nine similar educational programs for regional and hospital medical command and control in major incidents and disasters. Eighteen management groups were evaluated during 18 standardized simulation exercises.
More detailed and quantitative evaluation methods for systematic evaluation within disaster medicine have been asked for. The hypothesis was that measurable performance indicators can create comparable results and identify weak and strong areas of performance in disaster management education and training.
Evaluation of each exercise was made with a set of 11 measurable performance indicators for IRMCC. The results of each indicator were scored 0, 1, or 2 according to the performance of each management group.
The average of the total score for IRMCC was 14.05 of 22. The two best scored performance indicators, No 1 "declaring major incident" and No 2 "deciding on level of preparedness for staff" differed significantly from the two lowest scoring performance indicators, No 7 "first information to media" and No 8 "formulate general guidelines for response."
The study demonstrated that decisions such as "formulating guidelines for response and "first information to media" were areas in initial medical command and control that need to be improved. This method can serve as a quality control tool in disaster management education programs.
本研究旨在表明识别初始区域医疗指挥与控制(IRMCC)中哪些决策需要改进的可能性。
这是一项前瞻性观察性研究,在针对重大事件和灾难的九个类似的区域和医院医疗指挥与控制教育项目中进行。在18次标准化模拟演练中对18个管理小组进行了评估。
需要更详细和定量的评估方法用于灾害医学中的系统评估。假设是可衡量的绩效指标能够产生可比结果,并识别灾害管理教育与培训中的绩效强弱领域。
使用一套针对IRMCC的11个可衡量绩效指标对每次演练进行评估。根据每个管理小组的表现,每个指标的结果得分为0、1或2。
IRMCC的总分平均值为22分中的14.05分。得分最高的两个绩效指标,即第1项“宣布重大事件”和第2项“确定工作人员的准备水平”,与得分最低的两个绩效指标,即第7项“向媒体提供的首批信息”和第8项“制定总体应对指南”,存在显著差异。
该研究表明,诸如“制定应对指南”和“向媒体提供首批信息”等决策是初始医疗指挥与控制中需要改进的领域。这种方法可作为灾害管理教育项目中的质量控制工具。