Aitken Peter, Leggat Peter, Harley Hazel, Speare Richard, Leclercq Muriel
Anton Breinl Centre for Public Health and Tropical Medicine, James Cook University, Townsville, QLD, Australia.
Emerg Health Threats J. 2012;5. doi: 10.3402/ehtj.v5i0.18147. Epub 2012 May 31.
Calls for disaster medical assistance teams (DMATs) are likely to continue in response to international disasters. As part of a national survey, this study was designed to evaluate Australian DMAT experience in relation to the human resources issues associated with deployment.
Data was collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 South East Asian Tsunami disaster.
The response rate for this survey was 50% (59/118). Most personnel had deployed to the Asian Tsunami affected areas with DMAT members having significant clinical and international experience. While all except one respondent stated they received a full orientation prior to deployment, only 34% of respondents (20/59) felt their role was clearly defined pre deployment. Approximately 56% (33/59) felt their actual role matched their intended role and that their clinical background was well suited to their tasks. Most respondents were prepared to be available for deployment for 1 month (34%, 20/59). The most common period of notice needed to deploy was 6-12 hours for 29% (17/59) followed by 12-24 hours for 24% (14/59). The preferred period of overseas deployment was 14-21 days (46%, 27/59) followed by 1 month (25%, 15/59) and the optimum shift period was felt to be 12 hours by 66% (39/59). The majority felt that there was both adequate pay (71%, 42/59) and adequate indemnity (66%, 39/59). Almost half (49%, 29/59) stated it was better to work with people from the same hospital and, while most felt their deployment could be easily covered by staff from their workplace (56%, 33/59) and caused an inconvenience to their colleagues (51%, 30/59), it was less likely to interrupt service delivery in their workplace (10%, 6/59) or cause an inconvenience to patients (9%, 5/59). Deployment was felt to benefit the affected community by nearly all (95%, 56/59) while less (42%, 25/59) felt that there was a benefit for their own local community. Nearly all felt their role was recognised on return (93%, 55/59) and an identical number (93%, 55/59) enjoyed the experience. All stated they would volunteer again, with 88% strongly agreeing with this statement.
This study of Australian DMAT members provides significant insights into a number of human resources issues and should help guide future deployments. The preferred 'on call' arrangements, notice to deploy, period of overseas deployment and shift length are all identified. This extended period of operations needs to be supported by planning and provision of rest cycles, food, temporary accommodation and rest areas for staff. The study also suggests that more emphasis should be placed on team selection and clarification of roles. While the majority felt that there was both adequate pay and adequate indemnity, further work clarifying this, based on national conditions of service should be, and are, being explored currently by the state based teams in Australia. Importantly, the deployment was viewed positively by team members who all stated they would volunteer again, which allows the development of an experienced cohort of team members.
鉴于国际灾难频发，对灾难医疗援助团队（DMATs）的需求可能会持续存在。作为一项全国性调查的一部分，本研究旨在评估澳大利亚DMAT在与部署相关的人力资源问题方面的经验。
通过澳大利亚健康保护委员会的州和领地代表分发匿名邮寄调查问卷来收集数据，这些代表从2004年东南亚海啸灾难中确定了与澳大利亚DMAT部署相关的团队成员。
本次调查的回复率为50%（59/118）。大多数人员随DMAT部署到了亚洲海啸受灾地区，团队成员具有丰富的临床和国际经验。虽然除一人外所有受访者均表示在部署前接受了全面培训，但只有34%的受访者（20/59）认为他们在部署前的角色得到了明确界定。约56%（33/59）的受访者认为其实际角色与预期角色相符，且其临床背景非常适合其任务。大多数受访者准备好接受为期1个月的部署（34%，20/59）。部署所需的最常见通知时间为6 - 12小时，占29%（17/59），其次是12 - 24小时，占24%（14/59）。海外部署的首选时长为14 - 21天（46%，27/59），其次是1个月（25%，15/59），最佳轮班时长被66%（39/59）的人认为是12小时。大多数人认为薪酬足够（71%，42/59）且赔偿足够（66%，39/59）。近一半（49%，29/59）的人表示与来自同一家医院的人合作更好，虽然大多数人认为其工作场所的工作人员可以轻松替代其部署工作（56%，33/59），且这给同事带来了不便（51%，30/59），但不太可能中断其工作场所的服务提供（10%，6/59）或给患者带来不便（9%，5/59）。几乎所有人（95%，56/59）认为部署对受灾社区有益，而较少人（42%，25/59）认为对自己所在的当地社区有益。几乎所有人都觉得他们回国后其角色得到了认可（93%，55/59），同样比例（93%，55/59）的人享受这段经历。所有人都表示会再次志愿参加，88%的人强烈认同这一说法。
这项对澳大利亚DMAT成员的研究为一些人力资源问题提供了重要见解，应有助于指导未来的部署工作。确定了首选的“待命”安排、部署通知时间、海外部署时长和轮班长度。这种长时间的行动需要通过规划以及为工作人员提供休息周期、食物、临时住所和休息区域来提供支持。该研究还表明应更加注重团队选拔和角色明确。虽然大多数人认为薪酬和赔偿都足够，但基于澳大利亚各州的服务条件，目前正在并应该进一步开展工作来对此进行明确。重要的是，团队成员对部署给予了积极评价，所有人都表示会再次志愿参加，这有助于培养一批经验丰富的团队成员。
