Thomas D. Kirsch, MD, MPH, is a retired Professor and former Director, the National Center for Disaster Medicine and Public Health, Uniformed Services University of the Health Sciences. Bethesda, MD.
Clark J. Lee, JD, MPH, is a Senior Research Associate, the National Center for Disaster Medicine and Public Health, Uniformed Services University of the Health Sciences and The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD.
Health Secur. 2023 Jul-Aug;21(4):310-318. doi: 10.1089/hs.2023.0051. Epub 2023 Jun 9.
The National Disaster Medical System (NDMS) Pilot Program was authorized by Congress to improve the interoperability, capabilities, and capacity of the NDMS. To develop a roadmap for planning and research, the mixed methods Military-Civilian NDMS Interoperability Study (MCNIS) was conducted in 2020-2021. The initial qualitative phase of the study identified critical themes for improvement: (1) coordination, collaboration, and communication; (2) funding and incentives to increase private sector preparedness; (3) staffing capacity and competencies; (4) clinical and support surge capacity; (5) training, education, and exercises between federal and private sector partners; and (6) metrics, benchmarks, and modeling to track NDMS performance. These qualitative findings were subsequently refined, validated, and prioritized through a quantitative survey. Expert respondents ranked 64 statements based on weaknesses and opportunities identified during the qualitative phase. Data were collected using Likert scales, and multivariate proportions and confidence intervals were estimated to compare and prioritize each statement's level of support. Pairwise tests were conducted for each item-to-item pair to determine statistically significant differences. The survey results corroborated the earlier qualitative findings, with all weaknesses and opportunities ranked as important by a majority of respondents. Survey results also pointed to specific priorities for interventions within the 6 previously identified themes. As with the qualitative study, the survey found that the most common weaknesses and opportunities were related to coordination, collaboration, and communication, especially regarding information technology and planning at the federal and regional levels. These priority interventions are now being developed, implemented, and validated at 5 pilot partner sites.
国家灾害医疗系统 (NDMS) 试点计划获得了国会的授权，旨在提高 NDMS 的互操作性、能力和容量。为了制定规划和研究的路线图，2020-2021 年进行了军民两用 NDMS 互操作性研究 (MCNIS)。该研究的初始定性阶段确定了需要改进的关键主题：(1) 协调、合作和沟通；(2) 为增加私营部门的准备工作提供资金和激励；(3) 人员配备能力和能力；(4) 临床和支持能力；(5) 联邦和私营部门合作伙伴之间的培训、教育和演习；以及 (6) 跟踪 NDMS 绩效的指标、基准和建模。这些定性发现随后通过定量调查进行了细化、验证和优先级排序。专家受访者根据定性阶段确定的弱点和机会，对 64 项声明进行了排名。使用李克特量表收集数据，并估计多变量比例和置信区间，以比较和优先考虑每项声明的支持程度。对每个项目对项目对进行了成对测试，以确定统计学上的显著差异。调查结果证实了早期的定性研究结果，大多数受访者认为所有弱点和机会都很重要。调查结果还指出了在之前确定的 6 个主题内进行干预的具体优先事项。与定性研究一样，调查发现最常见的弱点和机会与协调、合作和沟通有关，特别是在联邦和地区各级的信息技术和规划方面。这些优先干预措施正在 5 个试点合作伙伴站点进行开发、实施和验证。
