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三级协作演练对基于情景的医院疏散演练中运用灵活扩充能力概念时的协作和领导力的影响:一项混合方法的横断面研究。

The impact of the three-level collaboration exercise on collaboration and leadership during scenario-based hospital evacuation exercises using flexible surge capacity concept: a mixed method cross-sectional study.

机构信息

Institute of Clinical Sciences, Department of Surgery, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 40530, Sweden.

Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand.

出版信息

BMC Health Serv Res. 2023 Aug 14;23(1):862. doi: 10.1186/s12913-023-09882-x.

Abstract

BACKGROUND

Hospitals play a crucial role in responding to disasters and public health emergencies. However, they are also vulnerable to threats such as fire or flooding and can fail to respond or evacuate adequately due to unpreparedness and lack of evacuation measures. The United Nations Office for Disaster Risk Reduction has emphasised the importance of partnerships and capacity building in disaster response. One effective way to improve and develop disaster response is through exercises that focus on collaboration and leadership. This study aimed to examine the effectiveness of using the 3-level collaboration (3LC) exercise in developing collaboration and leadership in districts in Thailand, using the concept of flexible surge capacity (FSC) and its collaborative tool during a hospital evacuation simulation.

METHODS

A mixed-method cross-sectional study was conducted with 40 participants recruited from disaster-response organisations and communities. The data from several scenario-based simulations were collected according to the collaborative elements (Command and control, Safety, Communication, Assessment, Triage, Treatment, Transport), in the disaster response education, "Major Incident Medical Management and Support" using self-evaluation survey pre- and post-exercises, and direct observation.

RESULTS

The 3LC exercise effectively facilitated participants to gain a mutual understanding of collaboration, leadership, and individual and organisational flexibility. The exercise also identified gaps in communication and the utilisation of available resources. Additionally, the importance of early community engagement was highlighted to build up a flexible surge capacity during hospital evacuation preparedness.

CONCLUSIONS

the 3LC exercise is valuable for improving leadership skills and multiagency collaboration by incorporating the collaborative factors of Flexible Surge Capacity concept in hospital evacuation preparedness.

摘要

背景

医院在应对灾害和突发公共卫生事件方面发挥着至关重要的作用。然而,它们也容易受到火灾或洪水等威胁的影响,如果准备不足或缺乏疏散措施,可能无法充分响应或疏散。联合国减少灾害风险办公室强调了在灾害应对中建立伙伴关系和能力建设的重要性。提高和发展灾害应对能力的一种有效方法是通过专注于协作和领导力的演习。本研究旨在检验在泰国地区使用三级协作(3LC)演习通过医院疏散模拟使用灵活的应变能力(FSC)及其协作工具来培养协作和领导力的效果。

方法

采用混合方法的横断面研究,从灾害应对组织和社区中招募了 40 名参与者。根据协作要素(指挥与控制、安全、沟通、评估、分诊、治疗、转运),在灾难应对教育中,根据基于情景的模拟收集了几个场景的数据,使用“重大事件医疗管理和支持”进行自我评估调查练习前后和直接观察。

结果

3LC 演习有效地促进了参与者对协作、领导力以及个人和组织灵活性的相互理解。演习还发现了沟通和利用现有资源方面的差距。此外,强调了早期社区参与的重要性,以在医院疏散准备中建立灵活的应变能力。

结论

3LC 演习通过将灵活的应变能力概念的协作因素纳入医院疏散准备,对于提高领导力和多机构协作能力非常有价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8f9/10426132/b4b45d852da7/12913_2023_9882_Fig1_HTML.jpg

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