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What a Disaster?! Assessing Utility of Simulated Disaster Exercise and Educational Process for Improving Hospital Preparedness

Published online by Cambridge University Press:  28 June 2012

Bruce H. Bartley ,
Julian B. Stella  and
Liam D. Walsh
Bruce H. Bartley*
Affiliation:
Emergency Department, Geelong Hospital, Barwon Health, Victoria, Australia
Julian B. Stella
Affiliation:
Emergency Department, Geelong Hospital, Barwon Health, Victoria, Australia
Liam D. Walsh
Affiliation:
Emergency Department, Geelong Hospital, Barwon Health, Victoria, Australia
*
Bruce Bartley The Geelong Hospital Emergency Department, Ryrie St. Geelong, Victoria, Australia 3220 E-mail: bruceb@barwonhealth.org.au
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Abstract

Introduction:

Recent events have brought disaster medicine into the public focus. Both the government and communities expect hospitals to be prepared to cope with all types of emergencies. Disaster simulations are the traditional method of testing hospital disaster plans, but a recent, comprehensive, literature review failed to find any substantial scientific data proving the benefit of these resource and time-consuming exercises.

Objectives:

The objective of this study was to test the hypothesis that an audiovisual presentation of the hospital disaster plans followed by a simulated disaster exercise and debriefing improved staff knowledge, confidence, and hospital preparedness for disasters.

Methods:

A survey of 50 members of the medical, nursing, and administrative staff were chosen from a pool of approximately 170 people likely to be in a position of responsibility in the event of a disaster.The pre-intervention survey tested factual knowledge as well as perceptions about individual and departmental preparedness. Post-intervention, the same 50 staff members were asked to repeat the survey, which included additional questions establishing their involvement in the exercise.

Results:

There were 50 pre-intervention tests and 42 post-intervention tests. The intervention resulted in a significant improvement in test pass rate: preintervention pass rate 9/50 (18%, 95% confidence interval ((CI) = 16.1–19.9%) versus post-intervention pass rate 21/42 (50%, 95% CI = 42.4–57.6%; X2 test, p = 0.002). Emergency department (ED) staff had a stronger baseline knowledge than non-ED staff: ED pre-test mean value for scores = 12.1 versus nonED scores of 6.2 (difference 5.9, 95% CI = 3.3–8.4); t-test, p <0.001. Those that attended >1 component had a greater increase in mean scores: increase in mean attendees was 5.6, versus the scores of non-attendees of 2.7 (difference 2.9, 95% CI = 1.0–4.9); t-test, p = 0.004. There was no significant increase in the general perception of preparedness. However, the majority of those surveyed described the exercise of benefit to themselves (53.7%,95% CI = 45.5–61.8%) and their department (63.2%, 95% CI = 53.5–72.8%).

Conclusions:

The disaster exercise and educational process had the greatest benefit for individuals and departments involved directly. The intervention also prompted enterprise-wide review, and an upgrade of disaster plans at departmental levels. Pre-intervention knowledge scores were poor. Post-intervention knowledge base remained suboptimal, despite a statistically significant improvement. This study supports the widely held belief that disaster simulation is a worthwhile exercise, but more must be done. More time and resources must be dedicated to the increasingly important field of hospital disaster preparedness.

Keywords

disaster response plandisaster statuseducationemergency departmentfactual knowledge surveyhospital staff preparednessself-assessment survey
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 21 , Issue 4 , August 2006 , pp. 249 - 255
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2006

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References

1.Menczer, LF: The Hartford disaster exercise. N Engl J Med 1968;278(15):822–824.CrossRefGoogle ScholarPubMed
2.Dixon, D: Position Description for Emergency Management Coordinator, Western Health. Personal Communication, Western Health; 2005.Google Scholar
3.Hosking, J: Personal Correspondence Regarding hospital early warning system. In: Eddey, , (ed) Geelong: Geelong Hospital; 2004.Google Scholar
4.Gray, D: Disaster plan education: How we made and tested a video. J Accid Emerg Med 1996;13(1):21–22.CrossRefGoogle ScholarPubMed
5.Cook, L: Hospital disaster drill game: A strategy for teaching disaster proto-cols to hospital staff. J Emerg Nurs 1990;16(4):269–723.Google Scholar
6.Tur-Kaspa, I, Lev, EI, Hendler, I, et al. : Preparing hospitals for toxicological mass casualties events. Crit Care Med 1999;27(5):1004–1008.CrossRefGoogle ScholarPubMed
7.Gofrit, ON, Leibovici, D, Shemer, J, et al. : The efficacy of integrating “smart simulated casualties” in hospital disaster drills. Prehosp Disast Med 1997;12(2):97–101.CrossRefGoogle ScholarPubMed
8.Levi, L, Bregman, D, Geva, H, Revach, M: Hospital disaster management sim-ulation system. Prehosp Disast Med 1998;13(1):29–34.CrossRefGoogle Scholar
9.JCoAoH:Comprehensive Accreditation Manual for Hospitals: The Official Handbook. Oakbrook Terrace, Illinois: Joint Commission Resources; 2003.Google Scholar
10.Hsu, EB, Jenckes, MW, Catlett, CL, et al. : Effectiveness of hospital staff mass-casualty incident training methods: A systematic literature review. Prehosp Disast Med 2004;19(3):191–199.CrossRefGoogle ScholarPubMed
11.Committee HHEP: AS–1997 Planning for Emergencies—Health Care Facilities: Council of Standards—Australia; 05/06/1997. Report No. 4083.Google Scholar
12.Milsten, A: Hospital responses to acute-onset disasters: A review. Prehosp Disast Med 2000;15(1):32–45.CrossRefGoogle ScholarPubMed
13.Rutherford, WH: The place of exercises in disaster management. Injury 1990;21(1):58–60.CrossRefGoogle ScholarPubMed