For the National Health Service (NHS) in England, incidents are defined as events that disrupt, or might disrupt, an organisation’s normal service provision below acceptable levels and require special arrangements to be put in place. NHS England is responsible for coordinating regional responses to incidents. Integrated Care Boards (ICBs) are responsible for coordinating local responses to incidents. This review assessed the records of regional and local incident responses held by NHS England and ICBs respectively.

The outcome of interest was the quantity of information regarding days at an incident response level held by organisations responsible for coordinating that level of incident response.

NHS England had a record of the number of days at regional incident response level for 3 of its 7 regions. 24 of the 42 ICBs had records of the number of days at local incident response level.

NHS England and ICB records of incident responses for which they are responsible were incomplete. They might benefit from reviewing how they measure and record this information. This review may also be of interest to other bodies at local, regional and state level which coordinate hospitals in response to incidents.

In England, the Civil Contingencies Act (Contingency Planning) Regulations 2005 require National Health Service (NHS) Trusts which provide hospital accommodation and services in relation to accidents or emergencies to conduct Emergency Preparedness, Resilience and Response (EPRR) exercises. The NHS England EPRR Framework specifies the minimum frequencies of these exercises. This review assessed the number of Trusts conducting exercises in accordance with these frequencies one year after the national NHS COVID-19 response was stepped down.

The outcome of interest was the number of Trusts having a record of conducting their most recent exercises in accordance with the minimum frequencies required by the NHS England EPRR Framework.

Of the applicable 122 Trusts, 95 had a record of conducting a communication systems exercise, 115 had a record of conducting a table-top exercise, 106 had a record of conducting a live play exercise and 90 had a record of conducting a command post exercise in accordance with the minimum frequencies.

Over one fifth of Trusts did not have a record of conducting an EPRR communications systems exercise as required. This review may also be of interest to other state-level bodies which specify high level EPRR requirements to healthcare providers.

Hospital-Based Health Technology Assessment (HB-HTA) is a heterogeneous phenomenon constantly evolving to respond to the needs of decision-makers at the hospital level. In 2023, The HB-HTA Interest Group of Health Technology Assessment International (HTAi) surveyed HB-HTA activities with the aim to provide an updated description of the actual scenario.

An online survey was conducted to gather data on the main characteristics of hospitals, HB-HTA activities, outputs, role in the decision-making processes, dissemination and training activities, and their interaction and collaboration with other stakeholders and HTA-related regulations. Finally, the survey collected feedback on the perception of and current barriers to HB-HTA. Three categories of responders were identified: Both hospitals performing and not performing HTA and policymakers.

Eighty-seven responses were collected from twenty-eight countries. Nearly half of the responders (n = 41) conducted HB-HTA, whereas eighteen consisted of hospitals not performing HTA, and twenty-eight were policy makers. HB-HTA was performed mainly in hospitals with >500 beds. HB-HTA units were organized in 40 percent of cases as an “independent group.” The survey showed that HTA units could contribute to all the steps of the decision-making processes, whereas the impact of the assessments on the decisions was mainly perceived as a medium. Furthermore, HB-HTA was not seen as a duplication of effort, even without specific regulations.

The survey highlighted the role of HB-HTA in hospital decision-making supporting the vision of HB-HTA as one of the actors in the HTA ecosystem, the success of which depends on collaboration with other stakeholders.

This study explored bereaved relatives’ experiences of end-of-life care (EoL care) in the last 3 days in an acute private hospital in Australia.

An interpretative qualitative study was conducted. Semi-structured interviews with 8 bereaved relatives whose family member had died at an acute private hospital shared their experiences of the EoL care during the last 3 days of life. The transcribed interviews were analyzed using inductive thematic analysis.

Bereaved family members had mixed experiences, and their primary concerns related to the need for improvements in support for the family; communication; and clinicians partnering with families. The need for family support encompassed care for the person dying and the bereaved relatives, before and during the last days of life, and after death. Bereaved relatives perceived that hospital based EoL care could be positive when the care was collaborative with health professionals, patients, and relatives and there was effective communication.

A patient- and family-centered approach to EoL care should be provided in hospitals, and it requires understanding of the needs of both patients and family members, including informational requirements, communication approaches, and care delivery. Health-care organizations have a responsibility to care for families and this must be considered as part of organizational readiness and ongoing assessment to determine if the standards for EoL care are met. The findings serve as a guide for evidence-informed practice and may contribute to the development of resources and guidelines for delivery of quality EoL care.

Stroke outcomes research requires risk-adjustment for stroke severity, but this measure is often unavailable. The Passive Surveillance Stroke SeVerity (PaSSV) score is an administrative data-based stroke severity measure that was developed in Ontario, Canada. We assessed the geographical and temporal external validity of PaSSV in British Columbia (BC), Nova Scotia (NS) and Ontario, Canada.

We used linked administrative data in each province to identify adult patients with ischemic stroke or intracerebral hemorrhage between 2014-2019 and calculated their PaSSV score. We used Cox proportional hazards models to evaluate the association between the PaSSV score and the hazard of death over 30 days and the cause-specific hazard of admission to long-term care over 365 days. We assessed the models’ discriminative values using Uno’s c-statistic, comparing models with versus without PaSSV.

We included 86,142 patients (n = 18,387 in BC, n = 65,082 in Ontario, n = 2,673 in NS). The mean and median PaSSV were similar across provinces. A higher PaSSV score, representing lower stroke severity, was associated with a lower hazard of death (hazard ratio and 95% confidence intervals 0.70 [0.68, 0.71] in BC, 0.69 [0.68, 0.69] in Ontario, 0.72 [0.68, 0.75] in NS) and admission to long-term care (0.77 [0.76, 0.79] in BC, 0.84 [0.83, 0.85] in Ontario, 0.86 [0.79, 0.93] in NS). Including PaSSV in the multivariable models increased the c-statistics compared to models without this variable.

PaSSV has geographical and temporal validity, making it useful for risk-adjustment in stroke outcomes research, including in multi-jurisdiction analyses.

Events, specifically those where excessive alcohol consumption is common, pose a risk to increase alcohol-related presentations to emergency departments (EDs). Limited evidence exists that synthesizes the impact from events on alcohol-related presentations to EDs.

This integrative review aimed to synthesize the literature regarding the impact events have on alcohol-related presentations to EDs.

An integrative literature review methodology was guided by the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) Guidelines for data collection, and Whittemore and Knafl’s framework for data analysis. Information sources used to identify studies were MEDLINE, CINAHL, and EMBASE, last searched May 26, 2021.

In total, 23 articles describing 46 events met criteria for inclusion. There was a noted increase in alcohol-related presentations to EDs from 27 events, decrease from eight events, and no change from 25 events. Public holidays, music festivals, and sporting events resulted in the majority of increased alcohol-related presentations to EDs. Few articles focused on ED length-of-stay (LOS), treatment, and disposition.

An increase in the consumption of alcohol from holiday, social, and sporting events pose the risk for an influx of presentations to EDs and as a result may negatively impact departmental flow. Further research examining health service outcomes is required that considers the impact of events from a local, national, and global perspective.

The evidence shows that the need for emergency evacuation in hospitals has arisen. Designing an emergency evacuation decision making tool increases the confidence of hospital managers in the decision made. Therefore, this study was aimed at the development, and the psychometric properties, of the decision-making scale for emergency hospital evacuation in disasters.

This study was done in 2 phases of qualitative study and literature review and designing and psychometric properties of the instrument. After development of the primary item pool, the psychometric properties of the questionnaire were evaluated. In this regard, face and content validity, internal consistency (Alpha’s Cronbach), reliability (ICC), and stability were assessed.

In the validity stage of the instrument, 4 items were removed. Also, 4 items were modified and 2 items were merged. The number of items was thus decreased to 64. After CVI calculation, 5 items were removed, 4 items were modified, and 2 items were merged. As a result of this, the number of items decreased to 58 items. The scale has good reliability and stability.

It seems that the instrument could be useful in decision-making for emergency hospital evacuation in disasters.