ABSTRACT
The District of Columbia Emergency Healthcare Coalition (DC EHC) brought together a Burn Task Force to tackle the issue of mass burn care in a metropolitan area in light of limited local burn center resources. This article outlines the development of the mass burn care plan. Using a tiered treatment approach, mass burn victims would be transported first to burn centers within the area, followed by nonburn center trauma centers, and finally to nonburn and nontrauma center acute care facilities. Once activated the Burn Task Force would triage and coordinate transfer of mass burn patients within the District for further care at burn centers using a strong link with the Eastern Regional Burn Disaster Consortium. This plan was exercised in the spring of 2014 to test all of the components. To strengthen mass burn care, this plan, put in place for the District of Columbia, has been expanded to include the National Capital Region as well.
Subject(s)
Burns/therapy , Disaster Planning/organization & administration , Health Care Coalitions/organization & administration , Mass Casualty Incidents/statistics & numerical data , Trauma Centers/organization & administration , Advisory Committees , Burn Units/organization & administration , Burns/epidemiology , District of Columbia , Female , Health Resources , Humans , Male , Outcome Assessment, Health Care , Program Evaluation , TriageABSTRACT
OBJECTIVES: The objectives of the study were to develop and evaluate an "all-hazards" hospital disaster preparedness training course that utilizes a combination of classroom lectures, skills sessions, tabletop sessions, and disaster exercises to teach the principles of hospital disaster preparedness to hospital-based employees. METHODS: Participants attended a two-day, 16-hour course, entitled Hospital Disaster Life Support (HDLS). The course was designed to address seven core competencies of disaster training for healthcare workers. Specific disaster situations addressed during HDLS included: (1) biological; (2) conventional; (3) radiological; and (4) chemical mass-casualty incidents. The primary goal of HDLS was not only to teach patient care for a disaster, but more importantly, to teach hospital personnel how to manage the disaster itself. Knowledge gained from the HDLS course was assessed by pre- and post-test evaluations. Additionally, participants completed a course evaluation survey at the conclusion of HDLS to assess their attitudes about the course. RESULTS: Participants included 11 physicians, 40 nurses, 23 administrators/directors, and 10 other personnel (n = 84). The average score on the pre-test was 69.1 +/- 12.8 for all positions, and the post-test score was 89.5 +/- 6.7, an improvement of 20.4 points (p < 0.0001, 17.2-23.5). Participants felt HDLS was educational (4.2/5), relevant (4.3/5) and organized (4.3/5). CONCLUSIONS: Identifying an effective means of teaching hospital disaster preparedness to hospital-based employees is an important task. However, the optimal strategy for implementing such education still is under debate. The HDLS course was designed to utilize multiple teaching modalities to train hospital-based employees on the principles of disaster preparedness. Participants of HDLS showed an increase in knowledge gained and reported high satisfaction from their experiences at HDLS. These results suggest that HDLS is an effective way to train hospital-based employees in the area of disaster preparedness.
Subject(s)
Disaster Planning/organization & administration , Emergency Service, Hospital/organization & administration , Hospital Planning , Mass Casualty Incidents , Personnel, Hospital/education , Relief Work/organization & administration , Teaching , Data Collection , District of Columbia , Educational Status , Humans , Life Support Care , Models, Educational , Patient Simulation , Program Development , Program Evaluation , United StatesABSTRACT
Recent terrorist and epidemic events have underscored the potential for disasters to generate large numbers of casualties. Few surplus resources to accommodate these casualties exist in our current health care system. Plans for "surge capacity" must thus be made to accommodate a large number of patients. Surge planning should allow activation of multiple levels of capacity from the health care facility level to the federal level. Plans should be scalable and flexible to cope with the many types and varied timelines of disasters. Incident management systems and cooperative planning processes will facilitate maximal use of available resources. However, resource limitations may require implementation of triage strategies. Facility-based or "surge in place" solutions maximize health care facility capacity for patients during a disaster. When these resources are exceeded, community-based solutions, including the establishment of off-site hospital facilities, may be implemented. Selection criteria, logistics, and staffing of off-site care facilities is complex, and sample solutions from the United States, including use of local convention centers, prepackaged trailers, and state mental health and detention facilities, are reviewed. Proper pre-event planning and mechanisms for resource coordination are critical to the success of a response.
