Disaster drill exercise documentation and management: are we drilling to standard?

Area of Science:

• Medical simulation
• Disaster medicine
• Patient safety

Background:

• Medical errors occur even in controlled settings.
• Mass-casualty events and disaster exercises may amplify errors.
• Pediatric disaster drills are crucial for preparedness.

Purpose of the Study:

• To compare the quality of medical documentation and care during a pediatric disaster drill versus routine care.
• To quantify and classify errors in both scenarios.

Main Methods:

• Retrospective review of charts from a disaster exercise and matched actual patient charts.
• Evaluation of 10 key documentation areas and appropriateness of diagnoses, medications, and procedures.
• Quantification and classification of errors; statistical comparison using Fischer's Exact Test.

Main Results:

• Drill charts showed significantly more errors in procedure performance, medication administration, and diagnostic accuracy.
• Sixteen percent of drill errors had the potential for permanent harm or admission.
• Drill charts had significantly more documentation omissions in 9 of 10 evaluated areas.

Conclusions:

• Both documentation and quality of care during the pediatric disaster drill were deficient compared to conventional care.
• Improving documentation clarity and linking it to prompts/algorithms may reduce errors.
• Findings highlight areas for improvement in disaster preparedness training.