A Critical Pathway for Mass Casualty Incident Preparedness

Area of Science:

• Emergency Medicine
• Healthcare Management
• Disaster Preparedness

Background:

• Mass casualty incidents (MCIs) are increasing in the U.S.
• Healthcare systems require robust emergency response plans.
• Trauma centers play a vital leadership role in MCI preparedness.

Purpose of the Study:

• To describe the design and implementation of simulated MCI drills.
• To evaluate the impact of MCI drills on staff performance.
• To assess improvements in emergency department (ED) patient throughput.

Main Methods:

• Quasi-experimental time-series design.
• Utilized an ED checklist and Critical Pathway Management (CPM) methodology.
• Conducted two in situ MCI simulation drills in October and December 2019.

Main Results:

• ED throughput time decreased by 26.7% (from 15 to 11 minutes).
• Identified notification and inpatient nursing staff presentation as key rate-limiting factors.
• Improvements were achieved by focusing on identified critical pathway bottlenecks.

Conclusions:

• Institution-specific checklists and CPM effectively identify critical pathways.
• Targeting rate-limiting tasks significantly improves patient throughput during simulated MCIs.
• This quality improvement project enhances ED readiness for mass casualty incidents.