Strategies to Strengthen Hospital Response for Chemical, Biological, Radiological, and Nuclear Incident: A Multisite...

Area of Science:

• Emergency Medicine
• Disaster Management
• Public Health

Background:

• Clinical leaders play a critical role in decision-making during Chemical, Biological, Radiological, and Nuclear explosive (CBRNe) disasters.
• Existing literature on strategies employed by emergency care clinical leaders during CBRNe events is limited.
• Effective management of CBRNe disasters requires robust hospital disaster protocols and incident command systems.

Purpose of the Study:

• To explore the strategies utilized by emergency care clinical leaders in managing patients following a CBRNe disaster.
• To identify facilitating strategies and barriers encountered by clinical leaders during CBRNe disaster response.
• To inform the development of enhanced preparedness and response protocols for CBRNe events.

Main Methods:

• Qualitative study employing focus groups.
• Conducted across 6 hospitals (5 tertiary, 1 rural) in Queensland, Australia.
• Involved 36 clinical leaders crucial to hospital disaster response, with focus groups held between February and May 2021.

Main Results:

• Facilitating strategies included conducting rehearsals, adopting flexible models of care, implementing surge management processes, and leveraging organizational lessons learned.
• Identified barriers comprised resource constraints and hospitals operating beyond capacity.
• Clinical leaders' decision-making processes were central to optimizing patient care during simulated CBRNe scenarios.

Conclusions:

• Enhanced education and training for clinical leaders are essential for strengthening hospital responses to CBRNe disasters.
• Flexible models of care and well-established, tested disaster response frameworks can significantly improve patient management.
• Addressing resource limitations and capacity issues is crucial for effective CBRNe disaster preparedness.