Risk Mitigation Measures Captured by a Tertiary Hospital's Disaster Simulation: An Observational Study

Area of Science:

• Healthcare preparedness and disaster medicine.
• Clinical operations and emergency management.
• Qualitative research methodologies in healthcare.

Background:

• Hospitals face unique challenges during mass casualty incidents.
• Effective disaster preparedness requires understanding real-time clinical responses.
• Simulated exercises are crucial for identifying gaps in disaster readiness.

Purpose of the Study:

• To document challenges and adaptations during a simulated hospital disaster.
• To inform hospital disaster preparedness strategies based on observed clinical responses.
• To identify practical solutions for mass casualty management.

Main Methods:

• Nonparticipant observational assessment of a simulated hospital disaster exercise.
• Researchers shadowed triage teams and observed various hospital departments.
• Inductive thematic analysis of field notes to synthesize challenges and adaptations.

Main Results:

• Key challenges included critical care equipment shortages, managing numerous minor injuries, lack of situational awareness, and patient tracking difficulties.
• Observed adaptations involved pediatricians treating adult patients, rapid triage, manual ventilation, and batching imaging requests.
• Improvisations were noted in resource allocation and patient management under pressure.

Conclusions:

• Clinicians encounter unforeseen challenges during mass casualty events.
• Practical adaptations and improvisations are essential for managing disaster influx.
• Findings can enhance clinician disaster preparedness and mass casualty management skills.