Hospital incident command system (HICS) performance in Iran; decision making during disasters

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Lisa Kurland⁵  Gunnar Ohlen¹  Mahmoud Khatib²  Vahid Hosseinijenab⁴  Maaret Castren⁵  Ahmadreza Djalali³ 

[1] Karolinska Institutet, Department of Clinical Science, Intervention and Technology, Stockholm, Sweden;Tehran social security organization, Tehran, Iran;Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden;Department of emergency management, Natural Disaster Research Institute, Tehran, Iran;Karolinska Institutet, Department of Clinical Sciences and Education and Department of Emergency Medicine, Södersjukhuset, Stockholm, Sweden

关键词: Exercise;    Performance;    Hospital Incident Command System;   

Others  :  826774
DOI  :  10.1186/1757-7241-20-14

 received in 2011-11-21, accepted in 2012-02-06,  发布年份 2012

【 摘 要 】

Background

Hospitals are cornerstones for health care in a community and must continue to function in the face of a disaster. The Hospital Incident Command System (HICS) is a method by which the hospital operates when an emergency is declared. Hospitals are often ill equipped to evaluate the strengths and vulnerabilities of their own management systems before the occurrence of an actual disaster. The main objective of this study was to measure the decision making performance according to HICS job actions sheets using tabletop exercises.

Methods

This observational study was conducted between May 1st 2008 and August 31st 2009. Twenty three Iranian hospitals were included. A tabletop exercise was developed for each hospital which in turn was based on the highest probable risk. The job action sheets of the HICS were used as measurements of performance. Each indicator was considered as 1, 2 or 3 in accordance with the HICS. Fair performance was determined as < 40%; intermediate as 41-70%; high as 71-100% of the maximum score of 192. Descriptive statistics, T-test, and Univariate Analysis of Variance were used.

Results

None of the participating hospitals had a hospital disaster management plan. The performance according to HICS was intermediate for 83% (n = 19) of the participating hospitals. No hospital had a high level of performance. The performance level for the individual sections was intermediate or fair, except for the logistic and finance sections which demonstrated a higher level of performance. The public hospitals had overall higher performances than university hospitals (P = 0.04).

Conclusions

The decision making performance in the Iranian hospitals, as measured during table top exercises and using the indicators proposed by HICS was intermediate to poor. In addition, this study demonstrates that the HICS job action sheets can be used as a template for measuring the hospital response. Simulations can be used to assess preparedness, but the correlation with outcome remains to be studied.

【 授权许可】

   
2012 Djalali et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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