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Efficacy of Critical Incident Monitoring for Evaluating Disaster Medical Readiness and Response During the Sydney 2000 Olympic Games

Published online by Cambridge University Press:  28 June 2012

Arthas Flabouris ,
Antony Nocera  and
Alan Garner
Arthas Flabouris*
Affiliation:
Medical Team Leaders, Disaster Medical Response Teams, New South Wales (NSW) Health, Liverpool BC, New South Wales, Australia
Antony Nocera
Affiliation:
Medical Team Leaders, Disaster Medical Response Teams, New South Wales (NSW) Health, Liverpool BC, New South Wales, Australia
Alan Garner
Affiliation:
Medical Team Leaders, Disaster Medical Response Teams, New South Wales (NSW) Health, Liverpool BC, New South Wales, Australia
*
Intensive Care Unit, Liverpool Health Service, Locked Bag 7103, Liverpool BC, NSW 1871Australia E-mail: [email protected]
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Abstract

Introduction:

Multiple casualty incidents (MCI) are infrequent events for medical systems. This renders audit and quality improvement of the medical responses difficult. Quality tools and use of such tools for improvement is necessary to ensure that the design of medical systems facilitates the best possible response to MCI.

Objective:

To describe the utility of incident reporting as a quality monitoring and improvement tool during the deployment of medical teams for mass gatherings and multiple casualty incidents.

Methods:

Voluntary and confidential reporting of incidents was provided by members of the disaster medical response teams during the period of disaster medical team deployment for the 2000 Sydney Olympic Games. Qualitative evaluations were conducted of reported incidents. The main outcome measures included the nature of incident and associated contributing factors, minimization factors, harm potential, and comparison with the post-deployment, cold debriefings.

Results:

A total of 53 incidents were reported. Management-based decisions, poor or non-existent protocols, and equipment and communicationrelated issues were the principal contributing factors. Eighty nine percent of the incidents were considered preventable. A potential for harm to patients and/or team members was documented in 58% of reports, of which 76% were likely to cause at least significant harm. Of equipment incidents, personal protective equipment (33%), medical equipment (27%), provision of equipment (22%), and communication equipment (17%) predominated. Personal protective equipment (50%) was reported as the most frequent occupational health and safety incident followed by fatigue (25%). Predeployment planning was the most important factor for future incident impact minimization.

Conclusions:

Incident monitoring was efficacious as a quality tool in identifying incident contributing factors. Incident monitoring allowed for greater systems evaluation. Further evaluation of this quality tool within different disaster settings is required.

Keywords

critical incident monitoringmedical responsemultiple casualty incidentsquality improvement
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 19 , Issue 2 , June 2004 , pp. 164 - 168
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2004

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