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Using Mixed Methods to Assess Pediatric Disaster Preparedness in the Hospital Setting

Published online by Cambridge University Press:  21 October 2014

Rita V. Burke ,
Tae Y. Kim ,
Shelby L. Bachman ,
Ellen I. Iverson  and
Bridget M. Berg
Rita V. Burke*
Affiliation:
Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CaliforniaUSA Keck School of Medicine, University of Southern California, Los Angeles, CaliforniaUSA
Tae Y. Kim
Affiliation:
Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CaliforniaUSA
Shelby L. Bachman
Affiliation:
Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CaliforniaUSA
Ellen I. Iverson
Affiliation:
Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CaliforniaUSA Keck School of Medicine, University of Southern California, Los Angeles, CaliforniaUSA
Bridget M. Berg
Affiliation:
Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CaliforniaUSA
*
Correspondence: Rita V. Burke, PhD, MPH Division of Pediatric Surgery Children's Hospital Los Angeles Keck School of Medicine University of Southern California 4650 Sunset Boulevard, Mailstop #100 Los Angeles, California 90027 USA E-mail [email protected]
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Abstract

Introduction

Children are particularly vulnerable during disasters and mass-casualty incidents. Coordinated multi-hospital training exercises may help health care facilities prepare for pediatric disaster victims.

Problem

The purpose of this study was to use mixed methods to assess the disaster response of three hospitals, focusing on pediatric disaster victims.

Methods

A full-functional disaster exercise involving a simulated 7.8-magnitude earthquake was conducted at three Los Angeles (California USA) hospitals, one of which is a freestanding designated Level I Pediatric Trauma Center. Exercise participants provided quantitative and qualitative feedback regarding their perceptions of pediatric disaster response during the exercise in the form of surveys and interviews. Additionally, trained observers provided qualitative feedback and recommendations regarding aspects of emergency response during the exercise, including communication, equipment and supplies, pediatric safety, security, and training.

Results

According to quantitative participant feedback, the disaster exercise enhanced respondents’ perceived preparedness to care for the pediatric population during a mass-casualty event. Further, qualitative feedback from exercise participants and observers revealed opportunities to improve multiple aspects of emergency response, such as communication, equipment availability, and physician participation. Additionally, participants and observers reported opportunities to improve safety and security of children, understanding of staff roles and responsibilities, and implementation of disaster triage exercises.

Conclusion

Consistent with previous investigations of pediatric disaster preparedness, evaluation of the exercise revealed several opportunities for all hospitals to improve their ability to respond to the needs of pediatric victims. Quantitative and qualitative feedback from both participants and observers was useful for comprehensively assessing the exercise's successes and obstacles. The present study has identified several opportunities to improve the current state of all hospitals’ pediatric disaster preparedness, through increased training on pediatric disaster triage methods and additional training on the safety and security of children. Regular assessment and evaluation of supplies, equipment, leadership assignments, and inter-hospital communication is also suggested to optimize the effectiveness and efficiency of response to pediatric victims in a disaster.

BurkeRV, KimTY, BachmanSL, IversonEI, BergBM. Using Mixed Methods to Assess Pediatric Disaster Preparedness in the Hospital Setting. Prehosp Disaster Med. 2014;29(6): 1-7.

Keywords

disaster medicinedisaster planninghospitalsmass-casualty incidentpediatrics
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 29 , Issue 6 , December 2014 , pp. 569 - 575
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

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References

1. Barthel, ER, Pierce, JR, Goodhue, CJ, et al. Can a pediatric trauma center improve the response to a mass casualty incident? J Trauma. 2012;73(4):885-889.Google Scholar
2. Chokshi, NK, Behar, S, Nager, AL, Dorey, F, Upperman, JS. Disaster management among pediatric surgeons: preparedness, training and involvement. Am J Disaster Med. 2008;3(1):5-14.Google Scholar
3. Gold, JI, Montano, Z, Shields, S, et al. Pediatric disaster preparedness in the medical setting: integrating mental health. Am J Disaster Med. 2009;4(3):137-146.CrossRefGoogle ScholarPubMed
4. Shirm, S, Liggin, R, Dick, R, Graham, J. Prehospital preparedness for pediatric mass-casualty events. Pediatrics. 2007;120(4):e756-761.CrossRefGoogle ScholarPubMed
5. Hupp, JR. Important take-aways from the Boston marathon bombing. J Oral Maxillofac Surg. 2013;71(10):1637-1638.CrossRefGoogle ScholarPubMed
6. Bar-On, E, Lebel, E, Blumberg, N, Sagi, R, Kreiss, Y, Israel Defense Forces Medical, C. Pediatric orthopedic injuries following an earthquake: experience in an acute-phase field hospital. J Trauma. 2013;74(2):617-621.Google Scholar
7. Kaji, AH, Lewis, RJ. Hospital disaster preparedness in Los Angeles County. Acad Emerg Med. 2006;13(11):1198-1203.Google Scholar
8. Mace, SE, Doyle, C, Fuchs, S, et al. Pediatric patients in a disaster: part of the all-hazard, comprehensive approach to disaster management. Am J Disaster Med. 2012;7(2):111-125.CrossRefGoogle Scholar
9. Allen, GM, Parrillo, SJ, Will, J, Mohr, JA. Principles of disaster planning for the pediatric population. Prehosp Disaster Med. 2007;22(6):537-540.CrossRefGoogle ScholarPubMed
10. Ferrer, RR, Ramirez, M, Sauser, K, Iverson, E, Upperman, JS. Emergency exercises and exercises in healthcare organizations: assessment of pediatric population involvement using after-action reports. Am J Disaster Med. 2009;4(1):23-32.CrossRefGoogle ScholarPubMed
11. Luby, J, Belden, A, Botteron, K, et al. The effects of poverty on childhood brain development: the mediating effect of caregiving and stressful life events. JAMA Pediatr. 2013;167(12):1135-1142.CrossRefGoogle ScholarPubMed
12. Mondal, R, Sarkar, S, Banerjee, I, et al. Acute stress-related psychological impact in children following devastating natural disaster, the Sikkim earthquake (2011), India. J Neurosci Rural Pract. 2013;4(Suppl 1):S19-23.Google Scholar
13. Thompson, T, Lyle, K, Mullins, SH, Dick, R, Graham, J. A state survey of emergency department preparedness for the care of children in a mass casualty event. Am J Disaster Med. 2009;4(4):227-232.CrossRefGoogle Scholar
14. Ballow, S, Behar, S, Claudius, I, Stevenson, K, Neches, R, Upperman, JS. Hospital-based disaster preparedness for pediatric patients: how to design a realistic set of exercise victims. Am J Disaster Med. 2008;3(3):171-180.Google Scholar
15. Burke, RV, Berg, BM, Vee, P, et al. Using robotic telecommunications to triage pediatric disaster victims. J Pediatr Surg. 2012;47(1):221-224.CrossRefGoogle ScholarPubMed
16. Burke, RV, Ryutov, T, Neches, R, Upperman, JS. Health informatics for pediatric disaster preparedness planning. Appl Clin Inform. 2010;1(3):256-264.CrossRefGoogle ScholarPubMed
17. Ferrer, RR, Balasuriya, D, Iverson, E, Upperman, JS. Pediatric disaster preparedness of a hospital network in a large metropolitan region. Am J Disaster Med. 2010;5(1):27-34.CrossRefGoogle Scholar
18. Petrosyan, M, Guner, YS, Emami, CN, Ford, HR. Disparities in the delivery of pediatric trauma care. J Trauma. 2009;67(2 Suppl):S114-119.Google ScholarPubMed
19. Cicero, MX, Baum, CR. Pediatric disaster preparedness: best planning for the worst-case scenario. Pediatr Emerg Care. 2008;24(7):478-481.Google Scholar
20. Eppich, WJ, Adler, MD, McGaghie, WC. Emergency and critical care pediatrics: use of medical simulation for training in acute pediatric emergencies. Curr Opin Pediatr. 2006;18(3):266-271.Google Scholar
21. Burke, RV, Iverson, E, Goodhue, CJ, Neches, R, Upperman, JS. Disaster and mass casualty events in the pediatric population. Semin Pediatr Surg. 2010;19(4):265-270.Google Scholar
22. Gausche-Hill, M. Pediatric disaster preparedness: are we really prepared? J Trauma. 2009;67(2 Suppl):S73-76.Google Scholar
23. Stamell, EF, Foltin, GL, Nadler, EP. Lessons learned for pediatric disaster preparedness from September 11, 2001: New York City trauma centers. J Trauma. 2009;67(2 Suppl):S84-87.Google ScholarPubMed
24. Middleton, KR, Burt, CW. Availability of pediatric services and equipment in emergency departments: United States, 2002-03. Adv Data. 2006(367):1-16.Google ScholarPubMed
25. Gausche-Hill, M, Schmitz, C, Lewis, RJ. Pediatric preparedness of US emergency departments: a 2003 survey. Pediatrics. 2007;120(6):1229-1237.CrossRefGoogle ScholarPubMed
26. Fox, L, Timm, N. Pediatric issues in disaster preparedness: meeting the educational needs of nurses-are we there yet? J Pediatr Nurs. 2008;23(2):145-152.CrossRefGoogle ScholarPubMed
27. Freyberg, CW, Arquilla, B, Fertel, BS, et al. Disaster preparedness: hospital decontamination and the pediatric patient--guidelines for hospitals and emergency planners. Prehosp Disaster Med. 2008;23(2):166-173.CrossRefGoogle ScholarPubMed
28. Gebbie, KM, Valas, J, Merrill, J, Morse, S. Role of exercises and exercises in the evaluation of public health in emergency response. Prehosp Disaster Med. 2006;21(3):173-182.CrossRefGoogle ScholarPubMed
29. Severin, PN. Pediatric disaster preparedness: what do we do next? Pediatrics. 2006;118(5):2254-2255.CrossRefGoogle ScholarPubMed
30. Center for Pediatric Emergency Medicine. Pediatric Tabletop Exercise Toolkit for Hospitals. New York City, New York USA: NYC Department of Health and Mental Hygiene Healthcare Emergency Preparedness Program; 2008.Google Scholar
31. Bioterrorism Hospital Preparedness Program. Pediatric Disaster Toolkit: Hospital Guidelines for Pediatrics in Disasters. New York City, New York USA: NYC Department of Health and Mental Hygiene; 2006.Google Scholar
32. Ramirez, M, Kubicek, K, Peek-Asa, C, Wong, M. Accountability and assessment of emergency exercise performance at schools. Fam Community Health. 2009;32(2):105-114.Google Scholar
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