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Identifying Deficiencies in National and Foreign Medical Team Responses Through Expert Opinion Surveys: Implications for Education and Training

Published online by Cambridge University Press:  19 June 2014

Ahmadreza Djalali ,
Pier Luigi Ingrassia ,
Francesco Della Corte ,
Marco Foletti ,
Alba Ripoll Gallardo ,
Luca Ragazzoni ,
Kubilay Kaptan ,
Olivera Lupescu ,
Chris Arculeo  and
Gotz von Arnim
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Ahmadreza Djalali*
Affiliation:
CRIMEDIM, Università del Piemonte Orientale, Novara, Italy
Pier Luigi Ingrassia
Affiliation:
CRIMEDIM, Università del Piemonte Orientale, Novara, Italy
Francesco Della Corte
Affiliation:
CRIMEDIM, Università del Piemonte Orientale, Novara, Italy
Marco Foletti
Affiliation:
CRIMEDIM, Università del Piemonte Orientale, Novara, Italy
Alba Ripoll Gallardo
Affiliation:
CRIMEDIM, Università del Piemonte Orientale, Novara, Italy
Luca Ragazzoni
Affiliation:
CRIMEDIM, Università del Piemonte Orientale, Novara, Italy
Kubilay Kaptan
Affiliation:
Disaster Research Center (AFAM), Istanbul Aydin University, Istanbul, Turkey
Olivera Lupescu
Affiliation:
URGENTA, Clinical Emergency Hospital, Bucharest, Romania
Chris Arculeo
Affiliation:
Hanover Associates, Teddington, London, United kingdom
Gotz von Arnim
Affiliation:
NHCS, National Health Career School of Management, Hennigsdorf/Berlin, Germany
Tom Friedl
Affiliation:
NHCS, National Health Career School of Management, Hennigsdorf/Berlin, Germany
Michael Ashkenazi
Affiliation:
Bonn International Center for Conversion, Bonn, Germany
Deike Heselmann
Affiliation:
University Clinic Bonn Department of Orthopedics and Trauma Surgery, Germany
Boris Hreckovski
Affiliation:
CROUMSA, Croatian Urgent Medicine and Surgery Association, Slav. Brod, Croatia
Amir Khorrram-Manesh
Affiliation:
Prehospital and Disaster Medicine Centre, Sahlgrenska Academy, Gothenburg, Sweden
Radko Komadina
Affiliation:
SBC, General &Teaching Hospital Celje, Medical Faculty Ljubljana, Slovenia
Kostanze Lechner
Affiliation:
German Aerospace Center (DLR), Oberpfaffenhofen, Germany
Cristina Patru
Affiliation:
Clinical Emergency Hospital Bucharest, Romania
Frederick M. Burkle Jr.
Affiliation:
Harvard Humanitarian Initiative, Cambridge, Massachusetts USA
Philipp Fisher
Affiliation:
University Clinic Bonn Department of Orthopedics and Trauma Surgery, Germany
*
Correspondence: Ahmadreza Djalali, MD, PhD CRIMEDIM Università del Piemonte Orientale Novara, Italy E-mail [email protected]
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Abstract

Introduction

Unacceptable practices in the delivery of international medical assistance are reported after every major international disaster; this raises concerns about the clinical competence and practice of some foreign medical teams (FMTs). The aim of this study is to explore and analyze the opinions of disaster management experts about potential deficiencies in the art and science of national and FMTs during disasters and the impact these opinions might have on competency-based education and training.

Method

This qualitative study was performed in 2013. A questionnaire-based evaluation of experts’ opinions and experiences in responding to disasters was conducted. The selection of the experts was done using the purposeful sampling method, and the sample size was considered by data saturation. Content analysis was used to explore the implications of the data.

Results

This study shows that there is a lack of competency-based training for disaster responders. Developing and performing standardized training courses is influenced by shortcomings in budget, expertise, and standards. There is a lack of both coordination and integration among teams and their activities during disasters. The participants of this study emphasized problems concerning access to relevant resources during disasters.

Conclusion

The major findings of this study suggest that teams often are not competent during the response phase because of education and training deficiencies. Foreign medical teams and medically related nongovernmental organizations (NGOs) do not always provide expected capabilities and services. Failures in leadership and in coordination among teams are also a problem. All deficiencies need to be applied to competency-based curricula.

DjalaliA , IngrassiaPL , Della CorteF , FolettiM , Ripoll GallardoA , RagazzoniL , KaptanK , LupescuO , ArculeoC , von ArnimG , FriedlT , AshkenaziM , HeselmannD , HreckovskiB , Khorrram-ManeshA , KomadinaR , LechnerK , PatruC , BurkleFMJr. , FisherP . Identifying Deficiencies in National and Foreign Medical Team Responses Through Expert Opinion Surveys: Implications for Education and Training. Prehosp Disaster Med. 2014;29(4):1-5.

Keywords

competenciesdisaster medicineeducationresponseteamtraining
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 29 , Issue 4 , August 2014 , pp. 364 - 368
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

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References

1. Burkle, FM Jr. The development of multidisciplinary core competencies: the first step in the professionalization of disaster medicine and public health preparedness on a global scale. Disaster Med Public Health Prep. 2012;6(1):10-12.Google Scholar
2. Inter-Agency Standing Committee, Global Health Cluster. Concept paper: foreign medical teams. May 17, 2011. http://www.who.int/hac/global_health_cluster/about/policy_strategy/fmt_concept_paper_16may11.pdf. Accessed January 26, 2012.Google Scholar
3. Proceedings of the WHO/PAHO technical consultation on international foreign medical teams (FMTs) post-sudden onset disasters (SODs), December 7-9, 2010. Havana, Cuba. http://new.paho.org. Accessed January 26, 2012.Google Scholar
4. Bradt, DA, Drummond, CM. From complex emergencies to terrorism--new tools for health-sector coordination in conflict-associated disasters. Prehosp Disaster Med. 2003;18(3):263-271.Google Scholar
5. Briggs, SM. Disaster management teams. Curr Opin Crit Care. 2005;11(6):585-589.CrossRefGoogle ScholarPubMed
6. Burkle, FM Jr. Integrating international responses to complex emergencies, unconventional war, and terrorism. Crit Care Med. 2005;33(1 Suppl):S7-12.Google Scholar
7. Aitken, P, Leggat, PA, Harley, H, et al. Human resources issues and Australian disaster medical assistance teams: results of a national survey of team members. Emerg Health Threats J. 2012;5.Google Scholar
8. Aitken, P, Leggat, PA, Robertson, AG, et al. Education and training of Australian disaster medical assistance team members: results of a national survey. Prehosp Disaster Med. 2011;26(1):41-48.Google Scholar
9. Aitken, P, Leggat, PA, Robertson, AG, et al. Leadership and use of standards by Australian disaster medical assistance teams: results of a national survey of team members. Prehosp Disaster Med. 2012;27(2):142-147.Google Scholar
10. Owens, PJ, Forgione, A Jr., Briggs, S. Challenges of international disaster relief: use of a deployable rapid assembly shelter and surgical hospital. Disaster Manag Response. 2005;3(1):11-16.Google Scholar
11. Edelman, N. The Kashmir Earthquake: a confluence of unfortunate events. December 1, 2006. http://neil.chaosnet.org/documents/courses/epsc-250/kashmir.pdf. Accessed March 26, 2014.Google Scholar
12. de Ville de Goyet, C. Health lessons learned from the recent earthquakes and tsunami in Asia. Prehosp Disaster Med. 2007;22(1):15-21.Google Scholar
13. Djalali, A, Khankeh, H, Öhlén, G, et al. Facilitators and obstacles in pre-hospital medical response to earthquakes: a qualitative study. Scand J Trauma Resusc Emerg Med. 2011, May 16;19:30.Google Scholar
14. Stuart, JJ, Johnson, DC. Air Force disaster response: Haiti experience. J Surg Orthop Adv. 2011;20(1):62-66.Google Scholar
15. Gunn, SW. The humanitarian imperative in disaster management--a memorial tribute to Professor Peter Safar. Prehosp Disaster Med. 2005;20(2):89-92.Google Scholar
16. Habibzadeh, F, Yadollahie, M, Kucheki, M. International aid in disaster zones: help or headache? Lancet. 2008;372(9636):374.Google Scholar
17. Jauregui, C, Sholk, J. Guide to giving international disaster response. Rootcause. http://www.rootcause.org/docs/Resources/Research/International-Disaster-Response/International%20Disaster%20Response-%20Guide%20to%20Giving.pdf. Accessed January 24, 2014.Google Scholar
18. Seynaeve, G, Fisher, AF, Lueger-Schuster, B, et al. International standards and guidelines on education and training for the multi-disciplinary health response to major events that threaten the health status of a community. Prehosp Disaster Med. 2004;19(2):S17-30.Google Scholar
19. Frank, JR, Snell, LS, Cate, OT, et al. Competency-based medical education: theory to practice. Medical Teacher. 2010;32(8):638-645.CrossRefGoogle ScholarPubMed
20. Subbarao, I, Lyznicki, JM, Hsu, EB, et al. A consensus-based educational framework and competency set for the discipline of disaster medicine and public health preparedness. Disaster Med Public Health Prep. 2008;2(1):57-68.Google Scholar
21. Schultz, CH, Koenig, KL, Whiteside, M, et al. Development of national standardized all-hazard disaster core competencies for acute care physicians, nurses, and EMS professionals. Annals Emerg Med. 2012;59(3):196-208.Google Scholar
22. Ingrassia, PL, Foletti, M, Djalali, A, et al. Education and training initiatives for crisis management in the European Union: a web-based analysis of available programs. Prehosp Disaster Med. 2014;29(2):115-126.Google Scholar
23. Burkle, FM Jr. The development of multidisciplinary core competencies: the first step in the professionalization of disaster medicine and public health preparedness on a global scale. Disaster Med Public Health Prep. 2012;6(1):10-12.Google Scholar
24. Burkle, FM, Walls, AE, Heck, JP, et al. Academic affiliated training centers in humanitarian health, part 1: program characteristics and professionalization preferences of centers in North America. Prehosp Disaster Med. 2013;28(2):155-162.Google Scholar
25. Hsu, EB, Ma, M, Lin, FY, et al. Emergency medical assistance team response following Taiwan Chi-Chi earthquake. Prehosp Disaster Med. 2002;17(1):17-22.Google Scholar
26. Waisman, Y. Integration of foreign and local medical staff in a disaster area: the Honduras and El Salvador experiences. Eur J Emerg Med. 2003;10(2):124-129.Google Scholar
27. Bridgewater, FH, Aspinall, ET, Booth, JP, et al. Team Echo: observations and lessons learned in the recovery phase of the 2004 Asian tsunami. Prehosp Disaster Med. 2006;21(1):s20-25.Google Scholar
28. Altevogt, BM, Stroud, C, et al. Barriers to integrating crisis standards of care principles into international disaster response plans: workshop summary. Washington, D.C. USA: National Academies Press. 2012.Google Scholar
29. Macpherson, R, Burkle, FM. Neglect and failures of human security in humanitarian settings: challenges and recommendations. Prehosp Disaster Med. 2013;28(2):174-178.Google Scholar
30. Archer, F, Seynaeve, G. International guidelines and standards for education and training to reduce the consequences of events that may threaten the health status of a community. A report of an open international WADEM meeting, Brussels, Belgium, October 29-31, 2004. Prehosp Disaster Med. 2007;22(2):120-130.Google Scholar
31. Daily, E, Padjen, P, Birnbaum, M. A review of competencies developed for disaster healthcare providers: limitations of current processes and applicability. Prehosp Disaster Med. 2010;25(5):387-395.Google Scholar
32. Hyde, J, Kim, B, Martinez, LS, et al. Better prepared but spread too thin: the impact of emergency preparedness funding on local public health. Disaster Manag Response. 2006;4(4):106-113.Google Scholar
33. Sauer, LM, McCarthy, ML, Knebel, A, et al. Major influences on hospital emergency management and disaster preparedness. Disaster Med Public Health Prep. 2009;3(2 Suppl):S68-73.Google Scholar
34. Djalali, A, Castren, M, Hosseinijenab, V, et al. Hospital Incident Command System (HICS) performance in Iran; decision making during disasters. Scand J Trauma Resusc Emerg Med. 2012, Feb 6;20:14.Google Scholar
35. McEntire, DA. Coordinating multi-organisational responses to disaster: lessons from the March 28, 2000 Fort Worth tornado. Disaster Prevention and Management. 2002;11(5):369-379.Google Scholar
36. Yi, W, Ozdamar, L. A dynamic logistics coordination model for evacuation and support in disaster response activities. European Journal of Operational Research. 2007;179(3):1177-1193.Google Scholar
37. McCunn, M, Ashburn, MA, Floyd, TF, et al. An organized, comprehensive, and security-enabled strategic response to the Haiti earthquake: a description of pre-deployment readiness preparation and preliminary experience from an academic anesthesiology department with no preexisting international disaster response program. Anesth Analg. 2010;111(6):1438-1444.Google Scholar
38. Brohi, K. The Utstein template for uniform reporting of data following major trauma: a valuable tool for establishing a pan-European dataset. Scand J Trauma Resusc Emerg Med. 2008, Aug 28;16:8.Google Scholar
39. Bradt, DA, Aitken, P. Disaster medicine reporting: the need for new guidelines and the CONFIDE statement. Emerg Med Australas. 2010;22(6):483-487.Google Scholar
40. US National Library of Medicine. Disaster Information Management Research Center. http://disasterinfo.nlm.nih.gov/. Accessed February 2014.Google Scholar
41. Debacker, M, Hubloue, I, Dhondt, E, et al. Utstein-style template for uniform data reporting of acute medical response in disasters. PLoS Curr. 2012 Mar 23;4:e4f6cf3e8df15a.Google Scholar
42. Samarasinghe, D. Disaster management: lessons from immediate responses to the tsunami. Ceylon Med J. 2005;50(1):25-27.Google Scholar