Abstract
BackgroundAn incident command structure is commonly used to manage responses to major incidents. In the hospital incident command structure, the medical officer in charge (MOC) is in a key position. The decision-making process is essential to effective management, but little is known about which factors influence the process. Therefore, the current study aimed to describe factors influencing decision-making of MOCs.MethodsA conventional content analysis was conducted based on 16 individual interviews with medical doctors who had been deployed as MOCs at Swedish hospitals during major incidents.ResultsThe results showed that the decision-making and re-evaluation process was a comprehensive analysis influenced by three categories of factors: event factors, including consequences from the type of event, levels of uncertainty and the circumstances; organizational factors, including the doctor’s role, information management and the response to the event; and personal factors, such as competence, personality and mental preparedness.ConclusionsReliable and timely information management structure enabling the gathering and analysis of essential information, a clear command structure and appropriate personal qualities were essential and contributed to successful MOCs decision making in major incidents.
Highlights
An incident command structure is commonly used to manage responses to major incidents
Aim This study aimed to describe factors influencing decision-making of medical officer in charge (MOC)
The current study has shown that event-related factors, including their consequences, organizational factors and personal factors, influenced the decision-making and reevaluation process among MOCs during major incidents
Summary
An incident command structure is commonly used to manage responses to major incidents. In the hospital incident command structure, the medical officer in charge (MOC) is in a key position. The current study aimed to describe factors influencing decision-making of MOCs. Crisis management is a systematic approach to averting crises and effectively managing those that do occur [1]. The medical system—including prehospital emergency services, hospitals and primary healthcare providers—must increase its capacity on short notice and switch into a response mode, which requires a well-functioning command structure that is capable of adapting patient flows, medical care and other attendant adjustments. Managing a complex and dynamic situation, such as a major incident, requires adjusting organizational and medical procedures at both individual and organizational
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