Emergency Operations Center Research Articles

Key stakeholders’ perspectives of public health emergency preparedness in Palestine: A qualitative exploratory study

ObjectivesPalestine continues to face emergencies and a series of humanitarian crises. This study aims to comprehend emergency planning and response including the recent COVID-19 pandemic. Comprehending and recording these experiences will facilitate on-going improvement of Palestine's Public Health Emergency Preparedness (PHEP). Study designA qualitative exploratory study. MethodsFifteen semi-structured interviews were conducted with key informant decision-makers representing various sectors of the Palestinian health system. The data collection period took place from April 2022–December 2022. A convenient purposive sample was chosen based on identifying important stakeholders in the West Bank's health sector. Every interview was transcribed. Major themes and subthemes were identified using content thematic analysis. ResultsThe study demonstrates Palestine's inadequate preparation for emergencies, instead there is a focus on response once a crisis has occurred. No national entity or mechanism is leading the collective preparedness efforts, which might ultimately result in a stronger emergency response. Instead, the efforts are dispersed across several entities, and decisions are not made cooperatively. As for resources, the study indicates that an emergency budget has not been allocated. The study showed a good degree of multi-sectoral collaboration with some reservations regarding the creation of various committees and their efficacy in handling crises. ConclusionThe findings made it abundantly evident that significant efforts are needed to improve Palestine's level of preparedness and planning. One of the study's primary conclusions is that the health sector must shift from a reactionary to a preparedness-oriented mindset. Additionally, it is necessary to keep an eye on any changes in the nation's health and analysis must take place to strengthen the health system's response plans. Moreover, the activation of the emergency operation center in Palestine is one of the key advancements of the preparedness system.

Psychological preparedness in disaster management: A survey of leaders in Saudi Arabia's emergency operation centers

This study assesses perceptions of psychological preparedness among leaders in Emergency Operation Centers (EOCs) across Saudi Arabia. Effective disaster management requires managing stress, maintaining emotional stability, and adapting to rapid changes. A descriptive survey was conducted in 2024 with 110 leaders from various Health regions and the National Health EOC, achieving an 86.4 % response rate. Participants completed a structured questionnaire assessing their confidence in managing stress, the effectiveness of stress-relief techniques, and emotional stability. Results indicated high confidence in stress management (mean score 4.19, SD = 0.88) and emotional stability (mean score 4.27, SD = 0.80), along with moderately high ratings for the effectiveness of stress-relief techniques (mean score 3.64, SD = 0.99). Only 30.53 % had received formal training on psychological preparedness, while 96.84 % expressed a need for additional training. The study found significant correlations between confidence, emotional stability, and the regular review of coping strategies. These results highlight the critical need for comprehensive training programs to improve the psychological preparedness of disaster management personnel.

Evaluation of the incident management system of a bigger city during the winter flood 2023/24 in northern Germany: Organized (ir)responsibility in the pre-disaster phase

Incident management systems operate within complex and uncertain conditions during disasters. Therefore, researching their activities is challenging as there is no clear right or wrong. The winter 2023/2024 flood event in the city of Oldenburg, Germany, provided an opportunity to evaluate crisis management under high uncertainty, although no disaster has eventually occurred. Three stakeholder groups of the Incident Management System were examined through After-Action Reviews: The Emergency Operation Center (EOC), specialist advisors, and the Area Command (AC). Data on performance shaping factors (descriptions and judgements) were collected and analyzed using the Countenance Evaluation Model as a general framework in combination with a Systems-Thinking approach. The study aimed to identify variables within and between groups as well as factors in the environment that either hindered or facilitated work transactions. It emerged that the work organization in bodies of public administration is at odds with the uncertain, fast-paced, and problem-oriented structure of Incident Management System operations, causing stress and adding workload to employees. Additionally, the separation of strategic and tactical decision making led to coordination issues due to divergent time structures and task logics of EOC and AC. Furthermore, although specialist advisors played a crucial role in risk assessments and setting the direction of risk mitigation activities, it became clear that this person related resource is scarce and difficult to embed into the Incident Command System. A final finding is the importance of the larger Emergency Operation Center working environment. The spatial constraints and noise levels caused stress.

Water, water, everywhere and not a drop to drink: Responding to water disruptions in two coastal healthcare facilities

Having a consistent and readily available clean water supply is essential, not only for convenience but also to safeguard public health. While disruptions to the supply of clean water can impact communities of all kinds, some infrastructures and healthcare facilities are more vulnerable than others, such as those located in remote areas or within First Nations communities. This paper presents a case study of water disruption events within Sechelt and the First Nations community of Bella Bella, describing also the associated response efforts and lessons learned. Both events shared similar response activities, requiring the curtailing of normal water usage, the establishment of emergency operations centres, the sourcing of resources via supply chain or transportation partners, implementation of infection prevention and public health considerations, and collaboration with internal and external agencies. The learnings highlight a need for greater focus on building resiliency within healthcare facilities, especially those that serve remote or First Nations communities. The study also presents recommendations for water disruption response planning at the site and community level, and the establishment of non-centralised backup water systems.

Using system dynamics to support a functional exercise for pandemic preparedness and response

AbstractIn pandemic preparedness and response, a Functional Exercise (FX) is used to simulate a situation as close to a real‐life event as possible without the deployment of resources. Participants are drawn from public health emergency operations centres, and work through a scenario script to test possible responses to a novel pathogen outbreak. This paper summarises the role of system dynamics modelling in the design and implementation of a functional exercise, which involved the Dutch and German national public health institutes in March 2023. The findings confirm the value of the system dynamics method in integrating disease and hospital models, and also highlights how well the method aligns with modern software development processes. The paper concludes with a discussion of what worked well, and presents areas for future enhancements of management flight simulators to support functional exercises. © 2024 The Author(s). System Dynamics Review published by John Wiley & Sons Ltd on behalf of System Dynamics Society.

The Lagos State COVID-19 Think-tank, a Potential Framework for Decision-making in a Pandemic Era.

Lagos state remains the epicenter of COVID-19 infection in Nigeria. To facilitate the emergency preparedness and response to COVID-19, the State Governor and Incident Commander constituted a Think Tank comprising 13 experts from various disciplines committed to the health of the public. The Think Tank assisted the government with decision-making strategies and supported the emergency operation centre (EOC) for the COVID-19 response. Their main achievements were developing frameworks for decision-making and strategies for phased easing of the State-wide lockdown. The challenges encountered were that it was often viewed as a parallel structure to the EOC and separated from the traditional civil service structure; causing some reluctance to implement ideas generated by the Think Tank. Nevertheless, the Think Tank played an important role during the COVID-19 pandemic; the lessons learned might help other states and resource-limited countries wishing to adopt this approach to emergency response.

Assessment of dispatch-assisted cardiopulmonary resuscitation performance during out-of- hospital cardiac arrest in a Tuscan emergency operation center: a retrospective study

Background: Time is the most crucial prognostic factor in out-of-hospital cardiac arrest (OHCA) owing to its clinical features. Dispatcher-assisted CPR (DA-CPR) by dispatch centers to a bystander calling for an ambulance, enabling even an inexperienced bystander to start CPR in 50% of cases and reducing the free therapy interval from chest compression to less than three minutes. Objectives: to assess the dispatch-assisted cardiopulmonary resuscitation performance during out-of-hospital cardiac arrest. Methods: a retrospective study was conducted at the Firenze-Prato Emergency Operation Centre to analyse data collected from all dispatch audio recordings of OHCA events that occurred between 1 January 2019 and 31 December 2020. Emergency calls lasting less than 60 s were excluded from the analysis, as this duration does not provide dispatchers with adequate time to accurately identify OHCA and provide pre-arrival instructions to the bystander.Results: A total of 1,267 OHCAs cases were included in this study, with 832 (65.7%) occurring in 2019 and 435 (34.3%) in 2020. Emergency nurses offered pre-arrival instructions in 272 cases (21.5%), with 160 cases in 2019 (19.2%) and 112 cases (25.7%) in 2020 (c2=7.19, p=0.007). These instructions were accepted by the caller in 9% (n=75) and 14% (n=61) of the cases, respectively (c2=7.48, p=0.006). OHCA events that could not be identified by telephone (therefore, DA-CPR was not possible) were 365 cases (43.9%) in 2019 and 175 cases (40.2%) in 2020 (c2=1.55, p=0.213). Conclusions: The adoption of a standardised protocol for delivering pre-arrival instructions, along with training programs focusing on OHCA and interview techniques, is strongly recommended based on the findings of our study. This was reinforced by the analysis of nighttime calls during which DA-CPR was not provided, including cases without clear justification.

Structural and Functional Requirements of Emergency Operations Centers: A Comparative Study

Structural and Functional Requirements of Emergency Operations Centers: A Comparative Study

Tanzania's first Marburg Viral Disease outbreak response: Describing the roles of FELTP graduates and residents.

Viral Haemorrhagic Fever Outbreak presents a significant public health threat, requiring a timely, robust, and well-coordinated response. This paper aims to describe the roles of the Tanzania Field Epidemiology and Laboratory Training Program (TFELTP) graduates and residents in responding to Tanzania's first Marburg Viral Disease (MVD) outbreak. We performed a secondary data analysis using a range of documents, such as rosters of deployed responders and the TFELTP graduate and resident database, to count and describe them. Additionally, we conducted an exploratory textual analysis of field deployment reports and outbreak situational reports to delineate the roles played by the residents and graduates within each response pillar. A total of 70 TFELTP graduates and residents from different regions were involved in supporting the response efforts. TFELTP graduates and residents actively participated in several interventions, including contact tracing and follow up, sensitising clinicians on surveillance tools such as standard case definitions, alert management, supporting the National and Kagera Regional Public Health Emergency Operations Centres, active case search, risk communication, and community engagement, coordination of logistics, passenger screening at points of entry, and conducting Infection Prevention and Control (IPC) assessments and orientations in 144 Health Facilities. The successes achieved and lessons learned from the MVD response lay a foundation for sustained investment in skilled workforce development. FELTP Training is a key strategy for enhancing global health security and strengthening outbreak response capabilities in Tanzania and beyond.

Hospital safety index: evaluation of the readiness and safety of hospitals in Isfahan province, Iran

Objective: Hospitals play a vital role in disaster management and their function must be maintained during crises. Isfahan province is susceptible to major crises and disasters at any time of the year. The study aimed to investigate the hospital safety index (HSI) in hospitals in Isfahan province. Methods: This cross-sectional study was conducted using the HSI questionnaire of the world health organization. The safety of all 55 hospitals in Isfahan province was evaluated with the Persian version of the questionnaire from 2017 to 2022. In this study, all hospitals were evaluated by a group of experts from the emergency operations center (EOC) of Isfahan University of Medical Sciences, and the checklists were completed with the cooperation of the hospital disaster committee, visiting the hospitals, and interviewing the personnel. Results: The safety level of hospitals has improved from 2017 to 2022 so in 2022, 38 hospitals (69.09%) had a high safety level, and 17 hospitals (30.91%) had a medium safety level. This increase in safety has happened in all three components of safety (functional, non-structural, and structural safety). There was no significant difference in the overall hospital safety score between academic-educational, non-academic governmental, social security and military, and private and charity hospitals (P<0.05). Conclusion: Although the safety in the hospitals of Isfahan province has improved due to the continuous disaster prevention and preparedness activities, hospitals still need to improve to achieve higher levels of safety. The HSI shows how well a hospital can maintain its organization and performance during disasters. This index will be useful for decision-making and policy-making to prioritize administrative and civil interventions.

Improvement of Personnel, Education and Working Environments via Surveying the Status of Personnel in 119 Emergency Operation Centers

Excluding the Sejong Fire Department Headquarters, visitations to 119 emergency operations centers in 17 cities and provinces across the country were conducted as of 2022 to assess the improvements in personnel arrangements, scope of work, and status of education and training after the placement of situation rooms. On-site visitations were conducted to 119 emergency operation centers in Seoul and 119 emergency operation centers in Busan. Interviews with security personnel participating in the study, such as emergency operation center managers and team leaders, were conducted at the 119 functional emergency operation centers. The status of the deployment, personnel matters, education and training in the operations center, and working conditions were assessed. The following improvements were suggested: The 119 emergency operation centers must be designated as heavy duty departments, provide personnel with the same or higher points as other departments, and provide training and comprehensive evaluation using common practice and simulations on the 119 Emergency Management Standard Response Manual of the National Fire Agency. In addition, working conditions, such as additional personnel points related to promotions, resolution of malicious complaints, difficulty adapting to sleep patterns, the need for psychological treatment, and lack of manpower, must be improved. The results suggest the benefits of operating 112 police emergency operation centers must be introduced.

A Comparison of Training and Dispatch Criteria for Security Personnel in 119 Domestic and Overseas General Situation Rooms

This study proposes an efficient way to strengthen work capabilities based on a comparison of the education and training of guard personnel before and after their deployment in the 119 Emergency Operations Center, which is in charge of elementary responses to various disasters and accidents, with that given to advanced foreign situation personnel. Only one area of Gyeonggi-do Province was identified in an internal document on personnel standards for moving into the situation room in Korea, and it was found that most of the situation room agents were used for situation room work through the informal OJT training of senior members of each city and provincial headquarters before deployment. Japan, like Korea, is organized into several prefectures and operates the same Emergency Operations Center or Joint Command Center. However, the most distinctive feature of the Japanese system with respect to Korea is that situation room agents are employed in the day-to-day operations of the command center after education with systematic and clear contents before being put into the work of the Emergency Operations Center. Similarly, the United States comprises 50 states, each with its own laws and emergency management systems. However, the federal government actively controls disaster safety and establishes and operates regulations by state, and each state has education and training, certification standards, and supplementary education regulations for existing agents. In Germany, there is a specific system of vocational education and training to become a worker in the Emergency Operations Center, and the curricula in vocational schools for security personnel, as well as the admission requirements and professional qualifications, are specified by the government.

Rapid Crisis Response in Resilient Cities: Emergency Response to and Reconnaissance of Earthquake Disasters in Taiwan

The devastating Chichi earthquake in Taiwan in 1999 highlighted the importance of disaster prevention and relief operations. In response to the challenge of extreme events and compound disasters, the National Science and Technology Center for Disaster Reduction (NCDR) contributes to operations at the Central Emergency Operation Center (CEOC) of Taiwan by providing integrated information and timely suggestions, and it delivers a common operational picture to central and local governments through a decision support system. This study was undertaken to explore the emergency response towards the reconnaissance of earthquake disasters in Taiwan to illustrate how resilient cities ensure rapid crisis response with a focus on the NCDR disaster response decision support system. This study examines the decision support system used following the 2016 ML 6.6 Meinong earthquake. The results demonstrate that the first line of relief for the emergency response commander is data-driven decision-making.

A Survey of the Use of Modeling, Simulation, Visualization, and Mapping in Public Health Emergency Operations Centers during the COVID-19 Pandemic.

The COVID-19 pandemic has significantly changed life and work patterns and reshaped the healthcare industry and public health strategies. It posed considerable challenges to public health emergency operations centers (PHEOCs). In this period, digital technologies such as modeling, simulation, visualization, and mapping (MSVM) emerged as vital tools in these centers. Despite their perceived importance, the potential and adaptation of digital tools in PHEOCs remain underexplored. This study investigated the application of MSVM in the PHEOCs during the pandemic in Canada using a questionnaire survey. The results show that digital tools, particularly visualization and mapping, are frequently used in PHEOCs. However, critical gaps, including data management issues, technical and capacity issues, and limitations in the policy-making sphere, still hinder the effective use of these tools. Key areas identified in this study for future investigation include collaboration, interoperability, and various supports for information sharing and capacity building.

MANIFESTATION OF COLLECTIVE SECURITY IN ASEAN AS A REGIONAL ORGANIZATION DURING PANDEMIC COVID-19

This research is entitled Manifestation of Collective Security in ASEAN as a Regional Organisation During the COVID-19 Pandemic. This research aims to identify ASEAN policies and efforts to realise collective security during the COVID-19 pandemic period. This research examines the manifestation of collective security in the Association of Southeast Asian Nations (ASEAN) as a regional organisation during the COVID-19 pandemic. The research method is to use a qualitative approach, combining desk research and data analysis. The results highlight ASEAN's important role in enhancing regional security through cooperation, particularly in the economic and diplomatic sectors, ASEAN utilises digital platforms for information exchange and coordination. The ASEAN Senior Officials Meeting on Health Development and the ASEAN Health Ministers Meeting facilitate open communication, allowing countries to share best practices and resources. For example, Thailand received early notification of COVID-19 through the ASEAN Emergency Operations Centre Network, enabling swift preparedness actions. The COVID-19 pandemic has demonstrated ASEAN's capacity to uphold its mission of regional stability and security. Through coordinated efforts, resource sharing, and international partnerships, ASEAN has effectively addressed the challenges posed by the pandemic. This experience underscores the importance of collective security and regional cooperation, reaffirming ASEAN's role as an important actor in maintaining stability and fostering resilience in Southeast Asia. This study concludes that ASEAN as a regional organisation plays an important role in ensuring the collective security of its members

Functional Simulation Exercise on Functionality of National Public Health Emergency Operations Centers in the African Region: Review of Strengths and Gaps.

National public health emergency operations centers (PHEOCs) serve as hubs for coordinating information and resources for effective emergency management. In the International Health Regulations (IHR 2005) Monitoring and Evaluation Framework, a simulation exercise is 1 of 4 components that can be used to test the functionality of a country's emergency response capabilities in a simulated situation. To test the functionality of PHEOCs in World Health Organization African Region member states, a regional functional exercise simulating an Ebola virus disease outbreak was conducted. The public health actions taken in response to the simulated outbreak were evaluated against the exercise objectives. Thematic analysis was conducted to summarize key strengths and areas for improvement. From December 6 to 7, 2022, more than 1,000 representatives from 36 of the 47 African Region member states participated in the exercise from their respective PHEOCs. Approximately 95% of the 461 participants polled agreed with the positive responses to the postexercise survey. More than half of the PHEOC participants were able to test their existing emergency preparedness and response plans and became familiar with the expected roles to be fulfilled during an event. Of the participants who responded to the survey, over 90% reported that the exercise helped them understand their roles during emergency management. The exercise met its objectives and provided an opportunity to test the functionality of PHEOCs using realistic scenarios, and it helped participants understand existing response systems and procedures. However, the exercise also revealed areas for improvement in terms of the timing and preparation of participants. We recommend conducting functional exercises at the regional and national levels at least once a year, early or midyear, to allow many stakeholders to take part in the exercise. Moreover, there is a need to train country-level evaluators and controllers in designing and conducting functional exercises.

Introducing www.epidemic-em.org: A Collection of Online Resources and Training Materials for Strengthening use of Emergency Operations Centers for Epidemic Response.

This work aimed to demonstrate that a website, www.epidemic-em.org, encompassing "static" resources, and videos, as well as other tools, can be used to strengthen public health emergency management capacity during epidemic response. Existing resources were updated and developed for self-directed Emergency Operations Centers' capacity strengthening, in order to encompass current best practices, and to emphasize how public health emergency management concepts can support epidemic response activities. These materials formed the core of the website, launched in June 2020, to which country case studies were added. In 2021, a pilot virtual training program was designed using recorded video lectures and interviews with global experts in addition to the website material, which was delivered to South African responders. The website has been accessed in more than 135 countries, demonstrating widespread reach and interest in online and freely accessible materials to support public health emergency operations. Over 30 people participated in the pilot virtual training, and the evaluation showed improvement in knowledge, confidence in using emergency management concepts for epidemic response, and positive feedback on the virtual modality. Online tools can expand access to materials and resources for public health emergency management capacity strengthening. Virtual modalities can further serve as a powerful complement, and perhaps replacement, for traditional in-person technical assistance, despite some limitations.

SmartEUS: An Integrated Dynamic Platform For The Innovation Of Healthcare Emergency-Urgency Services

The SmartEUS project aims to design, develop, and test a highly innovative model for the provision of Emergency Urgency Services (EUS) based on the concept of clinical pathway (i.e., the entire emergency care chain). The project is innovative both from an organizational and technological point of view. It is based on an e-Health approach, capable of exploiting new digital technologies in a coordinated way to support the evolution of emergency health systems towards dynamic and safer processes. The paper presents the SmartEUS platform which can integrate the information from all the key players in medical emergency response (emergency operation center, emergency medical service, hospital emergency department) improving their coordination. The most relevant innovations of the proposed solution are data integration and interoperability, advanced communication and collaboration, knowledge-based resource allocation, telemedicine integration to support decision making in dispatching and resource assignment. In fact, a Decision Support System is integrated into SmartEUS cloud platform to suggest to the emergency operation center which emergency medical service and hospital emergency department. In fact, information on the patient status can include results from ambulance’s on board telediagnosis equipment, alerting the hospital emergency department even before the arrive of the patient, thus guaranteeing the appropriateness of care according to patient needs (e.g., patient pre-triage index, potential pre-hospital diagnosis) and reducing emergency department overcrowding and resources saturation.

Lusaka Call-to-Action 2022: A Call to Strengthen Public Health Emergency Operation Centers in Africa.

In July 2022, on the sidelines of the 41st Ordinary Session of the Executive Council of the African Union and the 4th Mid-Year Coordination Summit in Lusaka, Zambia, Heads of state and government, and leaders of delegations of African Union Member States called on member states, African Union through Africa CDC, and partners to recognize, prioritize, and accelerate the establishment and strengthening of public health emergency operation centers (PHEOCs) in the context of health security and in line with Africa's new public health order. Implementing the declaration requires a multi-dimensional approach that spans across governance, operational capabilities, partnerships, workforce development, and sustainable financing.

Epidemic Intelligence Threat Reporting Profile in Portugal during the COVID-19: 2 Years of Decrease in Reporting on Non-COVID-19 Threats

Background: Epidemic intelligence (EI) ensures early detection, assessment, and communication of public health threats. Threat reporting defines priorities and mobilize resources for surveillance, prevention, and control. In Portugal, the Directorate-General of Health (DGS) is responsible for EI and publishes a weekly public health threat report (RONDA). Changes in threats in regular threat reports since COVID-19 have not been previously described. We analysed changes in non-COVID threat reporting in the weekly threat report. Methods: Using the DGS Emergency Operations Centre’s threat reporting database, we compared threats reported in RONDAs from 2016 to 2022 in three sequential periods: P1 before COVID-19 (January 2016–March 2020), P2 during acute COVID-19 restrictions (April 2020–February 2022), and P3 in post-acute COVID-19 phase (February 2022–September 2022). We described the monthly average frequency of reports on non-COVID-19 threats in those periods considering different disease groups, geographical focus, and information sources. We estimated expected non-COVID-19 reports on threats using a forecast model fitted to the time series until March 2020 and compared observed and expected values. Results: Non-COVID-19 threats had a decrease in the monthly average frequency of reporting in period 2 (x¯1: 4.7 vs. x¯: 2.3, p < 0.001) compared to period 1. Using the forecast methods, there were 114 fewer non-COVID threats than the 162 expected (−70%) in period 2. In period 3, there were 105 more threats than expected (+256%). The ECDC and the WHO were the most frequent sources of information followed by national Public Health sources. Conclusions: During COVID-19, there was a decrease in reports on non-COVID threats in Portugal. COVID-19 possibly affected global EI, by shifting attention and resources from other threats to the pandemic. However, the number of threats that warrant follow-up and communication is increasing. Further research is necessary to inform the EI research and development agenda, to ensure that all relevant threats are detected, accessed, and communicated according to evolving EI objectives and priorities while resources and preparedness are guaranteed.