Organizational Emergency Response Research Articles

Mass email risk communication: Lessons learned from COVID-19-triggered campus-wide evictions in Canada and the United States.

From an out-of-province/state and international post-secondary student perspective, this article (a) explores mass email risk communication facilitation during the COVID-19-triggered campus-wide evictions in Canada and the United States; and (b) develops relative recommendations to improve mass email risk communication strategies for future emergency response. Investigating mass email risk communication-related impacts on students in a tertiary educational context has revealed a significant deficit in emergency response research, practice, and policymaking. Mandatory temporary university and college closures during the COVID-19 first wave provided an opportunity to address this research and practice deficit, as most Canadian and American universities/colleges administered their eviction communication via daily mass email chains. Through a phenomenological lens, this study interviewed twenty out-of-province/state and international students, ten from each country respectively, to examine student eviction experiences associated with intensive mass email risk communication. This research identified four factors linked to mass email risk communication: email chain characteristics, student interpretation, interdepartmental cooperation, and frontline voices. Synthesizing these findings, four evidence-based recommendations were developed: to efficiently convey risk information to students, to understand student perceptions and to inform their behaviors, to enhance interdepartmental cooperation, and to enable mutual dialogue in decision making. These recommendations could assist post-secondary institutions, and other organizations, in strengthening their mass email risk communication strategies and advancing organizational emergency response plans for future extreme events.

Rising through the pandemic: a scoping review of quality improvement in public health during the COVID-19 pandemic

BackgroundThe COVID-19 pandemic generated a growing interest in and need for evidence-based tools to facilitate the implementation of emergency management strategies within public health practice. Quality improvement (QI) is a key framework and philosophy to guide organizational emergency response efforts; however, the nature and extent to which it has been used in public health settings during the COVID-19 pandemic remains unclear.MethodsWe conducted a scoping review of literature published January 2020 – February 2021 and focused on the topic of QI at public health agencies during the COVID-19 pandemic. The search was conducted using four bibliographic databases, in addition to a supplementary grey literature search through custom Google search engines and targeted website search methods. Of the 1,878 peer-reviewed articles assessed, 15 records met the inclusion criteria. An additional 11 relevant records were identified during the grey literature search, for a total of 26 records included in the scoping review.ResultsRecords were organized into five topics: 1) collaborative problem solving and analysis with stakeholders; 2) supporting learning and capacity building in QI; 3) learning from past emergencies; 4) implementing QI methods during COVID-19; and 5) evaluating performance using frameworks/indicators.ConclusionsThe literature indicates that QI-oriented activities are occurring at the organizational and program levels to enhance COVID-19 response. To optimize the benefits that QI approaches and methodologies may offer, it is important for public health agencies to focus on both widespread integration of QI as part of an organization’s management philosophy and culture, as well as project level activities at all stages of the emergency management cycle.

Drilling and evaluation of emergency rescue against mass casualties at general hospitals in Tianjin

Objective To understand the ability and level of emergency rescue at general hospitals in Tianjin city. Methods Such actions as formulating plans and examination forms, establishing assessment indicators and evaluation criteria, and simulation exercises were performed to evaluate the capacity of 28 general hospitals in terms of their organizational structure, emergency response, event reporting, and summary assessment. Results The emergency response assessment system consisted of 4 level-1 indicators, 19 level-2 indicators and 58 level-3 indicators. 28 hospitals were found high in their overall emergency response capacity, but some were found with setbacks. For example, the organizational structure scored the highest in 4 first-level indicators, up to 88.91%, while incident report scored the lowest, down to 67.99%. Among level-2 indicators, professional emergency professional procedures and initial reporting scored the lowest. Conclusions In order to further improve the ability of medical institutions to respond to emergency events, the hospitals are recommended to enhance their backup resources for emergency response, their staff′s awareness of first aid knowledge and first aid skills, as well as their timeliness of initial reports and the completeness of progress reports. Key words: Emergency medicine; Emergency drills; Emergencies; Medical institutions; Tianjin

Intelligent and communicating real-time diagnostics for the fight against the Fire Compartments.

This results aims to improve the effectiveness of security systems by optimizing the interaction between technological components and organizational and human intervention. Objectives are to determine the specific laws governing indoor fire phenomena by means of experimental full-scale and numerical approaches, to get real-time information about the fire during operations. A second phase consists in a transformation of the usual passive-safety systems into intelligent and communicating systems, thereby optimizing and securing the human and organizational emergency response. The dual competence numerical /experimental data is essential in this type of study since the experimental data suffer from a lack of resolution (spatial, temporal) but nevertheless represent information necessary for validating the codes.

Perceptions, behavioral expectations, and implementation timing for response actions in a hurricane emergency

This study examined the perceived attributes, behavioral expectations, and expected implementation timing of 11 organizational emergency response actions for hurricane emergencies. The perceived attributes of the hurricane response actions were characterized by two hazard-related attributes (effectiveness for person protection and property protection) and five resource-related attributes (financial costs, required knowledge/skill, required equipment, required time/effort, and required cooperation). A total of 155 introductory psychology students responded to a hypothetical scenario involving an approaching Category 4 hurricane. The data collected in this study explain previous findings of untimely protective action decision making. Specifically, these data reveal distinctly different patterns for the expected implementation of preparatory actions and evacuation recommendations. Participants used the hazard-related and resource-related attributes to differentiate among the response actions and the expected timing of implementation. Moreover, participants’ behavioral expectations and expected implementation timing for the response actions were most strongly correlated with those actions’ effectiveness for person protection. Finally, participants reported evacuation implementation times that were consistent with a phased evacuation strategy in which risk areas are evacuated in order of their proximity to the coast. However, the late initiation of evacuation in risk areas closest to the coast could lead to very late evacuation of risk areas farther inland.

New Soldiers in the War on Disasters

Humanity is “winning the war on war”; so says Joshua S. Goldstein (2011) in his recent book about the decline of armed conflict worldwide. The assertion may seem shocking based on the constant stream of negative coverage of international conflicts. Instead, Mr. Goldstein argues, decades of effort and sacrifice by people working through international organizations, humanitarian aid agencies, and popular movements around the world are making a measurable difference in reducing violence. There is reason to be optimistic about a peaceful future. One might also surmise, based on recent media coverage, that natural disasters are claiming more lives than ever before. However, of the more than 60 million deaths resulting from natural disasters over the past 100 years, approximately 85% occurred before 1950 (Bandyk 2010). The world is apparently getting safer, despite incidences of natural disasters increasing approximately 5% annually since the 1960s. Again, the efforts of international organizations, humanitarian aid agencies, scientists, and engineers appear to be paying off. The very nature of this special edition is proof of such efforts. Unfortunately, the 2010 Haiti earthquake, which claimed more than 220,000 lives (Rettner 2010), illustrates the inequality between wealthy and poor nations when it comes to disaster preparedness. Matthew Kahn, professor at the University of California, Los Angeles Institute of the Environment, observed that 65% of deaths from disasters between 1985 and 1999 occurred in countries in which annual incomes were less than $760 per capita. Countries with a higher gross domestic product have fewer deaths from natural disasters, likely a result of the ability to afford better building materials and an organized emergency response. However, greater wealth means that there is more wealth to destroy. Disasters’ cost to insurers has doubled in the past decade, so insurance companies are increasingly engaging engineers to assess losses and promoting more resilient building standards. My company projects our property loss division to grow faster than any other component of the business in the coming years. The practice serves insurance companies and their representative attorneys and adjusters in evaluating the scope and nature of a loss. Besides being profitable, the work also provides a unique opportunity for engineers, particularly younger engineers, to experience building failures firsthand. Responding to this type of work can be a challenge for traditional design firms. Immediately following a loss event, a large number of staff must be mobilized and sent to the site. Often, assignments can last weeks or months and require tedious canvassing of the project site. Younger engineers are frequently tapped for the work because of fewer local commitments and a willingness to take on physically challenging work. Such exposure to disaster sites is beneficial to the careers of younger engineers. The opportunity to travel to different parts of the country and the world expands the worldview of the investigators. Observing failed designs helps inform future design decisions. Coordinating with local officials, emergency responders, insurance companies, and other experts expands engineers’ perceived role in the community. It’s reasonable to hope that these engineers will hone their skills and become vocal proponents of improved disaster response at home and abroad. In recent years, engineers from Thornton Tomasetti have been mobilized to provide property loss consulting for damages from Hurricane Katrina, the 2010 Chilean earthquake, the 2011 Joplin, Missouri, tornado, and the 2011 New Zealand earthquakes. These engineers will take from these experiences lessons to inform their future careers as professionals. To date, I have not been called on to travel to such large disaster sites, but I have learned many lessons from similar projects. Last year, I worked with a group of students from the School of the Art Institute of Chicago who planned to travel to Talca, Chile, to assist in the earthquake recovery. This city experienced more damage than the capital because of the more traditional building techniques used. With the help of local engineers, the team came to L E A D E R S H I P O N T H E E N T R Y L E V E L

Improving Home-Based Hospice Understanding and Use of the National Incident Management System for Emergency and Disaster Preparation and Response

Critical to an organized and successful emergency response is having a plan based on the framework used exclusively by community and national emergency service organizations, that is, the National Incident Management System (NIMS). Standardization is vital so that diverse types of organizations can work in harmony to respond to emergencies. NIMS provides the opportunity for this standardization. Home-based hospices are generally unaware of NIMS and its value during a multiagency response to an incident. Care should be taken to revise emergency and disaster preparation and response plans to reflect the national standard.

Transfer delay and in-hospital mortality of trauma patients in Pakistan

Background Mortality and morbidity in trauma remain a major problem in developing countries. Organized emergency response systems for transfer of trauma patients to hospitals are absent and the consequent delays could cause significant complications. Aims This study assessed the outcomes as a result of hospital transfer and delays in trauma patients. Methods The study was based on trauma patients presenting to the Aga Khan University Hospital (AKUH), Karachi, Pakistan from 1998 to 2005, meeting the trauma team activation criteria. Data were collected and entered in a Trauma Registry. The study focused on analyzing the outcomes of injury to delay in definitive treatment and survival. Results Out of 978 patients, only 303 (30.9%) patients reached the emergency room (ER) within an hour. The mean time from injury occurrence to arrival in the ER was 4.7 h. There was no significant difference in mortality between all patients presenting early and those with more than 1 h delay (OR = 0.9, 95% CI: 0.6, 1.5). Conclusions Transfer and delay in admission to a tertiary care center does not affect in-hospital mortality of trauma patients in a setting with no emergency response system. This may be due to self selection of patients who survive long enough to reach the hospital.

Challenge of Hospital Emergency Preparedness: Analysis and Recommendations

In the United States, recent large-scale emergencies and disasters display some element of organized medical emergency response, and hospitals have played prominent roles in many of these incidents. These and other well-publicized incidents have captured the attention of government authorities, regulators, and the public. Health care has assumed a more prominent role as an integral component of any community emergency response. This has resulted in increased funding for hospital preparedness, along with a plethora of new preparedness guidance.Methods to objectively measure the results of these initiatives are only now being developed. It is clear that hospital readiness remains uneven across the United States. Without significant disaster experience, many hospitals remain unprepared for natural disasters. They may be even less ready to accept and care for patient surge from chemical or biological attacks, conventional or nuclear explosive detonations, unusual natural disasters, or novel infectious disease outbreaks.This article explores potential reasons for inconsistent emergency preparedness across the hospital industry. It identifies and discusses potential motivational factors that encourage effective emergency management and the obstacles that may impede it. Strategies are proposed to promote consistent, reproducible, and objectively measured preparedness across the US health care industry. The article also identifies issues requiring research.

Biotechnological research on the most dangerous pathogens: Challenges for risk governance and safety management

Biotechnological research on the deadliest pathogens has rapidly grown into a vast enterprise in the United States. With over $50 billion from federal agencies, thousands of projects are conducted at hundreds of university laboratories and other facilities in a national effort to gain the knowledge and methods for preventing the natural occurrence of pathogenic disease and protecting against bioterrorism. This paper describes this enterprise, defines several risk scenarios unrelated to terrorism which threaten lab workers and the public with lethal and contagious pathogenic disease, and evaluates the official policy framework for decision-making with regard to preventing and responding to the risk scenarios. It finds that the framework emphasizes physical security and secrecy to prevent terrorist exploitation of the enterprise, but fails to sufficiently address prevention of lab mishaps, accidental releases, and other incidents during the routine conduct of research which would expose workers and the public to the lethal pathogens. Nor does the framework effectively provide for the emergency response measures needed to prevent an accidental release of the more highly contagious pathogens from spiraling into a local or larger scale disease epidemic. These findings, supported by the growing number of near misses and small-scale incidents and lawsuits, point to major weaknesses in federal oversight and regulation, official disregard for siting criteria, inadequate self-regulation and management of lab safety practices, breakdowns in reporting systems, and obstacles to organizational learning and emergency response created by secrecy and security policies. Recommendations are made regarding these inadequacies of the federal framework and urge application of lessons learned from safety science experience with other hazardous technologies where increasing attention is being given to safety culture initiatives.

Reducing Barriers for Implementation of Bystander-Initiated Cardiopulmonary Resuscitation

Sudden cardiac arrest (SCA) is a leading cause of death in the United States and Canada. In the United States, each year ≈330 000 people die of coronary heart disease out of the hospital or in emergency departments. Of these, >150 000 SCAs occur out of the hospital.1,2 Despite the development of electrical defibrillation and the more recent implementation of lay rescuer defibrillation programs, the vast majority of these victims do not leave the hospital alive. In studies over the past 15 years, only 1.4% of patients with out-of-hospital arrest in Los Angeles, Calif, survived to hospital discharge3; in Chicago, Ill, the number was 2%,4 and in Detroit, Mich, it was <1%.5 Conversely, a few municipalities such as Seattle, Wash, report much higher survival rates from SCA—more than 15% in 1 study6—which suggests that survival rates need not remain so low. Recent work in Europe and elsewhere has confirmed that a higher survival-to-hospital discharge rate is indeed a realistic goal, with survival rates as high as 9% reported in Amsterdam7 and 21% in Maribor, Slovenia.8 The American Heart Association (AHA) uses 4 links in the “chain of survival” to illustrate the time-sensitive actions required for victims of SCA: (1) early recognition of the emergency and activation of emergency medical services (EMS), (2) early bystander cardiopulmonary resuscitation (CPR), (3) early delivery of shock(s) from a defibrillator if indicated, and (4) early advanced life support and postresuscitation care. Immediate bystander recognition of the emergency and EMS activation are critical. In many communities, however, these actions may be followed by significant delays, because the time interval from activation of EMS to arrival of these medical personnel may be 7 to 8 minutes or longer.4 Therefore, initial care in the first critical minutes after …

Organizational Culture and Emergency Response Actions: How Japanese Companies Behave?

Are Japanese companies insensitive for the crisis? From our survey, it is clear that the strong top down style management is not supported but bottom up style of management is supported. Also, in connection with the organization culture, it can be surmised that companies with a cheerful family-type culture are better able to effect a coordinated response to an emergency. In this type of culture, information tends to be passed on freely, and rather than having employees carry out response actions based on orders and directives conscious of the intentions of the top management. Keyword: crisis management, organizational culture, top down management, communication

Corporate crisis management: Managing a major crisis in a chemical facility

Chemical sites should have well trained and organized emergency response plans to manage an incident within the plant or during transport. The implementation of an incident command system utilizing either internal resources or external response through mutual aid agreements is generally sufficient to address the direct impact of an event on the site. When the site resources become overwhelmed in addressing resulting issues such as press releases, medical advice/support, employees and family support, Agency notifications, etc, Corporate should be ready and able to respond. This paper, taken from an in-depth CCPS workshop led by the author, describes an outline for corporate assistance in the event of a major incident at a site or during transportation.

The Road Map to Preparedness: A Competency-Based Approach to All-Hazards Emergency Readiness Training for the Public Health Workforce

Facing limited time and budgetary resources, state and local health departments need a practical, competency-based training approach to meet the all-hazards readiness requirements of their employees. The Road Map to Preparedness is a training tool designed to assist health departments in providing comprehensive, agency-tailored readiness instruction to their employees. This tool uses an incentive-based, game-like, experiential learning approach to meet the Centers for Disease Control and Prevention's nine core competencies for all public health workers while facilitating public health employees' understanding and acceptance of their emergency response roles. A corresponding evaluation tool, the Road Map to Preparedness Evaluation, yields metrically-driven assessments of public health employee readiness competencies. Since its pilot in 2003, the Road Map to Preparedness has met with enthusiastic response from participating health departments in the mid-Atlantic region. In addition to its public health impact, the Road Map offers future promise as a tool to assist organizational emergency response training in private sector and non-public health first-responder agency settings.

Code gray--an organized approach to inpatient stroke.

This article reviews the need for planning and implementation of an organized emergency response to stroke as a secondary diagnosis. Patients who are admitted to hospitals with a diagnosis other than stroke and experience stroke symptoms warrant immediate identification and rapid intervention. Code Gray is an emergency team response for inpatient stroke. Modeled after the response for Code Blue, this team quickly assesses, obtains further diagnostic studies, and provides appropriate intervention to patients who experience stroke symptoms while being hospitalized for some other diagnosis or problem. This emergency team response provides the ingredients for improved patient outcomes and promotes quality patient care.

B YSTANDER C ARDIOPULMONARY R ESUSCITATION IN P REHOSPITAL C ARDIAC A RREST P ATIENTS IN S INGAPORE

Introduction. The chain of survival emphasizes the importance of the four links associated with survival after cardiac arrest (CA). The involvement of laypersons has been increasing over the years. They have been contributing toward “early access,” “early cardiopulmonary resuscitation” (CPR), and, of late, “early defibrillation,” with the advent of automated external defibrillators (AEDs). Bystander CPR rates are difficult to assess due to the lack of formal documentation. Objective. To assess the bystander CPR rate for CA patients brought to the emergency department (ED) of an urban, tertiary teaching hospital in the central part of Singapore, over a period of 12 months. Methods. This was a retrospective cohort study carried out from May 1, 1999, to April 30, 2000. “Bystander CPR” refers to an attempt to perform basic CPR by someone who is not part of an organized emergency response system. In general, this refers to the person who witnesses the arrest. Results. There were 155 adult patients with CA who satisfied the inclusion criteria over the 12-month period. The median age was 62.1 ± 6.4 years, and the majority of patients were brought in by ambulances (126, or 81.3%). There were 142 (91.6%) non-trauma and 13 (8.4%) trauma CAs. Most patients had the CA at home (96, or 61.9%), and the most common initial rhythm at presentation upon the arrival of the paramedics was ventricular fibrillation (VF) (50 patients, or 32.2%). The bystander CPR rate was 20.0% (i.e., 31 of the 155 patients). A total of 32 (20.6%) patients had return of spontaneous circulation (ROSC, defined as the return of a palpable pulse) and 31 (96.9%, or 31/32) of them were those who had some form of bystander CPR performed. Of these 31 who had bystander CPR, four (12.9%) were subsequently admitted to the intensive care unit (ICU), while among those who did not have bystander CPR, all had death pronounced in the ED. Of the four patients admitted to the ICU, three (3 of 4, or 75.0%; or 3 of 155 CA patients, or 1.9%) were subsequently discharged alive from the hospital. Conclusion. The bystander CPR rate for prehospital CA was 20.0%. About 12.9% (4 patients) of those who had bystander CPR were admitted to the ICU, compared with none from the group that did not receive any form of bystander CPR. Three patients (1.9% of all prehospital CAs) were discharged alive from the hospital.