Just imagine a major train accident happens and the hospital suddenly has to deal with large numbers of acute patients. Or the intensive care unit of a hospital is struck by an energy breakdown and all patients must be evacuated. In both cases the involved health care institutions will face a shortage of staff and the immediate need for a crisis team. We are all confident that our hospitals are prepared to face such an emergency, and so we should be. But how can we be sure?
Dr. Selma van der Haar and Prof. Dr. Mien Segers, both from the Department Educational Research and Development at Maastricht University, wanted to find out. They were approached three years ago by OTO Limburg, which is in charge of showing that health care organisations in the Limburg region are sufficiently prepared to face emergencies. That is necessary to prolong the financial funding the Dutch Ministry of Health annually allocates to these organisations.
OTO Limburg makes sure that the staff of several regional hospitals, area health authorities, ambulance and general practice services receive training and participate in emergency simulations.
Clarien Schoeren, OTO Limburg coordinator for the Netwerk Acute Zorg Limburg (Network Acute Care Limburg) coordinates this mission: “We stimulate and subsidize the training programmes, because we know that crisis teams have to deliver top performances in case of an emergency. We make sure all involved professionals possess the knowledge and skills they need, we connect organisations, coordinate specific knowledge, monitor and evaluate. Both the government and the institutions invest a great deal of time, money and effort in these training practices. But how do we know if they are sufficient? We need a scientific method to investigate that.”
That’s where van der Haar and Prof. Dr. Mien Segers came in, along with several participating UM students. “In 2012, OTO Limburg asked us if and how we could measure the level of preparedness for a crisis situation of a health care organisation,” van der Haar and Segers say. “The action sufficiency level of preparedness will of course show when disaster strikes, but waiting for that moment is too risky. Therefore, we used scientific literature as well as interviews with professionals from OTO Limburg and health care organisations to gain insight in how to measure the level of preparedness without having to wait for an actual disaster. A combination of scientific research and practical expertise.
“We found that the level of preparedness should be valued on the individual, team and organisational layer: individuals should be competent in their crisis management role, teams should be able to interact accurately, and the organisational structure and culture should be supportive in the development of these competences and in learning from experiences. Is there, for example, room for learning from mistakes in the organisation? Is staff encouraged to take part in training and simulations?
We are now developing and validating a profile for each layer. These profiles form the ingredients for a web application that functions as a self-evaluation instrument. In addition, we include measures for staff participation in training and practice, and for the quality of these activities. Organisations can use this application to measure to which degree they are prepared for crises and emergencies. They will gain insight in their level of preparedness and the key components of training and exercise. They will know their strengths and weaknesses in case of emergency and can timely make adjustments and improvements at all levels. In the end, we aim to also include a process and instrument for evaluating incidents. This will enable the users to see whether their level of preparedness indeed was sufficient and what there is to learn next.”
“The test version will be launched this November,” adds Schoeren, “and we can’t wait to use it! It will provide us with all the validated data we need to improve our training and practice, and even tailor it to the specific needs of each organisation. The tool that is being developed here at Maastricht University by Selma van der Haar, Mien Segers and their students is crucial to emergency situations in health organisations in the entire region. But we think bigger: if the tool proves efficient in Limburg, we will introduce it nationwide and even in the Euregional context.”
Van der Haar: “All together we build a bridge between practice and science and create a brand-new and unique platform that will ultimately add to saving lives.” Schoeren adds: “All our partner organisations have been extremely cooperative, but I specifically want to mention OTO Project leader Gerrit Vernimmen for the Regional Medical Emergency Preparedness and Planning Office (GHOR) in Limburg, who continuously provides the students and researchers with all the information and data they need. Selma van der Haar and Mien Segers are the driving force behind the project. They are doing an amazing job.”