Dataset Information

Using Hospital Incident Command Systems to Respond to the Pediatric Mental and Behavioral Health Crisis of the COVID-19 Pandemic.

ABSTRACT:

Abstract

Hospital incident command systems (HICS) were implemented to expand mental and behavioral healthcare (MBHC) services during the COVID-19 pandemic. Data on patient census, nurse vacancies, staff injuries, and staff perceptions were analyzed to quantify issues and track progress toward HICS goals. Data, environment of care, staffing, staff support, staff education, and communication resources were developed. After HICS implementation, 84% of nurses reported confidence in providing care to youth with acute MBHC needs. Nurse leaders should consider HICS for addressing other crises.

SUBMITTER: Westley L

PROVIDER: S-EPMC9883042 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Using Hospital Incident Command Systems to Respond to the Pediatric Mental and Behavioral Health Crisis of the COVID-19 Pandemic.

Westley Laura L Manworren Renee C B RCB Griffith Debrea M DM Hoffmann Jennifer A JA Janssen Aron A Routburg Susan S Richey Karen K

The Journal of nursing administration 20230201 2

<h4>Abstract</h4>Hospital incident command systems (HICS) were implemented to expand mental and behavioral healthcare (MBHC) services during the COVID-19 pandemic. Data on patient census, nurse vacancies, staff injuries, and staff perceptions were analyzed to quantify issues and track progress toward HICS goals. Data, environment of care, staffing, staff support, staff education, and communication resources were developed. After HICS implementation, 84% of nurses reported confidence in providing ...[more]

PMID: 36692999

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Project description:BackgroundRecent trends indicate that the frequency of major incidents (MIs) is increasing. Healthcare systems are vital actors in societies' responses to MIs. Well-prepared healthcare systems may mitigate the effects of MIs. Disaster preparedness is based on region-specific risk and vulnerability analyses (RVAs). Hospital incident command groups (HICGs) are commonly formed per hospital's contingency plan MI to aid in disaster response. Acquiring situational awareness and decision-making in the face of uncertainty are known challenges for HICGs during MIs. However, the remoteness of rural hospitals presents unique challenges.AimThe aim of this study was to explore HICG leaders' perceptions of disaster preparedness in rural hospitals.MethodsA qualitative study with semi-structured, focus group, and individual interviews was used. The data were analyzed through inductive content analysis.ResultsThe analysis generated the main category, HICGs' confidence in handling major incidents and four categories. These were Uncertainty and level of recognition (containing two subcategories); Awareness of challenges and risks (containing two subcategories); Factors that facilitate preparedness, response, and leadership (containing three subcategories); and Prerequisites for decision-making (containing three subcategories and four subcategories).ConclusionsHICG leaders generally perceived their hospital's disaster preparedness as adequate. However, preparedness was found to be influenced by several factors. The findings revealed a complex interplay of factors influencing preparedness and response, particularly highlighting challenges related to geographical isolation and resource constraints. Effective preparedness requires a comprehensive understanding of local contexts, hospital capabilities, and risks, which directly impacts training, decision-making, and resource allocation. Addressing the identified vulnerabilities necessitates targeted interventions focused on situational awareness, decision-making, collaboration, and training.Clinical trial numberNot applicable.

Project description:BackgroundHospitals are cornerstones for health care in a community and must continue to function in the face of a disaster. The Hospital Incident Command System (HICS) is a method by which the hospital operates when an emergency is declared. Hospitals are often ill equipped to evaluate the strengths and vulnerabilities of their own management systems before the occurrence of an actual disaster. The main objective of this study was to measure the decision making performance according to HICS job actions sheets using tabletop exercises.MethodsThis observational study was conducted between May 1st 2008 and August 31st 2009. Twenty three Iranian hospitals were included. A tabletop exercise was developed for each hospital which in turn was based on the highest probable risk. The job action sheets of the HICS were used as measurements of performance. Each indicator was considered as 1, 2 or 3 in accordance with the HICS. Fair performance was determined as < 40%; intermediate as 41-70%; high as 71-100% of the maximum score of 192. Descriptive statistics, T-test, and Univariate Analysis of Variance were used.ResultsNone of the participating hospitals had a hospital disaster management plan. The performance according to HICS was intermediate for 83% (n = 19) of the participating hospitals. No hospital had a high level of performance. The performance level for the individual sections was intermediate or fair, except for the logistic and finance sections which demonstrated a higher level of performance. The public hospitals had overall higher performances than university hospitals (P = 0.04).ConclusionsThe decision making performance in the Iranian hospitals, as measured during table top exercises and using the indicators proposed by HICS was intermediate to poor. In addition, this study demonstrates that the HICS job action sheets can be used as a template for measuring the hospital response. Simulations can be used to assess preparedness, but the correlation with outcome remains to be studied.

Project description:BackgroundInpatient psychiatric care is unpopular and expensive, and development and evaluation of alternatives is a long-standing policy and research priority around the world. In England, the three main models documented over the past fifty years (teams offering crisis assessment and treatment at home; acute day units; and residential crisis services in the community) have recently been augmented by several new service models. These are intended to enhance choice and flexibility within catchment area acute care systems, but remain largely undocumented in the research literature. We therefore aimed to describe the types and distribution of crisis care models across England through a national survey.MethodsWe carried out comprehensive mapping of crisis resolution teams (CRTs) using previous surveys, websites and multiple official data sources. Managers of CRTs were invited to participate as key informants who were familiar with the provision and organisation of crisis care services within their catchment area. The survey could be completed online or via telephone interview with a researcher, and elicited details about types of crisis care delivered in the local catchment area.ResultsWe mapped a total of 200 adult CRTs and completed the survey with 184 (92%). Of the 200 mapped adult CRTs, there was a local (i.e., within the adult CRT catchment area) children and young persons CRT for 84 (42%), and an older adults CRT for 73 (37%). While all but one health region in England provided CRTs for working age adults, there was high variability regarding provision of all other community crisis service models and system configurations. Crisis cafes, street triage teams and separate crisis assessment services have all proliferated since a similar survey in 2016, while provision of acute day units has reduced.ConclusionsThe composition of catchment area crisis systems varies greatly across England and popularity of models seems unrelated to strength of evidence. A group of emerging crisis care models with varying functions within service systems are increasingly prevalent: they have potential to offer greater choice and flexibility in managing crises, but an evidence base regarding impact on service user experiences and outcomes is yet to be established.

Dataset Information

Using Hospital Incident Command Systems to Respond to the Pediatric Mental and Behavioral Health Crisis of the COVID-19 Pandemic.

Abstract

Publications

Using Hospital Incident Command Systems to Respond to the Pediatric Mental and Behavioral Health Crisis of the COVID-19 Pandemic.

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