Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-10-31T23:13:24.053Z Has data issue: false hasContentIssue false

Critical Decision-making in Medical Command and Control During Early Covid-19: An Interview Study

Published online by Cambridge University Press:  13 July 2023

Jenny Pettersson
Affiliation:
Center for Disaster Medicine and Traumatology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
Carl-Oscar Jonson
Affiliation:
Center for Disaster Medicine and Traumatology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
Marc Friberg
Affiliation:
Center for Disaster Medicine and Traumatology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden Department of Computer and Information Science, Linköping University, Linköping, Sweden
Anton Björnqvist
Affiliation:
Center for Disaster Medicine and Traumatology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden Department of Computer and Information Science, Linköping University, Linköping, Sweden
Peter Berggren
Affiliation:
Center for Disaster Medicine and Traumatology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden Department of Computer and Information Science, Linköping University, Linköping, Sweden
Jessica Frisk
Affiliation:
Department of Surgery in Norrköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
Erik Prytz
Affiliation:
Center for Disaster Medicine and Traumatology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden Department of Computer and Information Science, Linköping University, Linköping, Sweden
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Introduction:

A resilient health care system is expected to withstand disruptive events and consistently deliver high quality care by continually adapting, learning, and improving. To achieve these expectations, medical command and control teams are responsible for making relevant strategic decisions, reallocating resources, and initiating cooperation. Early during Covid-19, medical command and control teams were faced with an unforeseen increase in number of patients, as well as unknown disease mechanisms and treatment regimes. Timely and adequate decision-making to become a resilient healthcare system and maintain high quality care was necessary. The aim of the present study was to describe the challenges and strategies in a medical command and control team during the early phase of the Covid-19 pandemic.

Method:

A semi-structured retrospective in-depth interview study with phenomenological approach and inductive design was used. Thirteen experienced decision makers serving in a regional medical command and control team were interviewed using the Critical Decision Method. The interviews were analyzed using manifest conventional content analyses.

Results:

The respondents described twelve separate episodes during the Covid-19 management. The analysis resulted in five themes: organization, adaptation, common operational picture, assumptions, and analysis. Organization described how organizational challenges affected the decision-making process. Adaptation described the strategies to overcome the obstructive organizational factors. Common operational picture described how challenges in lack of available information affected decision-making and strategies used in creating situational awareness. Assumptions offered descriptions of strategies used to make decisions. Analysis emphasized descriptions and strategies affecting the decision-making process.

Conclusion:

This study enables a better understanding of how medical command and control teams can be organized and structured, while also highlighting challenges in maintaining high-quality care during unexpected events. The findings obtained in the present study provide further knowledge about disaster resilience and can be utilized in educational and training settings for medical command and control.

Type
Lightning and Oral Presentations
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine