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Identifying Factors That May Influence Decision-Making Related to the Distribution of Patients During a Mass Casualty Incident

Published online by Cambridge University Press:  18 September 2017

Trevor NT Hall Open the ORCID record for Trevor NT Hall [Opens in a new window] ,
Andrew McDonald  and
Kobi Peleg
Trevor NT Hall*
Affiliation:
Humber River Hospital, Department of Quality and Patient Safety, Toronto, Ontario, Canada
Andrew McDonald
Affiliation:
Sunnybrook Health Sciences Center, Department of Emergency Services, Trauma, Emergency and Critical Care Program and University of Toronto, Toronto, Ontario, Canada
Kobi Peleg
Affiliation:
The Gertner Institute for Epidemiology and Health Policy Research, National Center for Trauma and Emergency Medicine Research, Tel-Hashomer, Israel, and The Disaster Medicine Department & The Executive Master Programs for Emergency and Disaster Management, Faculty of Medicine, School of Public Health, Tel-Aviv University, Tel-Aviv, Israel
*
Correspondence and reprint requests to Trevor NT Hall, MSc, 1235 Wilson Ave, Toronto, Ontario, M3M 0B2, Canada (e-mail: trevor.n.hall@gmail.com).
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Abstract

Objective

We aimed to identify and seek agreement on factors that may influence decision-making related to the distribution of patients during a mass casualty incident.

Methods

A qualitative thematic analysis of a literature review identified 56 unique factors related to the distribution of patients in a mass casualty incident. A modified Delphi study was conducted and used purposive sampling to identify peer reviewers that had either (1) a peer-reviewed publication within the area of disaster management or (2) disaster management experience. In round one, peer reviewers ranked the 56 factors and identified an additional 8 factors that resulted in 64 factors being ranked during the two-round Delphi study. The criteria for agreement were defined as a median score greater than or equal to 7 (on a 9-point Likert scale) and a percentage distribution of 75% or greater of ratings being in the highest tertile.

Results

Fifty-four disaster management peer reviewers, with hospital and prehospital practice settings most represented, assessed a total of 64 factors, of which 29 factors (45%) met the criteria for agreement.

Conclusions

Agreement from this formative study suggests that certain factors are influential to decision-making related to the distribution of patients during a mass casualty incident. (Disaster Med Public Health Preparedness. 2018;12:101–108)

Keywords

mass casualty incidentsdecision-support techniquesemergency preparedness
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 12 , Issue 1 , February 2018 , pp. 101 - 108
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2017 

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