Lessons from surge disaster response simulation activities

Purpose: Emergency Departments (ED) play a sentinel role in disaster responses, from decontamination and triage to stabilisation of patients, while continuing to provide routine medical care for existing and new patients. However, the low frequency of disasters and patient surge and major internal catastrophes limits preparedness among emergency personnel. Aims: The aims of this study were to report how Patient Surge Disaster Response simulation activities impacted interagency preparedness and informed future planning of disaster preparedness training. Methods: We developed and delivered two tabletop ED reception activities and one in-person chemical, biological, radiation (CBR) decontamination scenario for a multi-disciplinary group of clinicians and senior administrators. Data were collected from participants and faculty via preand post-questionnaires and notes from debriefings and verbal feedback from faculty. Descriptive statistics were used to summarize numerical data and thematic analysis for textual data. Results: From around 100 participants, the preand post-questionnaires were completed by 73 (pre-PSDR) and 56 (post-PSDR). Participant professions in the pre-intervention and post-intervention questionnaires were similar. Participants' self-assessment demonstrated significant improvements in understanding and identifying roles, teamwork and confidence in disaster responses (p<0.001 for all outcomes). The key theme from qualitative data was that the capability of the response will influence future preparedness activities, including staff training, interdisciplinary collaboration, and equipment maintenance. Conclusion: Inter-agency simulation learning events were associated with improved confidence in preparedness and team response. These findings indicate the need for regular activities to ensure frontline staff are familiar with and prepared for disaster responses.