Exploring the continental staff system as a framework for the hospital incident command. Protocol for a qualitative grounded theory study

Background In order to maintain hospital functionality during exceptional situations, the hospital incident command must be adequately empowered and prepared. As hospitals in Germany and elsewhere are legally required to implement a Hospital Emergency and Response Plan, regular training exercises are essential to ensure that staff acquire the necessary knowledge and competencies. Objectives This study will investigate the transition process from routine clinical operations to an exceptional situation during the training of a continental staff-system based hospital incident command. Primary objective: 1) deepen the understanding of leadership communication and dynamics, 2) assess training outcomes for hospital incident command teams. Secondary objectives: examine a. the applicability of the traditional incident command model in hospitals with limited staff experience, b. evaluate participants’ operational confidence, c. analyze communication within command functions, and d. identify the strengths and weaknesses of a structured hospital incident command system Methods The study is based on a staff framework exercise conducted following targeted training. Data will be gathered prospectively through semi-structured interviews with participants, and an analysis of observational data, including notes and protocols recorded during the exercise. All data will be analyzed following Grounded Theory methodology, a systematic approach to theory construction through qualitative data analysis. Discussion Despite the growing importance of hospital incident command systems in disaster and business continuity management, research in this area remains limited. This study aims to fill the gap by examining the implementation and functioning of a continental staff system-based command in hospitals, with a particular focus on transition dynamics and internal communication processes.