Authors' objectives:

This evidence report identifies and synthesizes evidence on the effectiveness of hospital disaster drills, computer simulations, and tabletop or other exercises in training hospital staff to respond to an mass casualty incident (MCI), and it reviews the methods or tools that have been used to evaluate these types of training activities.

Authors' results and conclusions: Sixteen studies addressed hospital disaster drills as a training method for hospital staff to respond to an MCI and indicated lessons learned. The studies had significant limitations in design and evaluation methods. One study addressed computer simulation for training hospital staff to respond to an MCI and identified bottlenecks in patient care, security problems, and other issues. Four studies, covering issues from burn care to a regional coordinated response to a biological attack, addressed the effectiveness of tabletop or other exercises in training hospital staff to respond to an MCI. The reviewed studies used a variety of methods to evaluate the effectiveness of hospital drills, computer simulations, and tabletop and other exercises in training hospital staff to respond to an MCI, and they targeted different groups of hospital staff. Internal and external communications were the key to disaster response (e.g., a well-defined incident command center reduced confusion, conference calls were inefficient, and accurate phone numbers were vital).

Authors' recommendations: We concluded that enough studies were available to suggest that hospital disaster drills were effective in training hospital staff to respond to an MCI; however, weaknesses in study design limit the strength of these conclusions. Although computer simulations and tabletop and other exercises may have a role in identifying problems in disaster preparedness, the evidence is insufficient to judge their effectiveness in training.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.ahrq.gov/clinic/tp/hospmcitp.htm

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)