Rethinking preparedness planning in disaster emergency care: lessons from a beyond-surge-capacity event.

Background: Large-scale burn disasters can produce casualties that threaten medical care systems. This study proposes a new approach for developing hospital readiness and preparedness plan for these challenging beyond-surge-capacity events.

Methods: The Formosa Fun Coast Dust Explosion (FFCDE) was studied.

Ranking hospitals' burn care capacity using cluster analysis on open government data.

Background And Objective: To deal with burn mass casualty incidents (BMCIs), various countries have established national or regional BMCI emergency response plans (ERPs). A burn care capacity ranking model for hospitals can play an integral role in ERPs by providing essential information to emergency medical services for distributing and handling mass burn patients. Ranking models vary across countries and contexts.

Measurement of resilience potential - development of a resilience assessment grid for emergency departments.

Background: Resilience engineering has been advocated as an alternative to the management of safety over the last decade in many domains. However, to facilitate metrics for measuring and helping analyze the resilience potential for emergency departments (EDs) remains a significant challenge. The study aims to redesign the Hollnagel's resilience assessment grid (RAG) into a custom-made RAG (ED-RAG) to support resilience management in EDs.

Coping With a Mass Casualty: Insights into a Hospital's Emergency Response and Adaptations After the Formosa Fun Coast Dust Explosion.

Objective: The study provides a comprehensive insight into how an initial receiving hospital without adequate capacity adapted to coping with a mass casualty incident after the Formosa Fun Coast Dust Explosion (FFCDE).

Methods: Data collection was via in-depth interviews with 11 key participants. This was combined with information from medical records of FFCDE patients and admission logs from the emergency department (ED) to build a detailed timeline of patients flow and ED workload changes.

Beyond surge: Coping with mass burn casualty in the closest hospital to the Formosa Fun Coast Dust Explosion.

Purpose: To provide an insight into the challenges faced by the closest hospital to the Formosa Fun Coast Dust Explosion (FFCDE) disaster scene, and to examine how the hospital staff adapted to cope with the mass burn casualty (MBC) in their overcrowded emergency department (ED) after the disaster.

Material And Methods: The critical incident technique was used for the investigation. Data was gathered through in-depth individual interviews with 15 key participants in this event.

An international systems-theoretic comparison of hospital accreditation: developing an implementation typology.

Objective: The integration of quality indicators into the accreditation process has been recognized as a promising strategy worldwide. This study was to explore the implementation patterns of hospital accreditation through the lens of a systems-theory based model, and determine an international accreditation implementation typology.

Design: A qualitative comparative study of five established international hospital accreditation systems was undertaken based on a systems-theoretic holistic healthcare systems relationship model.

Bayesian methods in reporting and managing Australian clinical indicators.

Sustained clinical improvement is unlikely without appropriate measuring and reporting techniques. Clinical indicators are tools to help assess whether a standard of care is being met. They are used to evaluate the potential to improve the care provided by healthcare organisations (HCOs).

Implementing systems thinking for infection prevention: The cessation of repeated scabies outbreaks in a respiratory care ward.

Background: Root cause analysis (RCA) is often adopted to complement epidemiologic investigation for outbreaks and infection-related adverse events in hospitals; however, RCA has been argued to have limited effectiveness in preventing such events. We describe how an innovative systems analysis approach halted repeated scabies outbreaks, and highlight the importance of systems thinking for outbreaks analysis and sustaining effective infection prevention and control.

Methods: Following RCA for a third successive outbreak of scabies over a 17-month period in a 60-bed respiratory care ward of a Taiwan hospital, a systems-oriented event analysis (SOEA) model was used to reanalyze the outbreak.

Using clinical indicators to facilitate quality improvement via the accreditation process: an adaptive study into the control relationship.

Objective: The aim of the study was to determine accreditation surveyors' and hospitals' use and perceived usefulness of clinical indicator reports and the potential to establish the control relationship between the accreditation and reporting systems. The control relationship refers to instructional directives, arising from appropriately designed methods and efforts towards using clinical indicators, which provide a directed moderating, balancing and best outcome for the connected systems.

Design: Web-based questionnaire survey.

An effectiveness analysis of healthcare systems using a systems theoretic approach.

Background: The use of accreditation and quality measurement and reporting to improve healthcare quality and patient safety has been widespread across many countries. A review of the literature reveals no association between the accreditation system and the quality measurement and reporting systems, even when hospital compliance with these systems is satisfactory. Improvement of health care outcomes needs to be based on an appreciation of the whole system that contributes to those outcomes.

[Failure mode and effect analysis: application in chemotherapy].

Medical institutions are increasingly concerned about ensuring the safety of patients under their care. Failure mode and effect analysis (FMEA) is a qualitative approach based on a proactive process. Strongly promoted by the Joint Commission Accredited of Health Organization (JCAHO) since 2002, FMEA has since been adopted and widely practiced in healthcare organizations to assess and analyze clinical error events.