Dynamic Communication Quantification Model for Measuring Information Management During Mass-Casualty Incident Simulations

Abstract

Objective To develop a new model to quantify information management dynamically and to identify factors that lead to information gaps. Background Information management is a core task for emergency medical service (EMS) team leaders during the prehospital phase of a mass-casualty incident (MCI). Lessons learned from past MCIs indicate that poor information management can lead to increased mortality. Various instruments are used to evaluate information management during MCI training simulations, but the challenge of measuring and improving team leaders’ abilities to manage information remains. Method The Dynamic Communication Quantification (DCQ) model was developed based on the knowledge representation typology. Using multi point-of-view synchronized video, the model quantifies and visualizes information management. It was applied to six MCI simulations between 2014 and 2019, to identify factors that led to information gaps, and compared with other evaluation methods. Results Out of the three methods applied, only the DCQ model revealed two factors that led to information gaps: first, consolidation of numerous casualties from different areas, and second, tracking of casualty arrivals to the medical treatment area and departures from the MCI site. Conclusion The DCQ model allows information management to be objectively quantified. Thus, it reveals a new layer of knowledge, presenting information gaps during an MCI. Because the model is applicable to all MCI team leaders, it can make MCI simulations more effective. Application This DCQ model quantifies information management dynamically during MCI training simulations.

Mass Casualty Incident Commander Decision-Making Models: Novice vs. Expert Decision Making

“…The data for this study included two data-sets, the first of paramedic students, which was presented in Perry, Jaffe & Bitan (2022a) and included eight simulations with an η N = 1,068 interactions, and the second of an experienced MCI commander, which included one simulation with η E = 201 interactions. The categorization of interactions into sub-categories is presented in Table 1.…”

“…As this study followed previous paramedic students’ decision-making while managing an MCI (Perry, Jaffe, & Bitan, 2022b), it utilized a data collection method dedicated for MCI simulations that was previously harnessed (Perry, Jaffe, & Bitan, 2022a).…”

“…In contrast, preliminary leaders could only perceive changes. Perry, Jaffe, & Bitan (2022a) used quantitative data from MCI field simulations to explore the decision-making process of paramedic students at the end of their MCI management qualification harnessing the “dual-process” model (Kahneman, 2003; Norman, 2009). Because field simulations are known to improve communication skills (Gordon et al, 2016; Jorm et al, 2016), knowledge (Zinan, Puia, & Kinsley, 2015), clinical skills (Currie, Kourouche, Gordon, Jorm, & West, 2018), and performance (Bajow, Alassaf, & Cluntun, 2018), they provide the most realistic exposure to gain experience toward managing a real MCI (Gillett et al, 2008).…”

Mass Casualty Incident Commander Decision-Making Models

“…MCIs are known to be very chaotic, challenging the evaluation of commanders' decision-making processes. To overcome this challenge, we developed a data collection method (Perry et al, 2021) and a tagging method. We collected audio-visual quantitative data (Perry, Jaffe, & Bitan, 2021) from eight MCI simulations (2014-2021) conducted as part of a paramedic training course in collaboration with Israel's national EMS.…”

“…To overcome this challenge, we developed a data collection method (Perry et al, 2021) and a tagging method. We collected audio-visual quantitative data (Perry, Jaffe, & Bitan, 2021) from eight MCI simulations (2014-2021) conducted as part of a paramedic training course in collaboration with Israel's national EMS. We divided all data into interactions, defined as "information exchanges between two or more persons with no interruption".…”