Engagement and Education

Abstract

BACKGROUND: Engagement and education of ICU clinicians in disaster preparedness is fragmented by time constraints and institutional barriers and frequently occurs during a disaster . We reviewed the existing literature from 2007 to April 2013 and expert opinions about clinician engagement and education for critical care during a pandemic or disaster and off er suggestions for integrating ICU clinicians into planning and response. Th e suggestions in this article are important for all of those involved in a pandemic or large-scale disaster with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government offi cials. METHODS:A systematic literature review was performed and suggestions formulated according to the American College of Chest Physicians (CHEST) Consensus Statement development methodology. We assessed articles, documents, reports, and gray literature reported since 2007. Following expert-informed sorting and review of the literature, key priority areas and questions were developed. No studies of suffi cient quality were identifi ed upon which to make evidence-based recommendations. Th erefore, the panel developed expert opinion-based suggestions using a modifi ed Delphi process. RESULTS:Twenty-three suggestions were formulated based on literature-informed consensus opinion. Th ese suggestions are grouped according to the following thematic elements: (1) situational awareness, (2) clinician roles and responsibilities, (3) education, and (4) community engagement. Together, these four elements are considered to form the basis for eff ective ICU clinician engagement for mass critical care. CONCLUSIONS:Th e optimal engagement of the ICU clinical team in caring for large numbers of critically ill patients due to a pandemic or disaster will require a departure from the routine independent systems operating in hospitals. An eff ective response will require robust information systems; coordination among clinicians, hospitals, and governmental organizations; pre-event engagement of relevant stakeholders; and standardized core competencies for the education and training of critical care clinicians. CHEST 2014; 146 ( 4_Suppl ) 4. We suggest public health/government offi cials at centralized or regional emergency management coordinating centers use expert medical guidance, such as burn, neuro, or trauma critical care, specifi c to the nature of the incident to inform decision-making for mass critical care delivery. 5. We suggest every ICU clinician participate in disaster response training and education . 6. We suggest expectations regarding clinician response to pandemics or disasters be delineated in contractual agreements, medical staff bylaws, or other formal documents that govern the array of responsibilities to the health-care system. 7. We suggest hospitals employ and/or train ICU physicians in disaster preparedness and response. 8. We suggest hospitals ensure appropriate ICU leadership with knowledge and expertise in the management of ...

Legal Preparedness

“…1 Also integral to the planning process is identifying ethical principles to guide MCC decision-making (see the “Ethical Considerations” article by Daugherty Biddison et al 22 in this consensus statement). 23,24 To help confirm that MCC plans are just, as fair as possible, and accepted when implemented, comprehensive vetting by qualified experts and public engagement are needed (see the “Engagement and Education” article by Devereaux et al 25 in this consensus statement). Training of all relevant responders must occur in advance of disasters.…”

Resource-Poor Settings: Response, Recovery, and Research

“…56–58 Completion of the accredited training results in a certificate of completion that is placed in a professional registry available to NGOs and international organizations that employ and deploy health workers. The system also allows the health-care provider to add new training and field experiences to their personal registry “passport.” 49–52 Competencies and crisis standards of care for health specialists being developed in anesthesia, mental health, physical medicine and rehabilitation, critical care (see the “Engagement and Education” article by Devereaux et al 59 in this consensus statement), surgery, and other such activities must include ways to adjust and adapt their specialty skills to the resource-poor setting and learn the humanitarian core competencies that are crucial when working in an environment with multiple NGOs, international organizations, national agencies, and FMTs, among others 60,61 (Fig 1). 62…”