Background

Innovation and human adaptation in the face of unfolding catastrophe is the cornerstone of an effective systemwide response. Capturing, analysing, and disseminating this is fundamental in developing resilience for future events. The aim of this study was to understand the characteristics of adaptations to practice early in a paediatric major trauma centre during a mass casualty incident.

Methods

A qualitative interview study of 40 healthcare staff at a paediatric major trauma centre in the immediate aftermath of a terrorist bombing was conducted. An inductive thematic analysis approach was used, followed by a deductive analysis of the identified adaptations informed by constructs of resilience engineering.

Results

Five themes of adaptations to practice that enhanced the resilient performance of the hospital were identified: teamworking; psychologically supporting patients, families, and staff; reconfiguring infrastructure; working around the hospital electronic systems; and maintaining hospital safety. Examples of resilience potential in terms of respond, monitor, anticipate, and learn are presented.

Conclusions

Our study shows how adaptations to practice sustained the resilient performance of a paediatric major trauma centre during a mass casualty incident. Rapid, early capture of these data during a mass casualty incident provides key insights into enhancing future emergency preparedness, response, and resilience planning.

中文翻译：

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大规模伤亡事件期间儿科重大创伤中心对实践和复原力的适应

背景

面对不断发生的灾难，创新和人类适应是有效的全系统响应的基石。捕捉、分析和传播这一点对于发展未来事件的复原力至关重要。本研究的目的是了解大规模伤亡事件期间儿科重大创伤中心早期适应实践的特点。

方法

在恐怖爆炸事件发生后，对一家儿科主要创伤中心的 40 名医护人员进行了定性访谈研究。使用了归纳主题分析方法，然后对复原力工程构造所告知的已识别适应性进行演绎分析。

结果

确定了五个提高医院弹性绩效的实践适应主题：团队合作；为患者、家属和工作人员提供心理支持；重新配置基础设施；围绕医院电子系统工作；并维护医院安全。展示了在响应、监控、预期和学习方面的弹性潜力示例。

结论

我们的研究表明，在大规模伤亡事件中，对实践的适应如何维持儿科主要创伤中心的弹性表现。在大规模伤亡事件期间快速、及早地捕获这些数据为加强未来的应急准备、响应和弹性​​规划提供了关键见解。