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Legemaate GAG, Burkle FM Jr., Bierens JJLM: The evaluation of research methods during disaster exercises: Applicability for improving disaster health management. Prehosp Disaster Med 2012; 26(6):1-9.
Introduction
It is difficult to evaluate the quality of the performance of a health care system during a disaster. Research instruments may be not available, not validated, or impossible to administer during a crisis. Although descriptive performance evaluations often are administered post-disaster, specific disaster research is rare, and often limited in scope.1-4 On the other hand, disaster exercises are commonplace throughout the world and serve as a major education and training tool. The question arises whether exercises can be used to evaluate whether certain instruments can be applied to disaster research. If disaster exercises can be used as a proxy environment to evaluate the feasibility of potential research instruments, they should play an important role in the development of a research agenda for scientific analysis of health care performance during or immediately after a disaster-producing event.
The purpose of this study was to investigate the utility of questionnaires and chart reviews to assess the performance of incident command, patient flow, quality of patient distribution, and tertiary hospital capacity during a national disaster exercise.
Methods
This is a retrospective, mixed methodology study, using questionnaires and chart reviews from a national disaster exercise named "Bonfire." The exercise was organized by the Ministry of the Interior and Kingdom Relations in the Netherlands, with the main objective to practice the decision-making process within the full Incident Command System (ICS) structure at national (including the Prime Minister), regional and local levels.5 The event initially was planned to be an unannounced exercise, but three weeks before the date of the exercise, the ban on informing all stakeholders that the exercise was planned was waived. This unexpected opportunity allowed the Principal Investigator to inform the Ministry at extremely short notice that the exercise represented an unparalleled study platform for evaluating the utility of potential disaster research instruments. Permission and finances were granted within 10 days, at which time the research design preparation commenced. The Ministry stipulated that at no time would the research studies interfere with the exercise process, and that no research observers would be...