Jun 15 2021
Strengthening health system preparedness for mass casualty incidents: first WHO Academy learning programme in Europe

A hospital room, previously used for meetings and presentations, was transformed into a stage for a fictional re-enactment of an emergency unit during the hectic few minutes after the announcement of a mass casualty incident (MCI).

Dozens of wounded patients, busy hospital hallways, attempts to coordinate, and insistent reporters trying to catch a glimpse of the situation in the emergency unit, all came to life in tabletop exercises, as health workers from 4 major hospitals in Greece participated in the first European mass casualty management (MCM) in-person learning programme, which took place in Athens, Greece, under the supervision and coordination of members of the WHO Academy.

“This is an excellent course which is both interactive and practical, with a theoretical foundation,” said Marina Kalogridaki, Director of the emergency unit at KAT Attica General Hospital in Athens. She emphasized the value of the course, particularly in light of the COVID-19 pandemic, adding that implementing scientifically based action plans would certainly benefit the country’s National Health System.

Innovative and interactive

This WHO Academy programme provided comprehensive training for mass casualty preparedness, response and recovery. Specifically, the programme addressed the organization and actions of staff working in emergency units, with a focus on the first 30 minutes after the announcement of an MCI. Using an innovative, highly interactive methodology, with an emphasis on experiential learning, the programme incorporated concepts of adult learning, teamwork, roleplay, the acquisition of new competencies and behaviour change.

Dr Eleni Pavlidou, Director of the emergency unit at the General University Hospital of Patras, said she appreciated watching younger staff members, particularly those who had not previously participated in similar training, eagerly engage in the various activities. She noted that having action plans, distinctly defined roles and clear guidelines would greatly help in training the rest of the staff in her department and perhaps even the entire hospital, while improving the hospital’s response to unpredictable events.

Emergency unit teams from 4 different hospitals in Athens and Patras participated in this 4-day session: the Attikon University Hospital, the KAT Attica General Hospital, the General University Hospital of Patras, and the 251 Air Force General Hospital. The session took place on 24–28 May in the Attikon University Hospital.

Programme outcomes

This learning programme aims to develop both individual and team-based competences related to MCM, as follow:

  • prepare for, respond to and recover from MCIs with a coordinated collective approach, based on the emergency unit’s MCM plan;
  • describe the roles of all staff working at the emergency unit during an MCI, including the emergency unit’s Incident Command Team members, triage staff, and Green and Red Zone staff;
  • perform own role as an emergency unit team member during preparedness, response and recovery phases in tabletop exercises on own hospital map;
  • work collaboratively as a team and manage stress during an MCI;
  • manage information, and internal and external communication during an MCI;
  • manage patient flow during an MCI;
  • mobilize the equipment, supplies and logistics required during an MCI;
  • perform administrative and clinical procedures during an MCI;
  • control crowds and manage conflict;
  • analyse the team processes for responding to MCIs and improve the emergency unit’s MCM plan.

This was also an opportunity for the participants to share best practices and challenges, and recognize the different levels of preparedness between hospitals.

Building on success

The WHO Country Office in Greece coordinated the programme, in collaboration with the Medical School of the National and Kapodistrian University of Athens, under the supervision of Dr Emmanouil Pikoulis, Professor of General Surgery. Dr Pikoulis commented: “The programme of the WHO Academy is of a profoundly practical nature and is designed in a way which allows it to be easily adapted to the needs of the hospitals that are being trained, which is the reason for its success”.

Following the completion of the training, the WHO Academy members, along with representatives of the WHO Country Office in Greece, met with an official from the Directorate of Operational Preparedness for Public Health Emergencies at the Ministry of Health, to present the programme and propose a country-wide implementation for all hospitals across Greece.

“This training was innovative and came at an opportune moment, as COVID-19 has highlighted the need to increase capacity for emergency preparedness,” commented WHO Representative in Greece, Dr Marianna Trias. “The WHO Country Office in Greece is very happy to facilitate the rollout of such an important course. We hope that this will be the start of a series of WHO Academy MCM trainings across the WHO European Region, which will elevate the provision of emergency services in a uniform way, building a common base for understanding and for knowledge exchange.”

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