Methodological Lessons Learned

The differences in the results between the two simulations were small but detectable and the reproducibility of the simulation was satisfactory. Further experimental simulations are needed with defined interventions to ascertain outcome and examine whether preventable deaths and complications can be reduced. Measurable performance indicators through the ETS, as used in the present study, are obtainable and can depict a more effective management response. The experience from the present simulations using a simulation system that combines both process and outcome indicators can create important results that may serve to support disaster planning. Future studies are needed to further explore how national coordination of air transportation can be optimized for a mass casualty incident in Sweden.

The key improvement would be the extension of bidirectional communication between Emergency Operation Center and on-site emergency workforces. The simulation of extrication operations is difficult. A realistic training situation would endanger victim performer and represents a major time investment of 10 h in average.Ongoing developments about Pedestrian Dead Reckoning and SLAM will allow robust localization in all circumstances and enhance the capability to log operational progress in complex three-dimensional terrain.Conventional maps of operational progress are poor in content and functionality compared to GIS supported maps such as delivered by FRIEDAA. The benefits of non-verbal digital transmission of messages became evident through the first field test.Digital management of communication makes it possible to display delay between information in the field and reception in the emergency operation center.The WLAN communication infrastructure was lacking of coverage within and behind buildings during the first field test. The lack of coverage caused delays. However, this can be remedied with other digital radio communication technology such as GSM or TETRA.The SEEBA stressed the importance of portability of the assistive technologies. The bio-radar was particularly promising in this regard. It proved to be a valuable tool for detection of victims in rubble that are unable to alert rescuers.The search probe allowed a hitherto unreachable penetration depth. The navigation pane with two artificial horizons are important for the rescuers to orientate themselves within the rubble pile. A good coordination between the emergency workforce pushing the hose and the one controlling its stiffness and the navigation from the head joints is required.

To realistically predict the building egress performance, designers and managers of the building need to consider not only the building geometry but also the building occupants.Simulating emergency evacuations is a complicated and challenging task.

Not all information that is currently available to EMs during severe weather was provided during the scenarios.Results of this study cannot be completely generalized to operational settings because some aspects of an EM’s responsibilities during severe weather were excluded from the scenarios

The level of abstraction is high. Not all influencing variables can be incorporated due to the variety of flood events. The model is not aimed to be applied during the response phase, but is aimed to enrich training programmes by application during the prevention phase. As crisis managers may not directly use the output data for real-world relief operations, it is important to minimise negative impacts by responding quickly and efficiently as well as by being well-prepared.

The findings discuss the type of disaster education and training that nurses have completed but fail to determine exactly what the stated education or training involves.

Our findings demonstrate that tabletop exercises are inadequate to expose operational and logistic gaps in disaster response

A new decision-support system gathering all the knowledge about hazard and mitigation options produced in Theseus is currently being developed and will integrate the result of this work

It will also contribute towards a better understanding of strategy development, as it is the patterning of strategic issue responses over time that underlies the strategy formulation process.

Choice of the mini team as the unit of analysis. While preserving the participants’ perspective, this led to neglecting aspects of the broader organizational context (e.g. laboratory teams, other specialists), which might affect workflow and patient safety.Another limitation was that we did not collect data regarding the relationship between strategies used by nurses to monitor and support information flow and patient safety. It would be interesting to study in depth how the observed distribution of cognitive work improves a team’s ability to recover errors before they affect the patients.