Major incident preparation for acute hospitals: current state-of-the-art, training needs analysis, and the role of novel virtual worlds simulation technologies.
BACKGROUND
There is growing evidence that health systems in developed countries are poorly prepared to deal with major incidents.


OBJECTIVE
This study aimed to determine the skills required for successful major incident response, the factors that contribute to a successful major incident exercise, and whether there is a role for using novel simulation training (virtual worlds) in preparing for major incidents.


METHODS
This was a qualitative semi-structured interview study. Fourteen health care staff with experience of major incident planning and training in the United Kingdom were recruited. Interviews were content-analyzed to identify emergent themes.


RESULTS
The aims and benefits of current exercises were categorized into three major themes: Organizational, Interpersonal, and Cognitive. Participants felt that the main objective of current exercises is to see how a major incident plan is implemented, rather than training individual staff. Communications was the most frequently commented-on area requiring improvement. Participants felt that lack of constructive feedback reduced the effectiveness of the exercises. All participants commented that virtual worlds technology could be successfully utilized for training. The creation of an immersive environment, increased training opportunity, and improved participant feedback were thought to be amongst the greatest benefits.


CONCLUSIONS
There are clear deficiencies with current major incident preparation. Utilizing virtual worlds technology as an adjunct to existing exercises could improve training and response in the future.
Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
Daniel C
DC
Cohen
Nick
N
Sevdalis
Vishal
V
Patel
David
D
Taylor
Nicola
N
Batrick
Ara W
AW
Darzi
D004189:Disaster Planning; D006801:Humans; D054527:Mass Casualty Incidents; D010564:Personnel, Hospital / Q000193:education*; D006113:United Kingdom; D014584:User-Computer Interface