System-Level Planning, Coordination, and Communication Care of the Critically Ill and Injured During Pandemics and Disasters: CHEST Consensus Statement

被引：38

作者：

Dichter, Jeffrey R. ^{[1
,2
]}

Kanter, Robert K. ^{[3
,4
]}

Dries, David ^{[5
]}

Luyckx, Valerie ^{[6
]}

Lim, Matthew L. ^{[7
]}

Wilgis, John ^{[8
]}

Anderson, Michael R. ^{[9
]}

Sarani, Babak ^{[10
]}

Hupert, Nathaniel ^{[11
,12
]}

Mutter, Ryan ^{[13
]}

Devereaux, Asha V. ^{[14
]}

Christian, Michael D. ^{[15
,16
]}

Kissoon, Niranjan ^{[17
,18
]}

机构：

[1] Allina Hlth, Minneapolis, MN USA

[2] Aurora Healthcare, Milwaukee, WI USA

[3] SUNY Upstate Med Univ, Syracuse, NY 13210 USA

[4] Columbia Univ, New York, NY USA

[5] Univ Minnesota, HealthPartners Med Grp, Minneapolis, MN USA

[6] Univ Alberta, Int Soc Nephrol, Edmonton, AB, Canada

[7] US Dept HHS, Off Global Affairs, Washington, DC 20201 USA

[8] Florida Hosp Assoc, Orlando, FL USA

[9] Case Western Reserve Univ, Cleveland, OH 44106 USA

[10] George Washington Univ, Washington, DC USA

[11] Cornell Univ, Weill Med Coll, New York, NY 10021 USA

[12] New York Presbyterian Hosp, New York, NY USA

[13] Agcy Healthcare Qual Res, Washington, DC USA

[14] Sharp Hosp, Coronado, CA USA

[15] Canadian Armed Forces, Royal Canadian Med Serv, Toronto, ON, Canada

[16] Mt Sinai Hosp, Toronto, ON M5G 1X5, Canada

[17] Univ British Columbia, BC Childrens Hosp, Vancouver, BC V5Z 1M9, Canada

[18] Univ British Columbia, Sunnyville Hlth Ctr, Vancouver, BC V5Z 1M9, Canada

来源：

CHEST | 2014年 / 146卷 / 04期

关键词：

PEDIATRIC INTENSIVE-CARE; PUBLIC-HEALTH EMERGENCY; LENGTH-OF-STAY; SURGE CAPACITY; TASK-FORCE; MEDICAL RESOURCES; TRAUMA CENTERS; MASS CASUALTY; JANUARY; 26-27; MORTALITY;

D O I：

10.1378/chest.14-0738

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

BACKGROUND: System-level planning involves uniting hospitals and health systems, local/regional government agencies, emergency medical services, and other health-care entities involved in coordinating and enabling care in a major disaster. We reviewed the literature and sought expert opinions concerning system-level planning and engagement for mass critical care due to disasters or pandemics and off er suggestions for system-planning, coordination, communication, and response. The suggestions in this chapter are important for all of those involved in a pandemic or disaster with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. METHODS: The American College of Chest Physicians (CHEST) consensus statement development process was followed in developing suggestions. Task Force members met in person to develop nine key questions believed to be most relevant for system-planning, coordination, and communication. A systematic literature review was then performed for relevant articles and documents, reports, and other publications reported since 1993. No studies of sufficient quality were identified upon which to make evidence-based recommendations. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. RESULTS: Suggestions were developed and grouped according to the following thematic elements: (1) national government support of health-care coalitions/regional health authorities (HC/RHAs), (2) teamwork within HC/RHAs, (3) system-level communication, (4) system-level surge capacity and capability, (5) pediatric patients and special populations, (6) HC/RHAs and networks, (7) models of advanced regional care systems, and (8) the use of simulation for preparedness and planning. CONCLUSIONS: System-level planning is essential to provide care for large numbers of critically ill patients because of disaster or pandemic. It also entails a departure from the routine, independent system and involves all levels from health-care institutions to regional health authorities. National government support is critical, as are robust communication systems and advanced planning supported by realistic exercises. CHEST 2014; 146 (4_Suppl): e87S-e102S

引用

页码：E87S / E102S

页数：16

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