Abstract
Background
Mass emergencies are growing globally. They are frequent and cause significant human and economic loss. New Zealand and the Sultanate of Oman have suffered from devastating mass emergencies including the Canterbury earthquakes and Cyclone Gonu respectively. Healthcare services are central in mass emergency response. Acute healthcare services are usually the first to respond to mass emergencies. Successful mass emergency response is determined by the level of preparedness. The state of the New Zealand and Omani acute healthcare systems’ preparedness to deal with mass emergencies is yet to be systematically studied.
Objectives
The goals of this project were to:
1) Describe and compare the state of strategic healthcare mass emergency preparedness in New Zealand and the Sultanate of Oman.
2) Assess and compare the training, willingness, and perceived preparedness of acute care providers in Oman and New Zealand to respond to mass emergencies.
Methods
Mixed qualitative and quantitative methods were used in this project. First, semi-structured interviews with strategic emergency planners were utilized to answer the first objective. The second objective was answered using a mass emergency preparedness survey that was conducted among 1,500 doctors, nurses and ambulance officers from each country between 2009 and 2010.
Results
Seventeen key informants from each country participated in the qualitative study. The study highlighted that New Zealand has a well-established national strategy for emergency preparedness unlike Oman in which planning is a relatively new initiative. There is a gap between strategic and operational preparedness in New Zealand unlike Oman in which senior clinicians are in charge of the little emergency planning activities that exist in the country. Issues such as communication, responders’ welfare, and surge capability are critical challenges for both countries.
The survey response rate was 61% in both countries. The study found that 59.2% of Omani and 44.8% of New Zealand acute care providers have no prior training in mass emergency response. The willingness of acute care providers is event-dependent with the lowest being for infectious disease mass emergencies. 34% of acute care personnel in both countries were not willing to report to work during an infectious disease mass emergency. In addition, about 40% of acute care providers in both countries reported not being able to locate a written emergency plan. Training was associated with a 2.5 (CI 1.71-3.29, P<0.05) fold increase in preparedness of acute care providers to respond to mass emergencies. Providers who participated in a drill were 2.7 (CI: 1.92-3.79, P <0.05) times more likely to self-report being prepared to deal with mass emergencies than those who did not.
Conclusion
This project highlighted several areas for improvement. In New Zealand, there is an urgent need to integrate clinical providers into strategic planning for emergencies in order to ensure that acute care providers are involved in emergency preparedness. In Oman, there is a need to establish a standardized national healthcare preparedness strategy. In order to ensure that emergency preparedness is effective and continuous, the process has to be integrated into the daily operation of the wider healthcare system and should not be developed de novo. There is a need to establish a specific training programme in mass emergency response for all acute care providers in both countries.
Training is associated with an increase in self-reported preparedness of acute care providers to deal with victims of mass emergencies. Training is also associated with increased willingness of acute care providers to report to work during a mass emergency. Therefore, healthcare systems in New Zealand and Oman need to invest in the training of human resources for mass emergencies.
Finally, the Canterbury earthquakes in New Zealand and tropical cyclones Gonu and Phet in Oman have highlighted lessons for both countries. Emergency preparedness should continue to be a national priority because the hazards and risks are an integral part of today’s society and will never be completely eliminated.