Communication and Information Exchange-Related Challenges in Mass Casualty Incidents : An Integrative Literature Review

The purpose of this literature review was to investigate challenges and to enable development of communication and information exchange between incident sites and target hospitals. The objective was to identify and describe the 1) knowledge and 2) issues related to communication and information exchange between the incident site and the target hospital. The research questions of the study were used to define what relevant information was exchanged between incident sites and target hospitals and what were the communication and information exchange related challenges in cooperation between authorities. Mass casualty management and the medical response are the primary focus of the health sector during a mass casualty incident. Communication and information exchange have been identified as the biggest challenges hampering the effective creation of situational awareness among first responders at the incident site and officials in the target hospitals. These challenges reduce the ability of the health sector to provide the best possible care for the patients involved in the mass casualty incidents. This integrative literature review was conducted by doing a structured search in the electronic EBSCO and ProQuest databases. Thirty-six articles were reviewed and eleven articles with varying designs were included in the study. The findings from the primary studies were extracted, analyzed, categorized and synthesized by themes. The main findings related to the information needs were preliminary alerting of the target hospitals to enable comprehensive preparations and providing real-time patient-specific information to support preparations for individual patients and the use of limited resources in the hospital. The biggest challenges related to the communication and information exchange were identified to be the fragmentation of used command and information systems resulting in incoherent response. The need for national guidance to define and ensure unified operating systems and procedures for all first responders involved in mass casualty incidents was also recognized. The findings illustrate that local modifications to operational plans and command and communication systems are inadequate means to address current challenges. The need for support and guidance from national institutions and the need to increase and strengthen the cooperation of first responder organizations in all levels were highlighted. A lack of research addressing the interplay of information, communication and cooperation specifically between the incident site and the target hospitals was identified. It was recognized that the planning and training of an emergency response focus mostly on the response efforts and the organizations on the incident site and risks leaving hospitals out of the loop. This seems contradictory as the main objective of the emergency response is to reduce impacts of the incident and to save as many lives as possible and cooperation between emergency medical services and hospitals is crucial in that context