Lighthouse Innovation Teen-startup: Talking disasters and first responders

I was invited by the Lighthouse Business Innovation Centre (Lighthouse) to present at a Teen Start-up in January 2017. The topic of the start-up related to first responders and problem-solving real world situations relating disasters. Unfortunately, I was not available on the dates of the start-up to give a face-to-face presentation. As such, I participated in a prerecorded interview for the workshop participants.

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Health service impact from mass-gatherings: A systematic literature review

ABSTRACT:

Background: Mass gatherings are events where a large number of people congregate for a common purpose, such as sporting events, agricultural shows and music festivals. When definitive care is required for participants of mass gatherings, municipal ambulance services provide assessment, treatment and transport of participants to acute care settings, such as hospitals. The impact on both ambulance services and emergency department services from mass-gathering events was the focus of this literature review.

Aim: This literature review aims to develop an understanding of the impact of mass gatherings on local health services.

Method: This research used a systematic literature review methodology. Databases were searched to find articles related to aim of the review. Articles focused on mass-gathering health, provision of in-event health services, ambulance service transportation and hospital utilisation.

Results: Twenty-four studies were identified for inclusion in this review. These studies were all case-study based and retrospective in design. The majority of studies (n=23) provided details of in-event first responder services. There was variation in reporting of the number and type of in-event health professional services at mass-gatherings. All articles reported that patients were transported to hospital by the ambulance service. Only nine articles reported on patients presenting to hospital.

Conclusions: There is minimal research focusing on the impact of mass-gatherings on in-event and external health services, such as ambulance services and hospitals. A recommendation for future mass-gathering research and evaluation is to link patient-level data from in-event mass-gatherings to external health services. This type of study design would provide information regarding the impact on health services from a mass-gathering, to more accurately inform future health planning for mass-gatherings across the health care continuum.




Ranse J, Hutton A, Keene T, Lenson S, Luther M, Bost N, Johnston A, Crilly J, Cannon M, Jones N, Hayes C, Burke B. (2016) Health service impact from mass-gatherings: A systematic literature review; paper presented at the 14th International Conference for Emergency Nurses. Alice Springs, Australia. 20th October.

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The impact of mass gatherings on ambulance services and hospitals

This presentation was delivered as a webinar to members of the World Association of Disaster and Emergency Medicine.

ABSTRACT
During a mass-gathering, some participants may receive health care for injuries or illnesses that occur during the event. In-event first responders provide initial assessment and management in-event. However, when further definitive care is required, municipal ambulance services provide additional assessment, treatment and transport of participants to acute care settings, such as hospitals. The impact on both ambulance services and hospitals from mass-gathering events is the focus of this presentation. In particular, a case study of one outdoor music festival in 2012 in the Australian Capital Territory with approximately 20,000 participants will be analysed. This festival had one first aid post and a health team staffed by doctors, nurses and paramedics.


Ranse J. (2016). The impact of mass gatherings on ambulance services and hospitals; webinar presentation to members of the Mass Gathering Section of the World Association for Disaster and Emergency Medicine, 14th October.

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Australian civilian hospital nurses’ lived experience of an out-of-hospital disaster

This presentation was presented at the Higher Degrees Week - Flinders University, Faculty of Health Sciences, School of Nursing and Midwifery as a progress seminar for my PhD studies.

ABSTRACT
Disasters disrupt the normal functioning of a community resulting in an increased demand for health services. The literature pertaining to the experience of Australian nurses assisting in the out-of-hospital disaster environment is primarily descriptive of single events and does not include a phenomenological perspective. The aim of this research was to gain insight into what it may be like Being an Australian civilian in-hospital nurse working in the out-of-hospital disaster environment. Phenomenology as a method was used in this research, which is concerned with the essence of things as they are appearing in the conscious awareness of the first person. Narrative was obtained from eight participants using semi-structured interviews at two points in time. From the participant narrative, moments of their lived experience included; on the way to the disaster, prior to starting work, working the shift, end of the shift and returning home. From the lived experience description a reflection was undertaken against the phenomenological existentials of spatiality, corporeality, communality, and temporality. The existential theme of temporality emerged strongly. The lived experience description and existential reflection provide insight into what it may be like Being an Australian civilian in-hospital nurse working in the out-of-hospital disaster environment. This in turn, may inform future education, research, clinical practice and health policy related to nurses in the out-of-hospital disaster environment.

Ranse J. (2016). Australian civilian hospital nurses’ lived experience of an out-of-hospital disaster; presentation at the Higher Degrees Week - Flinders University, Faculty of Health Sciences, School of Nursing and Midwifery. Adelaide, South Australia, 30th June.

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Exploring international views on key concepts for mass gathering health through a Delphi process

Free full-text article is available here (PDF)

ABSTRACT

Introduction: The science underpinning mass-gathering health (MGH) is developing rapidly. However, MGH terminology and concepts are not yet well defined or used consistently. These variations can complicate comparisons across settings. There is, therefore, a need to develop consensus and standardize concepts and data points to support the development of a robust MGH evidence-base for governments, event planners, responders, and researchers. This project explored the views and sought consensus of international MGH experts on previously published concepts around MGH to inform the development of a transnational minimum data set (MDS) with an accompanying data dictionary (DD).

Report: A two-round Delphi process was undertaken involving volunteers from the World Health Organization (WHO) Virtual Interdisciplinary Advisory Group (VIAG) on Mass Gatherings (MGs) and the MG section of the World Association for Disaster and Emergency Medicine (WADEM). The first online survey tested agreement on six key concepts: (1) using the term “MG HEALTH;” (2) purposes of the proposed MDS and DD; (3) event phases; (4) two MG population models; (5) a MGH conceptual diagram; and (6) a data matrix for organizing MGH data elements. Consensus was defined as ≥80% agreement. Round 2 presented five refined MGH principles based on Round 1 input that was analyzed using descriptive statistics and content analysis. Thirty-eight participants started Round 1 with 36 completing the survey and 24 (65% of 36) completing Round 2. Agreement was reached on: the term “MGH” (n = 35/38; 92%); the stated purposes for the MDS (n = 38/38; 100%); the two MG population models (n = 31/36; 86% and n = 30/36; 83%, respectively); and the event phases (n = 34/36; 94%). Consensus was not achieved on the overall conceptual MGH diagram (n = 25/37; 67%) and the proposed matrix to organize data elements (n = 28/37; 77%). In Round 2, agreement was reached on all the proposed principles and revisions, except on the MGH diagram (n = 18/24; 75%).

Discussion/Conclusions: Event health stakeholders require sound data upon which to build a robust MGH evidence-base. The move towards standardization of data points and/ or reporting items of interest will strengthen the development of such an evidence-base from which governments, researchers, clinicians, and event planners could benefit. There is substantial agreement on some broad concepts underlying MGH amongst an international group of MG experts. Refinement is needed regarding an overall conceptual diagram and proposed matrix for organizing data elements.



Steenkamp M, Hutton A, Ranse J, Arbon P, Lund A, Turris S, Bowles R. (2016). Exploring international views on key concepts for mass gathering health through a Delphi process. Prehospital Disaster Medicine.

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International consensus on key concepts and data definitions for mass gathering health: Process and progress

Free full-text article is available here (PDF)

ABSTRACT
Mass gatherings (MGs) occur worldwide on any given day, yet mass-gathering health (MGH) is a relatively new field of scientific inquiry. As the science underpinning, the study of MGH continues to develop, there will be increasing opportunities to improve health and safety of those attending events. The emerging body of MG literature demonstrates considerable variation in the collection and reporting of data. This complicates comparison across settings and limits the value and utility of these reported data. Standardization of data points and/or reporting in relation to events would aid in creating a robust evidence base from which governments, researchers, clinicians, and event planners could benefit.Moving towards international consensus on any topic is a complex undertaking. This report describes a collaborative initiative to develop consensus on key concepts and data definitions for a MGH “Minimum Data Set.” This report makes transparent the process undertaken, demonstrates a pragmatic way of managing international collaboration, and proposes a number of steps for progressing international consensus. The process included correspondence through a journal, face-to-face meetings at a conference, then a four-day working meeting; virtual meetings over a two-year period supported by online project management tools; consultation with an international group of MGH researchers via an online Delphi process; and a workshop delivered at the 19thWorld Congress on Disaster and Emergency Medicine held in Cape Town, South Africa in April 2015. This resulted in an agreement by workshop participants that there is a need for international consensus on key concepts and data definitions.


Turris S, Steenkamp M, Lund A, Hutton A, Ranse J, Bowles R, Aruthnott K, Anikeeva O, Arbon P. (2016). International consensus on key concepts and data definitions for mass gathering health: Process and progress. Prehospital Disaster Medicine. 31(2):1-4.

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