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Simulation of a hospital disaster plan: a virtual, live exercise.

INTRODUCTION: Currently, there is no widely available method to evaluate an emergency department disaster plan. Creation of a standardized patient database and the use of a virtual, live exercise may lead to a standardized and reproducible method that can be used to evaluate a disaster plan.

PURPOSE: A virtual, live exercise was designed with the primary objective of evaluating a hospital's emergency department disaster plan. Education and training of participants was a secondary goal.

METHODS: A database (disastermed.ca) of histories, physical examination findings, and laboratory results for 136 simulated patients was created using information derived from actual patient encounters. The patient database was used to perform a virtual, live exercise using a training version of the emergency department's information system software.

RESULTS: Several solutions to increase patient flow were demonstrated during the exercise. Conducting the exercise helped identify several faults in the hospital disaster plan, including outlining the important rate-limiting step. In addition, a significant degree of under-triage was demonstrated. Estimates of multiple markers of patient flow were identified and compared to Canadian guidelines. Most participants reported that the exercise was a valuable learning experience.

CONCLUSIONS: A virtual, live exercise using the disastermed.ca patient database was an inexpensive method to evaluate the emergency department disaster plan. This included discovery of new approaches to managing patients, delineating the rate-limiting steps, and evaluating triage accuracy. Use of the patient timestamps has potential as a standardized international benchmark of hospital disaster plan efficacy. Participant satisfaction was high.

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