Contribution à la conception d'un système d'aide à la décision pour la gestion de situations de tension au sein des systèmes hospitaliers. Application à un service d'urgence.

The management of patient flow, especially the flow resulting from health (flu, heat waves and exceptional circumstances) is one of the most important problems to manage in the emergency department (ED). To handle the influx of patients, emergency departments require significant human and material resources, and a high degree of coordination between these resources. Under these conditions, the medical and the paramedical staffs are often confronted with strain situations which greatly complicate their task. The main purpose of this thesis is to contribute to improving the management of situations of tension occurring in the emergency department by providing a decision support system, SAGEST. This DSS allows i) a proactive control of the ED: predicting at short and/or medium-term the occurrence of potential strain situations and proposing corrective actions to prevent the occurrence of these situations, ii) a reactive control in the case of no-detection of the strain situation occurrence. A functional architecture of the SAGEST system, based on the manager’s decision making process is proposed. Used methodologies and models embedded in the main functions and the knowledge base of the SAGEST system are described. Finally, experiments and results of different models of SAGEST system applied to the paediatric emergency department (PED) of the Regional University Hospital of Lille are presented and discussed.La prise en charge des flux des patients, en particulier les flux récurrents et consécutifs à des crises sanitaires (grippes, canicules, situations exceptionnelles) est l'un des problèmes les plus importants auquel les services des urgences (SU) doivent faire face. Pour gérer cet afflux de patients, les services des urgences nécessitent des ressources humaines et matérielles importantes, ainsi qu'un degré élevé de coordination entre ces ressources. Dans ces conditions, le personnel médical se voit confronté très fréquemment à des situations de tension qui compliquent très fortement sa tâche. L‘objet de cette thèse est de contribuer à l’amélioration de la gestion des situations de tension se produisant dans un service d’urgence en proposant un système d’aide à la décision, SAGEST (Système d’Aide à la décision pour la GEstion des Situations de Tensions), permettant i) le pilotage proactif du SU : prévision à court et/ou moyen terme de l'apparition de situations de tension et l'évolution du flux patients et la proposition d'actions de correction afin d'éviter l’occurrence de ces situations et ii) le pilotage réactif dans le cas où l'occurrence de la situation de tension n'a pas été détectée. Une architecture fonctionnelle du système SAGEST, s'appuyant sur le processus décisionnel du responsable du service d'urgence, est proposée. Les méthodologies et les modèles utilisés dans la construction des principales fonctions et de la base de connaissances sont décrits. Enfin, les résultats d’application des différents modèles du système SAGEST pour le service d’urgence pédiatrique (SUP) du centre hospitalier régional universitaire du Lille sont présentés et discutés

Ready or Not? Protecting the Public's Health From Diseases, Disasters, and Bioterrorism, 2011

Highlights examples of preparedness programs and capacities at risk of federal budget cuts or elimination, examines state and local public health budget cuts, reviews ten years of progress and shortfalls, and outlines policy issues and recommendations

The Impact of the Covid-19 Pandemic on Law Enforcement Protocols in Middle Appalachian States

The COVID-19 pandemic is changing the operational procedures of law enforcement organizations across the United States. The COVID-19 virus has forced police administrators to rethink strategies and procedures dealing with law enforcement’s multiple functions and roles in society. The pandemic is causing unprecedented challenges for law enforcement administrators to balance the organization’s priorities and the safety of officers under their command. The police functions are adapting to include personal protection to prevent the spread of the virus among the law enforcement community. This multiple case qualitative study aimed to show the immediate operational changes in law enforcement since the start of the COVID-19 pandemic. Data from interviews with law enforcement officers were analyzed in this study to identify themes and patterns. The data showed significant changes in law enforcement policies and procedures occurring after the beginning of the COVID-19 pandemic. The interviews included law enforcement officers with a minimum of five years of experience as full-time officers in the middle Appalachia region of the United States. Results provided details about operational procedures and how these changes affected law enforcement

Beacons of Excellence in Stress Prevention

NoThis report describes the work of Robertson Cooper Ltd and UMIST to identify good practice in stress prevention and then identify organisations within the UK that could be called beacons of excellence in comparison to this model. Part one of this report summarises and draws conclusions from all of the substantive academic studies on stress prevention over the last decade and uses this information, as well as advice gained from a panel of international experts, to develop a comprehensive stress prevention model. Part two of the report uses this model to describe examples of stress prevention practices that Robertson Cooper Ltd has identified within a wide range of UK organisations. Case studies are presented for each aspect of the good practice model. Examples of real documentation and organisational practice are presented.Health and Safety Executive (HSE

The case of cholera preparedness, response and prevention in the SADC region: A need for proactive and multi-level communication and co-ordination

In this paper the authors seek to identify the most appropriate model for a regional co-ordination mechanism for cholera preparedness, response and prevention. The qualitative mixed-method data collection approach that was followed revealed the need for alternative solutions, including a socio-political understanding of cholera responses at different levels of scale and at different stages of an outbreak. Important areas that need to be understood include the multiplicity of actors and the complexity of their interaction, the importance of building local capacity, the need for varying responses at different levels of scale, the need for improved inter- and intra-country co-ordination and information exchange, the importance of cultural belief systems and the impact of the media on the response to cholera outbreaks. Ultimately, despite the proposed co-ordinating role that the Southern African Development Community (SADC) can play in a regional cholera response effort, the onus remains on states to build capacity at the local level and to capacitate local communities to drive response efforts semi-autonomously.Keywords: Cholera prevention, preparedness and response, socio-political understanding of cholera, socio-cultural understanding of cholera, transboundary disease, Southern African Development Community (SADC), choler

Policing in pandemics: A systematic review and best practices for police response to COVID-19

The COVID-19 pandemic has created a range of unforeseen and unprecedented challenges for police departments worldwide. In light of these challenges, the goal of this review is to understand the potential short- and long-term effects of disasters and public health emergencies on policing organisations and officers. A total of 72 studies were eligible for inclusion, based on their focus on policing and police work during and in the aftermath of natural disasters and public health emergencies. Through an extensive review, we compile and analyse the most common issues and best practices identified in the literature, and discuss ‘what works’ in the context of policing such emergencies. The literature reveals four categories of issues predominantly raised in this context, namely police-community relations, the mental health and wellbeing of officers, intra-organisational challenges, as well as inter-agency collaboration and cooperation. Based on our review and analysis, we offer a list of recommendations relevant for policing the current COVID-19 outbreak. The findings of this review have immediate implications for policing during COVID-19 but also cover long-term effects, providing valuable recommendations for after the crises has passed

Preparedness and Response to a Mass Casualty Event Resulting from Terrorist Use of Explosives

No DescriptionInjury Prevention and ControlPublic Health Preparedness and ResponseCurren

Preparedness and response to a mass casualty event resulting from terrorist use of explosives

"The purpose of this interim planning guidance is to provide valuable information and insight to help public policy and health system leaders at all levels prepare for and respond to a mass casualty event (MCE) caused by terrorist use of explosives (TUE). Medical preparations for an MCE have traditionally focused on the scene and prehospital sectors. Comprehensive mass casualty care, from a health systems perspective, has received far less attention and has evolved separately from the rest of the emergency response community. This document provides practical information to promote comprehensive mass casualty care in the event of a TUE. It is not intended to reflect U.S. Department of Health and Human Services (DHHS) policy but, rather, to provide public policy and health systems leaders with options to consider when planning their response to an MCE. This document is a collaboration between the Centers for Disease Control and Prevention (CDC) and the National Preparedness Leadership Initiative of Harvard University. CDC provides additional specific mass casualty and blast-injury related material that complements this document. These materials include "Blast Injuries: Fact Sheets for Professionals," "In a Moment's Notice: Surge Capacity for Terrorist Bombings: Challenges and Proposed Solutions," and the "Bombings: Injury Patterns and Care" course." - p. 4Executive summary -- 1. Introduction -- 2. Principles for health systems' preparedness in emergencies -- 3. Prehospital care -- 4. Patient distribution -- 5. Surge capacities and capabilities for hospitals -- Conclusion -- References -- AcknowledgementsTitle from PDF title screen (viewed on Mar. 19, 2010).Authors: Isaac Ashkenazi, MD, MPA, MSC, MNS, Richard C. Hunt, MD, FACEP, Scott M. Sasser, MD, FACEP, Sridhar V. Basavaraju, MD, Ernest E. Sullivent, MD, MPH, FACEP, Vikas Kapil, DO, MPH, FACOEM, Lisa C. McGuire, PhD, Lisa T. Garbarino, and Paula S. Peters, MPH, CHES.Mode of access: World Wide Web as an Arobat .pdf file (1.24 MB, 36 p.).Includes bibliographical references (p. 30).National Center for Injury Prevention and Control. Interim planning guidance for preparedness and response to a mass casualty event resulting from terrorist use of explosives. Atlanta, GA: Centers for Disease Control and Prevention; 2010

Under Pressure: Time Management, Self-Leadership, and the Nurse Manager

Decision making by nurses is complicated by the stress, chaos, and challenging demands of the work. One of the major stressors confronting nurses is perceived time pressure. Given the potential negative outcomes on nurses due to perceived time pressures, it seems logical that a nurse manager\u27s ability to lead nurses in moderating this time pressure and in turn to make better decisions could enhance nurse well-being and performance. Paralleling research in the nursing literature suggests that, in order to improve patients\u27 judgement of the care they received, nurse managers should embrace ways to lower nurses\u27 perceived time pressure. In this conceptual paper, we propose a model to help mitigate time pressure on nurse managers and their frontline nurses based on the research regarding time pressure, psychosocial care, time management, and self-leadership. Three metaconjectures and suggested future studies are given for further consideration by organizational and psychological researchers

Natural disasters : what is the role for social safety nets?

This paper makes the case for why safety nets are an important tool for managing the risk of natural hazards. The use of safety nets is advocated both ex ante, to prevent and mitigate the impact of natural disaster and ex post, to cope with the impacts of natural shocks. Firstly, the paper explores the implications of contextual factors to be taken into account in the design of an effective safety net system to respond to the needs generated by natural disasters. Learning from the responses to a number of recent natural disasters, a typology of the different types of natural hazards which require different approaches to reduce their risk is introduced. Secondly, the paper considers some'guidelines'for improving the design and implementation of safety nets either to prevent and/or to recover from natural disasters. Finally, some conclusions and recommendations for more effective safety net and suggestions for addressing key issues are outlined.Safety Nets and Transfers,Hazard Risk Management,Food&Beverage Industry,Labor Policies,Natural Disasters