Improving Mass Casualty Readiness in the Emergency Department: A Quality Improvement Project

Problem Statement A critical access point, such as the emergency department, unprepared for a mass casualty event, undoubtedly sets the hospital, patients, and staff up for failure (Chatha, 2020). From the SQUIRE 2.0 standpoint, a hospital that is not prepared for a mass casualty event will cause “meaningful disruption, failure, inadequacy, distress, confusion, or other dysfunction in a healthcare service delivery system that adversely affects patients, staff, or the system as a whole, or that prevents care from reaching its full potential” (Squire 2.0 Guidelines, 2021). Examples of how a mass casualty event can disrupt an entire hospital setting may include but are not limited to insufficient surge planning, inadequate staffing, overcrowding, dwindling supplies, and increased mortality rates (Racht, 2019). Through the successful implementation of this Doctor of Nursing Practice (DNP) project, there will be an improvement in emergency preparedness in the acute care setting. The proposed plan will implement changes in the current policy to improve mass casualty 10 readiness in the emergency department. The current policy was outdated, with the most recent update in 2013. The policy will include updates on the most current peer-reviewed and sciencebased mass casualty event planning (FEMA, 2021). Competency analysis will be evaluated by incorporating net-learning training modules, annual competency training, and real-life scenarios delivered by the local EMS, fire department, police department, and the public to create a real hands-on experience (FEMA, 2021). Project Question The project question is: Do emergency department staff and the executive leadership team (P) who have participated in the new training modules and hands-on experience (I) reveal a higher post-test compared to the pre-test (C), which will ensure uninterrupted patient care, continuity of community care, ensure staff safety, and protect the current supply chain (O) within a four-week project timeframe (T)? • Population: Emergency Department staff and executive leadership team • Intervention: ED staff education training session and new/updated mass casualty policy implementation. • Comparison: The comparison will be a pre-test competency evaluation compared to a posttest after implementing the DNP project, along with current practice versus stimulated mass casualty scenarios. • Outcomes: The outcomes after project implementation show uninterrupted patient care, the hospital will still adequately serve its community, the staff will remain safe, and the supply chain will not jeopardize. The revised policy will also include improved ED staff knowledge and compliance. • Time: Timeframe for project implementation will be five week