Defining Instrumental Support for Hospital Crisis Management: Example of the French "Plan Blanc"

By S. Molenda, S. Hamek, Françoise Anceaux

English

For more than a decade now, many studies have examined the concepts of crisis and crisis management. Many of the most recent focus on developing operational assistance tools based on crisis modelling, using, for example, a system model (Dautun, 2004). Other rarer studies (Rogalski, 1987, 2004; and Rogalski &?Samur?ay, 1994) focus on the team responsible for managing the crisis and dealing with the human resource problems caused by individual and collective decision-making processes. Our work, related to the development of instrumental support tools designed to help hospital decision-makers confronted with a crisis, falls into the second category. It is inspired by the work of Rogalski (1987), who defined support tools to facilitate the decision-making processes of professional firemen confronted with a large-scale disaster. It focuses on adapting Rogalski?s methods to hospital crisis management, using her methods to model the underlying decision-making processes encountered by hospital personnel during a crisis.
We began with the assumption that many decision-makers are novices in the field of crisis management. An activity analysis of simulated situations emphasized that this inexperience implies a significant lack of planning and lack of anticipation of the events. It also implies a global misreading of the activities that have to be carried out by other people. In order to alleviate these problems, procedures were elaborated to allow planning and anticipation strategies to be developed at the individual level and co-operative strategies to be acquired at the collective one. Ours is a three-phase procedure: (i)?diagnosis of the situation and its evolution; (ii)?definition of the objectives and resources; and (iii)?planning and organization of the chosen actions. This procedure was repeated for each of the high-level goals the crisis management team has to achieve in order to cope with the crisis. We used operational trees to decline all the high-level goals according to their level of abstraction. Based on those trees, we developed individual operational forms that specify the three phases of the decision-making process. Lists of the tasks necessary for the implementation of each one of them were also given. In order to encourage a collective activity, for every task, we integrated internal and external data transmission tasks. These tasks were impossible to circumvent. To promote the use of these operational forms, a training program was set up. This program has two objectives: to ensure the acquisition of a minimum of knowledge about hospital crisis management and existing organisational procedures, and to increase the awareness of the decision-makers with regard to the benefits of collective crisis management, helping them to see it as a dynamic situation.

Keywords

  • Hospital
  • Crisis management
  • Decision-making support
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