Table 2 Gaps and improvements identified by the assessors during the exercises
From: Full-scale simulations to improve disaster preparedness in hospital pharmacies
Gaps identified during exercises | Improvements observed in the second exercises | Additional improvements suggested by the assessors | ||
|---|---|---|---|---|
First | Second | |||
Disaster standard operating procedures (SOPs) | ●Only one pharmacy had SOPs ●Hospital management’s difficulties in informing the pharmacy of hospital SOPs (except for the pharmacy with SOP) ●Lack of hierarchical disaster management structure | ●Lack of enough tested informational and situational dashboards | ●Presence of SOPs in every pharmacy ●SOPs consulted early ●Easier, more comprehensive triggering of SOPs ●Use of dashboards | ●Train staff to use SOPs and dashboards |
Allocation of roles | ●No clear disaster management leader ●Spontaneous but uncoordinated allocation of tasks ●Lack of work delegation ●Lack of anticipation ●Only one pharmacy had action card, resulting in disorganized task attribution | ●Only one pharmacy had actions cards ●Lack of delegation of specific tasks ●Difficulty designating or identifying a manager for each process/department ●Poor optimization of human resources | ●Leader more clearly identifiable | ●Create actions cards |
Management | ●In pharmacies without SOPs, management committees were set up slowly or not at all ●Pharmacy heads’s mix of management roles and operational tasks ●Lack of knowledge about the concept of disaster management, and no SOPs ●Lack of organization and rhythm in disaster management (no meeting points, …) ●Tendency to include too many people in the disaster management team ●No feedback requested on the evolution of the tasks delegated | ●Inability to maintain overall situational awareness of the pharmacy ●Inability to manage and distribute tasks and collect feedback | ●Management teams established rapidly | ●Organize a rhythm to management via regular, scheduled meeting points |
Responses by different hospital pharmacy units | ●Poor redistribution of human resources ●No identification of leaders for the most affected processes or departments ●Lack of overall coordination and management ●Lack of separation between disaster-related and routine work flows | ●No identification of leaders for the most affected processes or departments | ●Improved separation of flow of disaster and routine requests to the pharmacy | ●Identify leaders for each of the most affected processes or departments |
Communication | ●No structured communication (no reformulation) ●Lack of pharmacy feedback on actions requested by other hospital departments ●Poor, unstructured communication both up and down the hierarchy, between management and staff and between different pharmacy departments ●Under-utilization of the means of communication available | ●Insufficient targeted communication with staff ●No acknowledgement of messages received (reformulation to demonstrate comprehension) | ●Improved general communication ●Improved communication of SOPs to all employees | ●Train and practice structured communication in routine practice (especially restating reformulating requests for action to demonstrate comprehension) ●Make sure to have regular status meeting points with a representative from each pharmacy department |