Multidisciplinary Team Response to Support Survivors of Mass Casualty Disasters

Background and Purpose:

Disaster response begins at the local level, but when needs are immense, promoting effective care and recovery for survivors may require activation of multiple systems from other parts of the country or even the world. Mass casualty disasters pose unique challenges, as survivors may be dealing not only with their own physical and/or psychological trauma, but also with the loss of family members and friends (Adams, Smith, & Weeks, 2013).  One technique humanitarian response organizations may use to integrate services is formation and deployment of multidisciplinary response teams.  Team members include individuals trained to respond to and provide referrals for the physical health, mental health, and financial needs of disaster survivors; additionally, the Integrated Care Team (ICT) model utilized by the American Red Cross may include individuals trained to respond to spiritual needs (Hassmiller, Adams, & Weeks, 2013). The poster describes a systematic review undertaken to synthesize evidence about the effectiveness of multidisciplinary response teams used to support individuals who survive a mass casualty disaster.  Specific objectives of the review are to identify effectiveness of multidisciplinary team response on the 1) resolution of immediate needs and 2) support perceived by survivors of mass casualty disasters.

Design: Systematic review

Inclusion criteria:

Studies published between 1995 and 2012 evaluating effectiveness of multidisciplinary response teams on the well-being of survivors of mass casualty disasters. These dates were selected because the ICT model was formalized following the April 1995 bombing of the Alfred P. Murrah Federal Building in Oklahoma City, Oklahoma, USA.

Methods:

The systematic review involves a three-step search strategy: 1) An initial limited search of MEDLINE, CINAHL, PsycINFO, EMBASE, and SocIndex, followed by analysis of text words in the title and abstract and index terms describing the article; 2) A second search using identified key words and index terms in the same data bases, with the addition of MEDNAR and Sociological Abstracts;  and 3) a search of the reference list of all identified reports and articles for additional studies. Identified studies will be assessed for relevance and any selected for retrieval will be assessed by two independent reviewers for methodological validity using standardized critical appraisal instruments from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Data from papers to be included in the review will be extracted by two reviewers independently using the standardized data extraction tool from JBI-MAStARI. Quantitative data will be pooled in statistical meta-analysis using JBI-MAStARI when possible; when not possible, findings will be presented in narrative form.

Results:

Although multidisciplinary teams in health care are prevalent, the use of multidisciplinary response teams in disaster have been less frequently studied, and authors acknowledge the difficulty of assessing quality and effectiveness of disaster response programs (Gill & Gershon, 2010). A preliminary search of multiple data bases for development of our systematic review protocol revealed that the majority of articles describing team response to disasters or their effectiveness were published between 1995 and 2010, with only a few published more recently (Briggs, 2010; Gill & Gershon; Meredith, Zazzali, Shields, Eisenman, & Alsabagh, 2010; Rosen, Greene, Young, & Norris, 2010). We would therefore have anticipated locating existing quantitative systematic reviews on the topic, yet we were unable to do so; we also found very little international literature. We hope to discover additional sources through our search strategy. The detailed search process for the systematic review is ongoing and will be complete by June 2015.

Implications:

Disaster-related literature suggests the need for integrated assessment of disaster survivors and collaborative response efforts (Pfefferbaum, et al., 2012).  The review’s detailed search strategy was designed to uncover and synthesize available literature on the effectiveness of multidisciplinary response teams. Our systematic review seeks to provide a guide for future planning, deployment, and evaluation of these specialized teams that can be crucial to local, regional, or global response to mass casualty disasters.