Leadership During the Boston Marathon Bombings: A Qualitative After-Action Review
Leadership During the Boston Marathon Bombings: A Qualitative After-Action Review
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DOI：
10.1017/dmp.2015.42
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发表时间：
2015-06
影响因子：
2.7
通讯作者：
E. Goralnick;P. Halpern;Stephanie Loo;J. Gates;P. Biddinger;J. Fisher;G. Velmahos;Sarita Chung;D. Mooney;C. Brown;B. Barnewolt;P. Burke;Alok Gupta;Andrew Ulrich;H. Hojman;E. McNulty;B. Dorn;L. Marcus;K. Peleg
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作者：
E. Goralnick;P. Halpern;Stephanie Loo;J. Gates;P. Biddinger;J. Fisher;G. Velmahos;Sarita Chung;D. Mooney;C. Brown;B. Barnewolt;P. Burke;Alok Gupta;Andrew Ulrich;H. Hojman;E. McNulty;B. Dorn;L. Marcus;K. Peleg
摘要目的2013年4月15日，波士顿马拉松发生两起简易爆炸装置（IED）爆炸事件，264名患者在26家医院接受治疗。尽管受害者受伤严重，但随后在医院接受治疗的人没有死亡。主要创伤中心的领导决策和行动是这一反应的关键因素。方法本调查的目的是描述和表征组织动态和领导的主题后，立即利用一种新的结构化的顺序定性方法组成的焦点小组，随后进行详细的访谈和专家分析。结果在代表7家医院的医生领导者中，我们的分析中出现了几个领导和管理主题：沟通和志愿者激增，灵活性，技术挑战，以及命令与协作。结论灾害提供了一个独特的背景下，研究响应系统的鲁棒性和弹性。因此，在发生大规模危机后，应尽一切努力组建一个联盟，收集重要的经验教训，以便分享这些经验教训，并将其纳入最佳做法和准备工作。新的沟通策略、灵活的领导结构和改进的信息系统将是必要的，以减少未来事件中的发病率和死亡率。（公共卫生应急预案。2015;9：489-495）
Abstract Objective On April 15, 2013, two improvised explosive devices (IEDs) exploded at the Boston Marathon and 264 patients were treated at 26 hospitals in the aftermath. Despite the extent of injuries sustained by victims, there was no subsequent mortality for those treated in hospitals. Leadership decisions and actions in major trauma centers were a critical factor in this response. Methods The objective of this investigation was to describe and characterize organizational dynamics and leadership themes immediately after the bombings by utilizing a novel structured sequential qualitative approach consisting of a focus group followed by subsequent detailed interviews and combined expert analysis. Results Across physician leaders representing 7 hospitals, several leadership and management themes emerged from our analysis: communications and volunteer surges, flexibility, the challenge of technology, and command versus collaboration. Conclusions Disasters provide a distinctive context in which to study the robustness and resilience of response systems. Therefore, in the aftermath of a large-scale crisis, every effort should be invested in forming a coalition and collecting critical lessons so they can be shared and incorporated into best practices and preparations. Novel communication strategies, flexible leadership structures, and improved information systems will be necessary to reduce morbidity and mortality during future events. (Disaster Med Public Health Preparedness. 2015;9:489–495)