Lorraine de Montmollin

Committee for Rehabilitation Disaster Relief (CRDR)

ISPRM Guidance Document Development Workshop

‘Rehabilitation doctors as leaders on rehabilitation response teams in disasters’

What were the characteristics of the rehab disaster team(s) that you led?- disaster type, place, date- disaster impact (# deaths, # injured, degree of damage [currency, infrastructure], etc)-team timeframe of service -team composition (rehab doctors, other rehab professionals, non-medical volunteers, other)- team primary focus/’mission’ (initial rehab assessment, medical rehab services, etc)- care setting (established hospital, field hospital, outpatient clinic, designated shelter, etc)

Disaster/disaster team characteristics

What PRM medical rehab services did your team provide?

What other disaster rehab services did your team provide? (PT, OT, PO, SLP, etc)?

What other medical services did your team provide? (triage, emergency medicine, general medicine, pediatrics, mental health, etc)

PRM/other medical services provided

How did your team adapt to the more austere, resource scarce disaster setting by providing care differently than you would in a normal setting ‘at home’?

- Did you medically manage patients differently? How?

- Did you make special arrangements such as evacuation of severely injured or special populations (ie SCI) to tertiary centers, etc?

- Other?

Adaptation due to the disaster setting

What other services/products did your team provide? (assessment of medical rehab needs, assessment of rehab services infrastructure, education/training [whom?/what?], etc)

Other services provided

*What was your team's focus/’mission’ (medical rehab services, etc) during the: (a) acute rehab response (~0-72 hours)?(b) sub-acute/intermediate rehab response (~3 days – 12 weeks)?(c) long-term rehab response (~12 weeks onward)?

* See ‘Disaster rehab continuum’ figure

Team focus/’mission’ (by phase/time post-disaster)

Which of these expenses were incurred:-team-related expenses (medications, medical supplies)?-personal expenses (travel/visa, paid time off, etc)?-services & equipment for beneficiaries?

Who provided funding? (ISPRM NS, INGO, DPO, NGO, GO, etc)

What other in-kind gifts/resources were provided? by whom? (ISPRM NS, INGO, NGO, DPO, GO, etc)

Expenses/funding/other resources

What qualifications (professional/general, clinical, and non-clinical*) were required of your team members?

What qualifications (‘selection criterion’) were preferred (but not required) of your team members?

What specific duties did your team members perform?

How did your expectations of team member performance as part of a team in a disaster setting differ as compared to as in a ‘normal’ setting?

How was team member performance measured? *See team leader qualifications and duties prior to answering.

Team members: qualifications, duties & performance*

What additional partners/ stakeholders did your disaster team interact with as part of your response? (local, national, or international organizations which provided assistance or to whom you provided assistance during the different phases/times of your response*)

What roles/activities did they perform? What activities did you coordinate/ perform together?

* See ‘Disaster rehab continuum’ figure

Partners/stakeholders

What team outputs were measured? (# patients evaluated, patients referred, aid items distributed, training provided, etc)

What functional clinical outcomes were measured/documented? (in patient charts, by formal assessment tool [eg, SF-36], etc)

Team output/patient outcome measurement

What disaster-related/humanitarian professional qualifications do you have? (besides medical/PRM training such as an accredited/recognized formal disaster ‘degree’, training course, etc)?

What general qualifications helped prepare you to be a rehab team leader in a disaster? (past experience, willingness, availability, etc)

How did you ‘become’ the team leader (appointment, selection, volunteer)?

Team leader qualifications: disaster-related professional & general

What clinical skills did you use? - Which specialty? (PRM, General Medicine, Emergency Medicine, etc)- If PRM, what aspect of management?* (acute triage, initial field assessment, peri-operative consultation, post-surgical rehab, sub-acute/long-term rehab, etc) - What disabling injury type(s)?(amputation, SCI, TBI, burn, nerve injury) - If a different specialty, what patient population, injury type, and aspect of management?

* See ‘Disaster rehab continuum’ figure

Team leader qualifications: clinical skills

What PRM clinical skills should rehab doctors serving as rehab team leaders in a resource-scarce, disaster environment have? (list 3).

What additional specialty/other medical skills should rehab doctors serving as team leaders in a disaster have?

Recommendations: clinical skills

What disability inclusion measures were taken for newly impaired patients, pre-existing PWDs, or team members?

Disability inclusion

What non-clinical skills/qualifications helped prepare you to be a rehab doctor team leader? (leadership/communication/organizational abilities, fiscal skills, resilient attitude, resourcefulness, stress management, etc)

Team leader qualifications: non-clinical skills

What non-clinical skills should rehab doctors leading rehab teams in a disaster have (list 5)?

Recommendations: non- clinical skills

What specific duties did you perform in planning the mission? - initial assessment of damage/need? - identification of mission requirements (human & material resources)?

- team equipment, material, supplies, other - beneficiary medical equipment, supplies, medication, other- logistics: communications, transportation, security, food, shelter, other - financing: budgeting & fundraising, other

-?

Team leader duties: planning the mission

What duties did you perform in preparing your team? (recruitment, coordination, training, etc [If you organized training, what was its purpose (desired skills, knowledge, attitude, etc) and type/mode (online, classroom, field exercise, etc])?

Team leader duties: preparing the team

What specific duties did you perform in executing the mission? - team supervision? - management of partners/stakeholders? - provision of medical care? - financing: funds disbursement? - other ?

Team leader duties: executing the mission

What specific duties did you perform in concluding the mission? - arrangement of follow-up beneficiary care? - end-of-mission needs (rehab/other) assessment? - team debriefing ? - performance evaluation(s)? - coordination with partners/stakeholders?

- other ?

Team leader duties: concluding the mission

What specific duties did you perform in following up on the mission? - mission/project evaluation & future development? - publication/dissemination of results/outcomes (venue, audience)? - future needs/resources (rehab) forecasting? - coordination with partners/stakeholders?

- other ?

Team leader duties: following up on the mission

What special challenges and/or difficulties did you as a team leader face in: - planning the mission?- preparing the team?- executing the mission? - concluding the mission?- following up on the mission?

What did you do to overcome these challenges/difficulties? (generally or specifically)

Team leader challenges and/or difficulties

What will you do differently if leading a team in a similar disaster in the future (list 3)?

Have you applied your lessons learned in subsequent disasters? - If so, how? - If not, in what specific ways would you suggest? (formation of a PRM task force/ disaster

relief committee in your National Society, development of guidance documents, etc)

Lessons learned & application

What recommendations do you have for rehab doctors to help them be successful rehab team leaders in disasters (list 3)?

Overall recommendations

(Papers/online accounts of your mission and/or other references or resources you would like to recommend to rehab doctors leading teams in disasters).

References

Lorraine de Montmollin