The Boston Marathon Bombings mass casualty incident: One emergency department's information systems challenges and opportunities

Adam Landman*, Jonathan M. Teich, Peter Pruitt, Samantha E. Moore, Jennifer Theriault, Elizabeth Dorisca, Sheila Harris, Heidi Crim, Nicole Lurie, Eric Goralnick

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

44 Scopus citations

Abstract

Emergency department (ED) information systems are designed to support efficient and safe emergency care. These same systems often play a critical role in disasters to facilitate real-time situation awareness, information management, and communication. In this article, we describe one ED's experiences with ED information systems during the April 2013 Boston Marathon bombings. During postevent debriefings, staff shared that our ED information systems and workflow did not optimally support this incident; we found challenges with our unidentified patient naming convention, real-time situational awareness of patient location, and documentation of assessments, orders, and procedures. As a result, before our next mass gathering event, we changed our unidentified patient naming convention to more clearly distinguish multiple, simultaneous, unidentified patients. We also made changes to the disaster registration workflow and enhanced roles and responsibilities for updating electronic systems. Health systems should conduct disaster drills using their ED information systems to identify inefficiencies before an actual incident. ED information systems may require enhancements to better support disasters. Newer technologies, such as radiofrequency identification, could further improve disaster information management and communication but require careful evaluation and implementation into daily ED workflow.

Original languageEnglish (US)
Pages (from-to)51-59
Number of pages9
JournalAnnals of Emergency Medicine
Volume66
Issue number1
DOIs
StatePublished - Jul 1 2015

ASJC Scopus subject areas

  • Emergency Medicine

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