Hazel Harley

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Papers by Hazel Harley

A Risk-Based Approach to Provision of Medical Services at Remote Sites

SPE Symposium: Asia Pacific Health, Safety, Security, Environment and Social Responsibility, 2019

Objectives / Scope To develop a risk assessment tool for measuring the level of medical services ... more Objectives / Scope To develop a risk assessment tool for measuring the level of medical services required at remote sites during a medical emergency. Methods, Procedures, Process At Chevron Australia, in addition to on-site clinical resources, Medivac and Medical Support Procedures provide rotary wing and fixed wing medical evacuation from our sites when required. According to definitions prescribed by the Institute of Remote Healthcare (IRHC) 2013, all of Chevron Australia's operating environments are considered "remote" or "extreme remote" locations. "Critically" ill patients are defined as those patients who are at high risk for actual of potential life-threatening health problems, due to either illness of injury. Importantly, these critically ill patients require expedient medical treatment within the first hour after presentation to enable the greatest opportunity of survival. Lifesaving medical interventions due to workplace injury are rarely ...

Using Technology to Aid Communications in the Medical Emergency Response of a Remote Industrial Site

SPE Symposium: Asia Pacific Health, Safety, Security, Environment and Social Responsibility, 2019

Objectives / Scope To ensure effective and efficient communications in a mass casualty response s... more Objectives / Scope To ensure effective and efficient communications in a mass casualty response scenario at a remote industrial site with limited clinical personnel. Methods, Procedures, Process Changing site conditions including transitioning to a Major Hazard Facility with an increased risk profile, reduction in on-site clinical resources, and the introduction of new emergency processes prompted a rethink of Chevron Australia’s existing medical emergency communications and the development of an electronic tracker. Information in medical emergency situations had traditionally been communicated verbally via radio or phone. When SMART triage cards with eight-digit "unique identifiers" were introduced, communicating via this technology increased the potential margin of error. An electronic tracker allows every level of response to receive timely, reliable information they require for decision-making purposes during an emergency event. The tracker was developed with a separat...

Education and Training of Australian Disaster Medical Assistance Team Members: Results of a National Survey

by A. Robertson and Hazel Harley

Prehospital and Disaster Medicine, 2011

Introduction:Calls for disaster medical assistance teams (DMATs) are likely to continue in respon... more Introduction:Calls for disaster medical assistance teams (DMATs) are likely to continue in response to international disasters.Objective:As part of a national survey, the present study was designed to evaluate the education and training of Australian DMATs.Methods:Data were collected via an anonymous, mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 Southeast Asia tsunami disaster.Results:The response rate for this survey was 50% (59/118). Most of the personnel had deployed to the tsunami-affected areas. The DMAT members were quite experienced, with 53% of personnel in the 45–55-year age group (31/59). Seventy-six percent of the respondents were male (44/58). While most respondents had not participated in any specific training or educational program, any kind of relevant training was regarded as important in preparing personnel for dep...

Leadership and Use of Standards by Australian Disaster Medical Assistance Teams: Results of a National Survey of Team Members

by A. Robertson and Hazel Harley

Prehospital and disaster medicine, 2012

IntroductionIt is likely that calls for disaster medical assistance teams (DMATs) will continue i... more IntroductionIt is likely that calls for disaster medical assistance teams (DMATs) will continue in response to international disasters. OBJECTIVE: As part of a national survey, the present study was designed to evaluate leadership issues and use of standards in Australian DMATs. METHODS: Data was collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 Asian Tsunami disaster. RESULTS: The response rate for this survey was estimated to be approximately 50% (59/118). Most of the personnel had deployed to the Asian Tsunami affected areas. The DMAT members were quite experienced, with 53% (31/59) of personnel in the 45-55 years of age group. Seventy-five percent (44/59) of the respondents were male. Fifty-eight percent (34/59) of the survey participants had significant experience in international disasters, although few ...

Health and safety aspects of deployment of Australian Disaster Medical Assistance Team members: Results of a national survey

Travel Medicine and Infectious Disease, 2009

Disaster medical assistance teams (DMATs) have responded to numerous international disasters in r... more Disaster medical assistance teams (DMATs) have responded to numerous international disasters in recent years. As part of a national survey, the present study was designed to evaluate Australian DMAT experience in relation to health and safety aspects of actual deployment. Data were collected via an anonymous mailed survey distributed by State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the time of the 2004 South East Asian tsunami disaster. The response rate for this survey was 50% (59/118). Most of the personnel had deployed to the tsunami affected areas. The DMAT members were quite experienced with 53% of personnel in the 45-55 years age group (31/59) and a mean level of clinical experience of 21 years. 76% of the respondents were male (44/58). Once deployed, most felt that their basic health needs were adequately met. Almost all stated there were adequate shelter (95%, 56/59), adequate food (93%, 55/59) and adequate water (97%, 57/59). A clear majority, felt there were adequate toilet facilities (80%, 47/59), adequate shower facilities (64%, 37/59); adequate hand washing facilities (68%, 40/59) and adequate personal protective equipment (69%, 41/59). While most felt that there were adequate security briefings (73%, 43/59), fewer felt that security itself was adequate (64%, 38/59). 30% (18/59) felt that team members could not be easily identified. The optimum shift period was identified as 12h (66%, 39/59) or possibly 8h (22%, 13/59) with the optimum period of overseas deployment as 14-21 days (46%, 27/59). Missing essential items were just as likely to be related to personal comfort (28%) as clinical care (36%) or logistic support (36%). The most frequently nominated personal items recommended were: suitable clothes (49%, 29/59); toiletries (36%, 22/59); mobile phone (24%, 14/59); insect repellent (17%, 10/59) and a camera (14%, 8/59). The most common personal hardship reported during their deployment was being away from home/problems at home (24%, 14/59); however, most felt that their family was adequately informed of their whereabouts and health status (73%, 43/59). This study of Australian DMAT members suggests that, in the field, attention should be given to basics, such as adequate food, water, shelter and personal hygiene as well as appropriate clothing, sunscreen and vector protection. The inclusion of appropriate personal items can be assisted by provision of a minimum suggested personal equipment list, with local conditions and the nature of the deployment being taken into account. A personal survival kit should also be recommended. There should be medical and psychological support for team members themselves, including the provision of a dedicated team member medical cache. Concern for their own health and ability to communicate with family members at home are major issues for deployed team members and need to be addressed in mission planning. This should also recognise security issues, including briefings, evacuation plans and exit strategies. The team members concerns about adequate security and the risk profile of humanitarian intervention in natural disasters compared with complex humanitarian emergencies may help determine future deployment of civilian or defence based teams.

Education and training of Australian disaster medical assistance team members: results of a national survey

Prehospital and disaster medicine, 2011

Human resources issues and Australian Disaster Medical Assistance Teams: results of a national survey of team members

Emerging Health Threats Journal, 2012

Calls for disaster medical assistance teams (DMATs) are likely to continue in response to interna... more Calls for disaster medical assistance teams (DMATs) are likely to continue in response to international disasters. As part of a national survey, this study was designed to evaluate Australian DMAT experience in relation to the human resources issues associated with deployment. Data was collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 South East Asian Tsunami disaster. The response rate for this survey was 50% (59/118). Most personnel had deployed to the Asian Tsunami affected areas with DMAT members having significant clinical and international experience. While all except one respondent stated they received a full orientation prior to deployment, only 34% of respondents (20/59) felt their role was clearly defined pre deployment. Approximately 56% (33/59) felt their actual role matched their intended role and that their clinical background was well suited to their tasks. Most respondents were prepared to be available for deployment for 1 month (34%, 20/59). The most common period of notice needed to deploy was 6-12 hours for 29% (17/59) followed by 12-24 hours for 24% (14/59). The preferred period of overseas deployment was 14-21 days (46%, 27/59) followed by 1 month (25%, 15/59) and the optimum shift period was felt to be 12 hours by 66% (39/59). The majority felt that there was both adequate pay (71%, 42/59) and adequate indemnity (66%, 39/59). Almost half (49%, 29/59) stated it was better to work with people from the same hospital and, while most felt their deployment could be easily covered by staff from their workplace (56%, 33/59) and caused an inconvenience to their colleagues (51%, 30/59), it was less likely to interrupt service delivery in their workplace (10%, 6/59) or cause an inconvenience to patients (9%, 5/59). Deployment was felt to benefit the affected community by nearly all (95%, 56/59) while less (42%, 25/59) felt that there was a benefit for their own local community. Nearly all felt their role was recognised on return (93%, 55/59) and an identical number (93%, 55/59) enjoyed the experience. All stated they would volunteer again, with 88% strongly agreeing with this statement. This study of Australian DMAT members provides significant insights into a number of human resources issues and should help guide future deployments. The preferred &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;on call&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; arrangements, notice to deploy, period of overseas deployment and shift length are all identified. This extended period of operations needs to be supported by planning and provision of rest cycles, food, temporary accommodation and rest areas for staff. The study also suggests that more emphasis should be placed on team selection and clarification of roles. While the majority felt that there was both adequate pay and adequate indemnity, further work clarifying this, based on national conditions of service should be, and are, being explored currently by the state based teams in Australia. Importantly, the deployment was viewed positively by team members who all stated they would volunteer again, which allows the development of an experienced cohort of team members.

Logistic support provided to Australian disaster medical assistance teams: results of a national survey of team members

Emerging Health Threats Journal, 2012

Background: It is likely that calls for disaster medical assistance teams (DMATs) continue in res... more Background: It is likely that calls for disaster medical assistance teams (DMATs) continue in response to international disasters. As part of a national survey, the present study was designed to evaluate the Australian DMAT experience and the need for logistic support. Methods: Data were collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 Asian Tsunami disaster. Results: The response rate for this survey was 50% (59/118). Most of the personnel had deployed to the South East Asian Tsunami affected areas. The DMAT members had significant clinical and international experience. There was unanimous support for dedicated logistic support with 80% (47/59) strongly agreeing. Only one respondent (2%) disagreed with teams being self sufficient for a minimum of 72 hours. Most felt that transport around the site was not a problem (59%; 35/59), however, 34% (20/59) felt that transport to the site itself was problematic. Only 37% (22/59) felt that pre-deployment information was accurate. Communication with local health providers and other agencies was felt to be adequate by 53% (31/59) and 47% (28/59) respectively, while only 28% (17/59) felt that documentation methods were easy to use and reliable. Less than half (47%; 28/59) felt that equipment could be moved easily between areas by team members and 37% (22/59) that packaging enabled materials to be found easily. The maximum safe container weight was felt to be between 20 and 40 kg by 58% (34/59). Conclusions: This study emphasises the importance of dedicated logistic support for DMAT and the need for teams to be self sufficient for a minimum period of 72 hours. There is a need for accurate pre deployment information to guide resource prioritisation with clearly labelled pre packaging to assist access on site. Container weights should be restricted to between 20 and 40 kg, which would assist transport around the site, while transport to the site was seen as problematic. There was also support for training of all team members in use of basic equipment such as communications equipment, tents and shelters and water purification systems.

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Hospital Impact: Immediate Issues

International Disaster Nursing, 2010

Leadership and Use of Standards by Australian Disaster Medical Assistance Teams: Results of a National Survey of Team Members

Prehospital and disaster medicine, 2012

Pre- and post-deployment health support provided to Australian Disaster Medical Assistance Team members: Results of a national survey

by Peter Leggat, A. Robertson, and Hazel Harley

Travel Medicine and Infectious Disease, 2009

Calls for disaster medical assistance teams (DMATs) are likely to continue in response to interna... more Calls for disaster medical assistance teams (DMATs) are likely to continue in response to international disasters. As part of a national survey, the present study was designed to evaluate Australian DMAT experience in relation to pre- and post-deployment health care. Data was collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 South East Asian Tsunami disaster. The response rate for this survey was estimated to be around 50% (59/118). Most of the personnel had deployed to the tsunami affected areas. The DMAT members were quite experienced with 53% of personnel in the 45-55 years age group (31/59). Seventy-six percent of the respondents were male (44/58). Only 42% (25/59) received a medical check prior to departure and only 15% (9/59) received a psychological assessment prior to deployment. Most respondents indicated that both medical and psychological screening of personnel would be desirable. Most DMAT personnel received some vaccinations (83%, 49/59) before departure and most felt that they were adequately immunised. While nearly all DMAT members participated in formal debriefing post-deployment (93%, 55/59), far less received psychological debriefing (44%, 26/59), or a medical examination upon return (10%, 6/59). Three respondents reported experiencing physical ill health resulting in time off work following their return. While only one reportedly experienced any adjustment problems post-deployment that needed time off work, 32% (19/59) found it somewhat difficult to return to work. There were multiple agencies involved in the post-deployment debriefing (formal and psychological) and medical examination process including Emergency Management Australia (EMA), Australian Government, State/Territory Health Departments, District Health services and others. This study of Australian DMAT members suggests that more emphasis should be placed on health of personnel prior to deployment with pre-deployment medical examinations and psychological assessment. Following the return home, and in addition to mission and psychological debriefing, there should be a post-deployment medical examination and ongoing support and follow-up of DMAT members. More research is needed to examine deployment health support issues.

A Risk-Based Approach to Provision of Medical Services at Remote Sites

SPE Symposium: Asia Pacific Health, Safety, Security, Environment and Social Responsibility, 2019

Using Technology to Aid Communications in the Medical Emergency Response of a Remote Industrial Site

SPE Symposium: Asia Pacific Health, Safety, Security, Environment and Social Responsibility, 2019

Education and Training of Australian Disaster Medical Assistance Team Members: Results of a National Survey

by A. Robertson and Hazel Harley

Prehospital and Disaster Medicine, 2011

Leadership and Use of Standards by Australian Disaster Medical Assistance Teams: Results of a National Survey of Team Members

by A. Robertson and Hazel Harley

Prehospital and disaster medicine, 2012

Health and safety aspects of deployment of Australian Disaster Medical Assistance Team members: Results of a national survey

Travel Medicine and Infectious Disease, 2009

Education and training of Australian disaster medical assistance team members: results of a national survey

Prehospital and disaster medicine, 2011

Human resources issues and Australian Disaster Medical Assistance Teams: results of a national survey of team members

Emerging Health Threats Journal, 2012

Logistic support provided to Australian disaster medical assistance teams: results of a national survey of team members

Emerging Health Threats Journal, 2012

Download

Hospital Impact: Immediate Issues

International Disaster Nursing, 2010

Leadership and Use of Standards by Australian Disaster Medical Assistance Teams: Results of a National Survey of Team Members

Prehospital and disaster medicine, 2012

Pre- and post-deployment health support provided to Australian Disaster Medical Assistance Team members: Results of a national survey

by Peter Leggat, A. Robertson, and Hazel Harley

Travel Medicine and Infectious Disease, 2009

Calls for disaster medical assistance teams (DMATs) are likely to continue in response to interna... more Calls for disaster medical assistance teams (DMATs) are likely to continue in response to international disasters. As part of a national survey, the present study was designed to evaluate Australian DMAT experience in relation to pre- and post-deployment health care. Data was collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 South East Asian Tsunami disaster. The response rate for this survey was estimated to be around 50% (59/118). Most of the personnel had deployed to the tsunami affected areas. The DMAT members were quite experienced with 53% of personnel in the 45-55 years age group (31/59). Seventy-six percent of the respondents were male (44/58). Only 42% (25/59) received a medical check prior to departure and only 15% (9/59) received a psychological assessment prior to deployment. Most respondents indicated that both medical and psychological screening of personnel would be desirable. Most DMAT personnel received some vaccinations (83%, 49/59) before departure and most felt that they were adequately immunised. While nearly all DMAT members participated in formal debriefing post-deployment (93%, 55/59), far less received psychological debriefing (44%, 26/59), or a medical examination upon return (10%, 6/59). Three respondents reported experiencing physical ill health resulting in time off work following their return. While only one reportedly experienced any adjustment problems post-deployment that needed time off work, 32% (19/59) found it somewhat difficult to return to work. There were multiple agencies involved in the post-deployment debriefing (formal and psychological) and medical examination process including Emergency Management Australia (EMA), Australian Government, State/Territory Health Departments, District Health services and others. This study of Australian DMAT members suggests that more emphasis should be placed on health of personnel prior to deployment with pre-deployment medical examinations and psychological assessment. Following the return home, and in addition to mission and psychological debriefing, there should be a post-deployment medical examination and ongoing support and follow-up of DMAT members. More research is needed to examine deployment health support issues.

Hazel Harley

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