Factors affecting the organization and management of emergency mass casualty events public health institutions: Lazio Region ARES experience

Background: Mass Casualty Events also referred to as Disasters, are those occurrences causing damage, ecological disruption, loss of human life or destruction of health and health services on a scale sufficient to warrant an extraordinary response from outside the affected community or area. Methods: The study was carried out in Rome between 2008/2009 while based at Sapienza University Departmento Esperimentale at Policlinico emergency hospital. Data was collected by interviews from key professional informants in the organization and management of disasters in Lazio region referred to as Azienda Regionale di Emergenza Sanitaria (ARES) using interview guides, questionnaires and focused group discussions. Additional data on identified sites and installations was collected by the observational survey method (transect  visits/walks) around Rome installations that the authority considers prone to disasters including tourist parks and public parks, hotels, stadia, train stations and Vaticans. Observations were analyzed qualitatively. This study was approved through the institutional review board of Rome University through the Departimento Medicina Esperimentale and Departmento d’Emergenza Accetazzione (DEA).  Results: Disaster Management was found to be prioritized always and effectively represented for ready intervention by prepared pre- organized multi- agency teams at every site visited. These on- scene project squads comprised a representation from the armed forces, police, fire department, medical and ambulance service all under a unified command of leadership with a specified job description. Factors identified were: Political will, human resource planning, appropriate communication utilization, time management and sufficient preparedness for disasters in Region Lazio. Conclusion: Disaster Management is a necessity since liability to disasters is open to all to humanity around the world. Factors affecting disaster management enable an efficient fore casting and prompt response to avoid worsening that chaotic situation upon disaster intervention in any affected community. Keywords: Disasters, Calamity, Catastrophes, Mass emergency Casualty events, Organization