Eric Carlström

University of Gothenburg | GU · Institute of Health and Care Sciences

Background: The global escalation of Emergency Department (ED) crowding has prompted the development of innovative solutions to alleviate strain and enhance patient prioritization. One such solution is the WEst coast System for Triage (WEST), based on the South African Triage Scale. Initially Introduced at Sahlgrenska University Hospital in Western...

Background Ensuring the transition towards person-centred care is a growing focus in health and social care systems globally. Presented as an ethical framework for health and social care professionals, such a transition requires strong leadership and organisational changes. However, there is limited guidance available on how to assist health and so...

Background Mass casualty incidents (MCI) pose significant challenges to existing resources, entailing multiagency collaboration. Triage is a critical component in the management of MCIs, but the lack of a universally accepted triage system can hinder collaboration and lead to preventable loss of life. This multinational study uses validated patient...

Stroke patients not eligible for acute intervention often have low priority and may spend long time at the emergency department (ED) waiting for admission. The aim of this retrospective case–control register study was to evaluate outcomes for such “low priority” stroke patients who were transported via Fast Track directly to the stroke unit, accord...

Background Hospitals play a crucial role in responding to disasters and public health emergencies. However, they are also vulnerable to threats such as fire or flooding and can fail to respond or evacuate adequately due to unpreparedness and lack of evacuation measures. The United Nations Office for Disaster Risk Reduction has emphasised the impor...

This study evaluates the need for changes in Saudi Arabia's current disaster and emergency management curriculum, incorporating disaster exercises and using the collaborative tool of CSCATTT (Command and Control, Safety, Communication, Assessment, Triage, Treatment, Transport). Several statements were presented among five experts in three rounds of...

Introduction: This study evaluates the perceptions of preparedness and willingness to work during disasters and public health emergencies among 213 healthcare workers from 10 ministries of health hospitals in the southern region of Saudi Arabia, which is exposed to the risk of disasters such as flash floods in wadis, fires, sandstorms, armed confli...

Introduction: Hospitals are subject to internal and external threats which could necessitate an evacuation. Such evacuation needs deliberate surge and collaboration, particularly collaborative use of community capacities to handle affected patients, personnel, devices, and hospital structures using consensus systems. Therefore, it is crucial to ide...

Introduction: This study measured the impact of virtual three-level collaboration (3LC) exercises on participants’ perceived levels of collaboration, learning, and utility (CLU) at hospitals in the southern region of Saudi Arabia. Our 3LC exercise is a tabletop training tool used to facilitate disaster education and document CLU. This model enables...

Introduction: Saudi Arabia has experienced special challenges calling for effective teamwork in the management of disasters and emergencies, such as wars, earthquakes, and major accidents linked to the Hajj pilgrimage over the years. In 2015, 769 pilgrims died in a crowd stampede during Hajj. The outcome of the incident could have been different if...

Introduction: The SARS-CoV-2 virus 2019 (COVID-19) has consumed many available resources within contingency plans, necessitating new capacity surges and novel approaches. This study aimed to explore the possibility of implementing the Flexible Surge Capacity concept in relieving hospitals by focusing on the community resources to develop “Home Isol...

This study aimed to evaluate the development of healthcare teamwork during and after the collaboration tabletop exercises, through observation and interview methods. Integration and maturity theoretical models were employed to explain the collaborative challenges in teams that may suffer from unequally distributed power, hierarchies, and fragmentat...

This article provides a systematic review of the literature on backsourcing. The aim is to synthesize existing literature in order to compare and analyze similarities and differences in backsourcing in the private and public sectors. The study asks questions about: which methods and theories have been used, why backsourcing has been implemented, an...

According to the concept of "flexible surge capacity," hospitals may need to be evacuated on two occasions: (1) when they are exposed to danger, such as in war; and (2) when they are contaminated, such as during the Covid-19 pandemic. In the former, the entire hospital must be evacuated, while in the latter, the hospital becomes a pandemic center n...

Purpose This study aimed to describe facilitators and barriers in terms of regulation and financing of healthcare due to the implementation and use of person-centred care (PCC). Design/methodology/approach A qualitative design was adopted, using interviews at three different levels: micro = hospital ward, meso = hospital management, and macro = na...

Background: Hospitals are subject to internal and external threats, which could necessitate an evacuation. Such evacuation needs deliberate surge and collaboration, particularly collaborative use of community capacities to handle affected patients, personnel, devices, and hospital structures using consensus systems. Therefore, it is crucial to iden...

This study evaluates the perceptions of preparedness and willingness to work during disasters and public health emergencies among 213 healthcare workers at hospitals in the southern region of Saudi Arabia by using a quantitative survey (Fight or Flight). The results showed that participants’ willingness to work unconditionally during disasters and...

Most hospitals have a contingency plan, based on all-risks and all-hazards assessment principles. However, emerging threats and risks often necessitate a flexible approach to emergency management at several levels of a disaster response system, for example, in hospitals. Sweden, and possibly other countries, has limited possibilities of surge capac...

Background There are different prehospital triage systems, but no consensus on what constitutes the optimal choice. This heterogeneity constitutes a threat in a mass casualty incident in which triage is used during multiagency collaboration to prioritize casualties according to the injuries’ severity. A previous study has confirmed the feasibility...

This article explores how women in top leader positions navigate between the two contradictory cultures of masculinity and femininity and, in particular, if and how these positionings and negotiations develop over time. Drawing on working-life biographical interviews with women on the top of organizational hierarchies within the crisis management s...

Objectives This study aims to develop a theoretical framework for the flexible surge capacity, inspired by existing surge capacity, complexity theory, and collaborative theoretical frameworks, and discuss its implementation and use in emergencies. Study design This was a descriptive study. Methods Theoretical frameworks for surge capacity, the co...

Objectives Coronavirus disease 2019 (COVID-19) has consumed many available resources within contingency plans, necessitating new capacity surges and novel approaches. This study aimed to explore the possibility of implementing the concept of flexible surge capacity to reduce the burden on hospitals by focusing on community resources to develop home...

Objectives: The overall objective was to analyse service-related factors involved in the complex processes that precede suicide in order to identify potential targets for intervention. Design and setting: Explorative network analysis study of post-suicide root cause analysis data from Swedish primary and secondary healthcare. Participants: 217...

Background There has been in increase in the use of systems for organizing lay responders for suspected out-of-hospital cardiac arrests (OHCAs) dispatch using smartphone-based technology. The purpose is to increase survival rates; however, such systems are dependent on people’s commitment to becoming a lay responder. Knowledge about the characteris...

Background Establishing more substantial patient involvement in the health care has become fundamental to Western health care services. Person-centred care (PCC) has been developed as a way of working that involve the patients and family members. However, the implementation of PCC in clinical practice has proven to be challenging. The aim of this s...

Civilian-military collaboration in humanitarian crises has been encouraged globally; however, little is known about their diverse ethical viewpoints towards challenging and critical situations , which may cause difficulties in the partnership, and influence the outcomes of their mutual activities. The aim of this study was to identify the diversity...

Background The time delay from alerted ambulance to arrival at the stroke unit is crucial for patients suffering a suspected stroke. This is a recognized problem why additional explorative knowledge regarding actions taken are needed. Aim To explore actions taken by nurses that affect lead times in the care pathway from the alerted ambulance to th...

The aim of this study is to map the process involved in terminating a long-standing business relationship in a public context. It employed an exploratory study to interview 35 politicians, senior- and middle managers, ambulance- and dispatch centre staff and representatives of a regional alliance of patients. Growing criticism from a county council...

This study measured the impact of virtual three-level collaboration (3LC) exercises on participants’ perceived levels of collaboration, learning, and utility (CLU) at hospitals in the southern region of Saudi Arabia. Our 3LC exercise is a tabletop training tool used to facilitate disaster education and document CLU. This model enables the practitio...

Purpose This study aims to describe how person-centred care, as a concept, has been adopted into discourse in 23 European countries in relation to their healthcare systems (Beveridge, Bismarck, out of pocket). Design/methodology/approach A literature review inspired by the SPICE model, using both scientific studies (CINHAL, Medline, Scopus) and gr...

Background The time elapsing from the alarm being raised to arrival at the stroke unit is crucial for patients suffering a conceivable stroke. More knowledge is needed about critical incidents—both favourable and unfavourable—affecting the lead time in the care chain. Aim To explore favourable and unfavourable critical incidents (CIs), affecting l...

Background There is no global consensus on the use of prehospital triage system in mass casualty incidents. The purpose of this study was to evaluate the most commonly used pre-existing prehospital triage systems for the possibility of creating one universal translational triage tool. Methods The Rapid Evidence Review consisted of (1) a systematic...

The management of emergencies consists of a chain of actions with the support of staff, stuff, structure, and system, i.e., surge capacity. However, whenever the needs exceed the present resources, there should be flexibility in the system to employ other resources within communities, i.e., flexible surge capacity (FSC). This study aimed to investi...

There is no global consensus on the use of prehospital triage systems in mass casualty incidents [1,2]. However, most of the triage systems aim to cover four essential factors: speed, precision, fairness, and compatibility [3], of which the element of speed of decision-making is of importance, due to the large number of casualties that should be ma...

Background: Non-traumatic abdominal pain may have several causes and often needs physicians' consultation. In a pilot study, a template was used to assist ambulance nurses and technicians to assess this medical condition. Objectives: This study aimed to evaluate the use of the template and the outcome of the pilot study. Methods: A prehospital temp...

The aim of this study is to contribute to the literature on how involuntary backsourcing in public organisations is performed in practice and how it affects the relationship between principal and agent. The study focuses on two questions; 1) Which stages characterise the process when public contracts are involuntary terminated? 2) How does involunt...

Traditional healthcare services have demonstrated structural shortcomings in the delivery of patient care and enforced numerous elements of integration in the delivery of healthcare services. Integrated healthcare aims at providing all healthcare that makes humans healthy. However, with mainly chronically ill people and seniors, typically suffering...

Sudden cardiac arrest is one of the leading causes of death globally. The recommended clinical management in out-of-hospital cardiac arrest cases is the immediate initiation of high-quality cardiopulmonary resuscitation (CPR). Training mannequins should be combined with technology that provides students with detailed immediate feedback on the quali...

Background: Sudden cardiac arrest is one of the leading causes of death globally. The recommended clinical management in out-of-hospital cardiac arrest cases is the immediate initiation of high-quality Cardiopulmonary Resuscitation (CPR). Training mannequins should be combined with technology that provide students with detailed immediate feedback o...

Objective To analyze the evacuation preparedness of hospitals within the European Union (EU). Method This study consisted of 2 steps. In the first step, a systematic review of the subject matter, according to the PRISMA flow diagram, was performed. Using Scopus (Elsevier, Amsterdam, Netherlands), PubMed (National Library of Medicine, Bethesda, MD)...

PurposeThere is a gap in time between the occurrence of a mass casualty incident (MCI) and the arrival of the first responders to the scene, which offers an opportunity for the public (immediate responders) to perform life-saving measures. The purpose of this study was to identify these measures and the public’s willingness to conduct them.Method A...

Local governments are bringing previously outsourced services back in-house. Research into explanations for sourcing decisions in the public sector is growing, however, few researchers have investigated drivers of both outsourcing and backsourcing in local public-governance organizations. In this study we utilize transaction cost economic theory (T...

Introduction:Historical changes have transformed Sweden from being an offensive to a defensive and collaborative nation with nationaland international engagement, allowing it to finally achieve the ground for the civilian–military collaboration and theconcept of a total defense healthcare. At the same time, with the decreasing number of internation...

The degree to which exercises improve the collaboration among different organizations during an emergency is under debate. This study aims to contribute to the scarce research on this topic by giving insight into the perceived effects of exercises on collaboration, learning, usefulness and interorganizational trust. In particular, this quantitative...

Introduction: Historical changes have transformed Sweden from being an offensive to a defensive and collaborative nation with national and international engagement, allowing it to finally achieve the ground for the civilian-military collaboration and the concept of a total defense healthcare. At the same time, with the decreasing number of internat...

This study evaluates the perceptions of preparedness and willingness to work during disasters and public health emergencies among 213 healthcare workers at hospitals in the southern region of Saudi Arabia by using a quantitative survey (Fight or Flight). The results showed that participants' willingness to work unconditionally during disasters and...

The emergency department (ED) is one of the busiest facilities in a hospital, and it is frequently described as a bottleneck that limits space and structures, jeopardising surge capacity during Major Incidents and Disasters (MIDs) and pandemics such as the COVID 19 outbreak. One remedy to facilitate surge capacity is to establish an Urgent Care Cen...

This study aims to assess the readiness of emergency nurses in Southern part of Saudi Arabia in management of public health emergencies, major incidents and disasters, and their need in further educational initiatives, by using quantitative research through a self-reporting validated questionnaire. Although most of the nurses in this study reported...

Objective This study aims to clarify the association between prosperity and novel coronavirus disease 2019 outcomes and its impact on the future management of pandemics. Methods This study is an observational study using information from two online registries. The numbers of infected individuals and deaths and the prosperity rank of each country w...

Based on the assumption that crisis collaboration exercises lead to better team-integration and more efficient problem solving, the aim of this study is to test whether there is a relationship between exercise participation and perceived levels of learning and utility. Online survey data was collected from participants in a 2018 two-day, full-scale...

Flexible surge capacity aims to activate and utilize other resources than normally are surged in a community during the primary and secondary surge capacity. The presence of alternative leadership, skilled and knowledgeable in hospital and prehospital emergency management, is invaluable. Thai emergency physicians work at both levels, emphasizing th...

Surge capacity is the ability to manage the increased influx of critically ill or injured patients during a sudden onset crisis. During such an event, all ordinary resources are activated and used in a systematic, structured, and planned way to cope with the situation. There are, however, occasions where conventional healthcare means are insufficie...

This is a study of inter-organisational exercises arranged by on-shore organisations (ONSOs) and off-shore organisations (OFFSOs). The aim was to compare findings from trained emergency staffs’ perceptions of the impact of exercises. The data were retrieved from surveys conducted by the research team in conjunction with exercises. The surveys inclu...

Background The Wet-Bulb Globe Temperature (WBGT) index is a common tool to screen for heat stress for sporting events. However, the index has a number of limitations. Rational indices, such as the physiological equivalent temperature (PET) and Universal Thermal Climate Index (UTCI), are potential alternatives. Aim To identify the thermal index tha...

Rationale and aim: Ambulance staff, i.e. registered nurses and assistant nurses, receive assignments from emergency dispatch centres including information on level of priority, address and patient’s care requirements. One problem is that the preliminary information the dispatcher gives to the ambulance staff may be incomplete. The purpose of this s...

Objectives Intrahospital transports are associated with complications and adverse events in intensive care patients. Yet, little is known about how patients’ percive these tranfers. Thus, this study aimed to explore patients’ experiences of the intrahospital transport process. Research Design An exploratory qualitative study compromising interview...

Background: Mass gatherings may strain the planning and response resources of the community hosting the event and create security and public health challenges. We aimed to explore whether a mutual planning and risk assessment tool used by emergency public agencies (EPA=emergency medical services, police officers, and firefighters), and organizers m...

Among several serious medical conditions, arrhythmia and heat stroke are two important causes of death during endurance races. Clinically, collapsing might be the first sign of these serious conditions and may mimic the more common and benign exercise-associated collapse. Several risk factors have been reported in the literature. We aimed to conduc...

Objectives The aim of this study was to develop and validate a scale to measure the coping strategies used by emergency staff in response to workplace stress. To achieve this aim, we developed a refined Jalowiec Coping Scale (JCS), termed the Jalowiec Coping Scale-Emergency Department (JCS-ED) and validated this scale on a sample of emergency clini...

Aims and objectives: To explore the views of registered nurses experienced in aesthetic nursing regarding medically safe practices and sound ethical standards BACKGROUND: Aesthetic nursing is an emerging field of modern-day healthcare encompassed within aesthetic medicine. There is a distinct lack of research regarding how registered nurses who sp...

Background The ED Stressor Scale outlines 15 stressors that are of importance for ED staff. Limited research has identified how commonly such stressors occur, or whether such factors are perceived with similar importance across different hospitals. This study sought to examine the frequency or perceived severity of these 15 stressors using a multic...

The current global security threats indicate a need for a change in the Swedish defense policies including the role of civilian and military healthcare in an armed conflict. The magnitude, outcome and management of the recent terror and mass casualty incidents in Europe necessitate a closer Swedish civilian-military collaboration. However, in reali...

Objectives: The aims of this study were to describe clinical staff perceptions of their ED working environment and to explore associations between staff demographics, coping styles and the work environment. Methods: A cross-sectional study was conducted in one Swedish ED and two Australian EDs in 2015-2016. Descriptive statistics were used to ex...

Emergency department (ED) overcrowding is caused by external and/or internal factors. One critical internal factor, leading to longer length of stay (LOS) at ED (eg, frequent ED users), is the physician's uncertainty in management of patients with unclear diagnosis and or complex medical history. The aim of this study was to identify whether the ca...

Background Whilst many health benefits are associated with regular exercise, medical complications may occur during higher-intensity activities, such as long distance running contests. The most common complication is collapse. However, the incidence and characteristics of these collapses are not very well studied. Method This is a retrospective st...

In crisis management, cross-sector collaboration exercises are perceived as improving preparedness and develop team-integration efforts. However, studies show that exercises may tend to produce results with limited learning and usefulness. The purpose of this nonexperimental, survey-based study was to measure the difference in perceived exercise ef...

Purpose Head and neck cancer and its treatment deteriorate quality of life, but symptoms improve with person-centred care. We examined the cost-effectiveness of a person-centred care intervention versus standard medical care. Methods In this randomized clinical trial of a person-centred intervention, patients were planned for outpatient oncology t...

Background: Emergency departments (EDs) are stressful workplaces. Limited research explores components ED staff find stressful and how they cope. The aim of this study is to describe ED staff perceptions of their working environment. Methods: A cross-sectional study was undertaken in 2017 in a public, teaching hospital ED situated in an outer-me...