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1.	Andersson, Peter, 1957-, et al. (författare) Varaktig vård 2020 Ingår i: Partnerships for sustainable health care systems. - Linköping : Region Östergötland. - 9789151953120 - 9789151953137 ; , s. 25-29 Bokkapitel (övrigt vetenskapligt/konstnärligt)
2.	Assessing Command and Control Effectiveness : Dealing with a changing world 2014 Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract Assessing Command and Control Effectiveness: Dealing with a Changing World offers a description of the current state of Command and Control (C2) research in imperfect settings, showing how a research process should assess, analyse and communicate results to the development cycle of methods, work, manning and C2-technology. Special attention is given to the development of C2 research methods to meet the current and coming needs. The authors also look forward towards a future where effective assessment of C2 abilities are even more crucial, for instance in agile organisations.The purpose of the C2 research is to improve the process and make it more effective while still saving time and money. Research methods have to be chosen carefully to be effective and simple, yet provide results of high quality. The methodological concerns are a major consideration when working under such circumstances. Furthermore, there is often a need for a swift iterative development cycle, and thus a demand to quickly deliver results from the research process. This book explains how field research experimentation can be quick, simple and effective, being able to draw valid conclusions even when sample sizes are small and resources are limited, collecting empirical data using measures and procedures that are minimally intrusive.
3.	Baroutsi, Nicoletta, 1987-, et al. (författare) Assessing development of team training in emergency management 2014 Ingår i: Proceedings of the 11th ISCRAM. Konferensbidrag (refereegranskat)
4.	Berggren, Peter, 1971-, et al. (författare) The quasi-dynamic approach to measuring complex systems 2009 Ingår i: Proceedings of the Europe Chapter Human Factors and Ergonomics Society (HFES) conference 2009. Konferensbidrag (refereegranskat)
5.	Fornander, Liselott, 1981- (författare) How we talk : aspects of communication and team cognition of trauma resuscitation teams 2024 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract A trauma team consists of professionals assembling in an ad hoc manner to resuscitate a patient with life-threatening injuries. In such a team, how the team manages to use non-technical skills, such as communication is important to achieve task management and decision making. Communication is practised in simulations, and the simulation environment has also been used in research to understand teamwork processes. This thesis is based on video observations of trauma teams working in real life (IRL) and in situ simulations of trauma resuscitations. The aim was to assess the creation of team cognition IRL and in simulation, to analyse verbal communication in the teams and the effects of real-time communication on team structure. In Study I, a grounded theory analysis was undertaken to understand how verbal and non-verbal interactions create team cognition. The analysis resulted in a theory pointing to “split vision” as a team’s ability to alter process modes between team positioning and sensitivity to the patient that was dependent on patient and situational values absorbed from team members’ implicit actions. In Study II, the verbal response modes taxonomy was applied to analyse both the grammatical and pragmatic meaning of verbal interactions that were compared between team roles. In the six most communicative team roles in the context of IRL trauma teamwork, pure mode communication dominated the way of delivering messages. In Study III, the structures of four IRL and four simulated trauma teams were analysed using a social network analysis of real-time communication. Overall, the teams were highly centralised, with the examining physician functioning as an information hub. In Study IV, communication from the same teams was categorised according to information and task management, as well as different coordination behaviours. We compared the IRL and simulation domains based on the proportions of utterances of each category/code, and found that “Give information after request” and closed-loop communication were more prevalent in simulation. Observing real-time communications using different methodologies gave a perspective on the conditions and possibilities for adaptation in terms of work prescriptions and team training, such as room for more communication and possible congestions of nodes in terms of occupancy and tacit communications and working modes thus far unnoticed by us and unreported. Such understanding complements established knowledge about coordination behaviours and interactive team cognition and should be taken into consideration in the practise and training of trauma teams.
6.	Hodza-Beganovic, Ruhija, et al. (författare) Supporting development of health care in resource scarce environments 2017 Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 27, s. 315-315 Tidskriftsartikel (refereegranskat)
7.	Hälso- och sjukvårdens förmåga att hantera en allvarlig händelse med många skadade : erfarenheter och lärdomar av Övning TYKO 2016 Rapport (övrigt vetenskapligt/konstnärligt)abstract Den 3 mars 2016 fick Socialstyrelsen i uppdrag av regeringen att öva hälsooch sjukvårdens förmåga att hantera en allvarlig händelse med många skadade. Myndigheten beslutade att genomföra övningen som en funktionell simuleringsövning med motspel. De övade utvärderades med hjälp av mätbara kvalitetsindikatorer som tidigare identifierats inom ramen för Socialstyrelsens arbete med att ta fram en gemensam modell för särskild sjukvårdsledning vid allvarlig händelse. Inför övningen skapades ett scenario som var utmanande för hälso- och sjukvården men, för att möjliggöra genomförandet inte innefattade alla potentiella komplexa faktorer. En kritisk observation är att analysen utifrån en övning bör vara restriktiv med slutsatser ifall dessa inte samtidigt kan styrkas utifrån tidigare övningar eller verkliga händelser. Övningens scenario samt patienternas skadepanorama och utfall visualiserades med hjälp av simuleringsverktyget Emergo Train System® och dess instruktörer vid Katastrofmedicinskt Centrum i Linköping. Ett väsentligt mål med övningen var att den ska utgöra ett underlag för att stärka förmågan inom hälso- och sjukvården genom att identifiera utvecklingsområden. I rapporten redovisas under övningen identifierade förmågor och utvecklingsområden som myndigheten bedömer som viktiga för att upprätthålla, säkra och förbättra förmågan att hantera allvarliga händelser: • Dokumentation och lägesbild • Kommunikation och terminologi • Mobilisering och dirigering av resurser • Fördelningsstrategi och gränssättande kapacitet • Nationell samordning • Övningsteknisk utveckling En gemensam lägesbild är viktig efter som det stödjer de involverade aktörerna i arbetet med att värdera behovet av stöd under pågående händelse. Därför var en viktig del i övningens utvärdering huruvida påverkade landsting hade förmågan att snabbt skapa sig en uppfattning om aktuellt behov, tillgängliga resurser och hur ytterligare pre- hospitala samt hospitala resurser skulle kunna mobiliseras. Dessa kritiska faktorer skapar förutsättningar för att korrekta fördelningsstrategier för de skadande patienterna ska kunna utarbetas. Övning Tyko visade att staber med hög upplevd arbetsbelastning och låg upplevd situationsmedvetenhet hade svårt att värdera sitt eget behov av stöd från andra aktörer. Att i förväg ha kännedom om vilken typ av stöd man behöver och kan förvänta sig i olika situationer kräver ett arbete för att identifiera detta redan i före-perspektivet. Det går inte att utesluta att en annan överblick av tillgängliga resurser och en annan förutsägbarhet i vad som kan förväntas av andra hade föranlett en annan fördelningsstrategi som hade förbättrat patientfallet i övningen. För att avgöra effektiviteten av fattade beslut i enlighet med framtagna strategier behövs även en förmåga till 8 HÄLSO- OCH SJUKVÅRDENS FÖRMÅGA ATT HANTERA EN ALLVARLIG HÄNDELSE MED MÅNGA SKADADE SOCIALSTYRELSEN uppföljning huruvida tagna beslut får förväntad effekt inom rimlig tid, under övningen observerades kommunikationsproblem gällande kvittens, förfrågan och bekräftelse. En viktig sammanfattande slutsats som Socialstyrelsen drar inför fortsatt arbete är att myndigheten ska verka för att etablera en funktion för nationell samordning med syfte att ge förutsättningar till en bättre behovs- och resursmatchning vid stora skadeutfall. Inom ramen för en sådan samordning bör gemensamma triage och larmkriterier, medicinska bedömningskriterier och skadeklassificeringar, gemensamma rapportmallar och system för distribution av diagnostiskt material samt gemensam terminologi m.m. inkluderas. Metoder och teknik för framtagandet och kommunikationen av fördelningsnycklar och aktuella kapacitetsbedömningar över tid behöver tas fram för att skapa förutsättningar för en aktuell bild av resurstillgången. Socialstyrelsen vill skapa förutsättningar för ett nationellt kompetenscentrum med inriktning på ökad förmåga och samordning i hela traumavårskedjan. I detta arbete kan även arbetet med Socialstyrelsens förmåga till nationell samordning under pågående händelse utarbetas, definieras och implementeras. Myndigheten vill slutligen lyfta fram att en samlad nationell plan för både trauma- och katastrofmedicinsk utbildning och övning ger ytterligare förutsättningar att upprätthålla och öka förmågan att hantera allvarliga händelser. Dessa viktiga slutsatser avser myndigheten ta med sig in i sitt fortsatta arbete med att stärka hälso-och sjukvårdens förmåga vid allvarlig händelse.
8.	Oskarsson, Per-Anders, 1957-, et al. (författare) Transfer of training from simulator to aircraft - the usefulness of embedded training tools 2009 Ingår i: The Europe Chapter Human Factors and Ergonomics Society (HFES) conference 2009. Konferensbidrag (refereegranskat)
9.	Pettersson, Jenny, et al. (författare) Critical Decision-making in Medical Command and Control During Early Covid-19: An Interview Study 2023 Ingår i: 2023 WADEM congress on disaster and emergency medicine. ; , s. s53-s54 Konferensbidrag (refereegranskat)
10.	Thunholm, Peter, 1959-, et al. (författare) Evaluating the effectiveness of an armoured brigade staff 2014 Ingår i: Assessing command and control effectiveness. - London : Ashgate. - 9781472436948 ; , s. 141-160 Bokkapitel (refereegranskat)abstract The purpose with this chapter is to present a study of the effectiveness of an Armoured Brigade Headquarters (HQ) in some specific respects. Important issues were (1) how is the HQ Staff dimensioned in relation to its tasks, (2) how does the three staff processes work (Planning, Execution and Coordination / Decision) and (3) how well does the HQ’s Standard Operating Procedure (SOP) and Battle Rhythm function in the light of the HQ’s organization and work processes? The study was designed as a survey study and was based on the following four instruments: (1) Military Command Team Effectiveness Instrument (CTEF 2.0; Essence, Vogelaar, Baranski, Berggren, Van Buskirk, Goodwin & Myller, 2008); (2) Measurement of workload according to the Borg scale (Borg, 1998); (3) Subjective assessments of quality of the Brigade HQ’s orders and reports, and (4) verification that the Brigade HQ followed it’s Standard Operating Procedure. Fifty-four staff members of an Armoured Brigade HQ volunteered as participants. In the study, the HQ was challenged with a peace support / peace keeping operation exercise.The overall result regarding the CTEF and quality measurements on orders and reports indicate that the HQ worked well during the entire exercise and that the SOP and Battle Rhythm worked rather well. However, through the CTEF, four problem areas were identified. These areas regarded (1) the level of uncertainty in the mission, (2) the high complexity of the task, (3) the perceived instability of the objectives that were supposed to be attained in the mission environment, and (4) a high level of workload in some staff sections. Three of these areas are not under the control of the Brigade HQ (high level of uncertainty, high task complexity and unstable objectives of the operation). However, the fourth area, workload, could be influenced. Some staff sections seem to be undermanned in the current organization and that problem needs to be handled, by increasing some staff sections or by moving some duties to other sections.
11.	Andersson, Jan, et al. (författare) Oxygen saturation and cognitive performance. 2002 Ingår i: Psychopharmacology. - : Springer Science and Business Media LLC. - 0033-3158 .- 1432-2072. ; 162:2, s. 119-128 Tidskriftsartikel (refereegranskat)abstract The purpose of the experiments was to investigate how inhalation of 100% oxygen affected cognitive performance. A test battery was developed that was designed to capture different aspects of cognitive processes, i.e., perception, attention, working memory, long-term memory and prospective memory. All tests were verbally based, thus reducing cognitive spatial processes to a minimum. In experiment 1, 48 participants volunteered in a complete factorial within-participant design. Two different conditions for type of gas were used, inhalation of 100% oxygen and inhalation of breathing air (approximately 21% oxygen balanced with nitrogen). The inhalation was performed during the 1 min prior to starting each separate test. The instructions for each test were given during the inhalation period. All participants inhaled oxygen or breathing air through a Swedish military pilot mask. Physiological (heartbeats per minute and blood oxygen saturation level) reactions were recorded continuously throughout the session. Participants also completed a mood-state questionnaire before and after the test battery. The results revealed that cognitive performance were not affected by inhalation. Hence, this experiment does not replicate previous findings that suggest that inhalation of 100% oxygen could increase cognitive performance. Another experiment was performed to control for methodological issues. Experiment 2 revealed exactly the same pattern, i.e., inhalation of oxygen did not affect cognitive functioning.
12.	Berggren, Peter, 1971- (författare) Assessing Shared Strategic Understanding 2016 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract This thesis describes the development of an instrument for assessing shared understanding in teams. The purpose was to develop an instrument that would be usable, understandable, objective, flexible and self-explanatory. Teams working in naturalistic settings are expected to have a shared understanding concerning common goals and how to achieve these. The problem investigated in this thesis is that current techniques and instruments for assessing shared understanding in teams generally suffer from one or more of the following drawbacks, namely that they are expensive, difficult to use, time-consuming, requiring expertise, and are often based on subjective perceptions. Departing from existing theory in team cognition techniques and theories, the research questions posed in this thesis are: 1) How can shared understanding be measured without the disadvantages of existing methods? 2) How can shared understanding be assessed without the bias of self-ratings and/or assessments by experts/observers? 3) Can team performance be better understood by the outcomes of an instrument that measures shared understanding?These research questions are answered through six studies that are presented in this thesis. Over the six studies an instrument was iterated and subsequently developed, called the “shared priorities instrument”. When using this instrument, team members are instructed to generate items and rank these in order of importance. By comparing these rank orders from different participants, a team measure of shared understanding can be calculated. The advantages of this instrument compared to earlier measures are that it is less expensive, easier to use, less time-consuming, does not require subject matter expertise, and that the instrument is distanced from subjective perceptions. Furthermore, the final study provides results where outcomes from the shared priorities instrument correlate with performance, supporting earlier research connecting shared understanding in teams with team performance. A structural equation model, a result of the final study, shows that the instrument is both valid and reliable.
13.	Berggren, Peter, 1971-, et al. (författare) Assessing the quality of Shared Priorities in teams using content analysis in a microworld experiment 2017 Ingår i: Theoretical Issues in Ergonomics Science. - : Taylor & Francis. - 1463-922X .- 1464-536X. ; 18:2, s. 128-146 Tidskriftsartikel (refereegranskat)abstract Objective, easy to use, and easy to comprehend assessment methods for measuring shared understanding in teams are hard to find. This paper describes an experiment where a measure called Shared Priorities, which is based on ranking of self-generated strategic items, is assessed. Trained teams were compared to non-trained teams in a dynamic problem-solving task. The maturity of the participating teams was also assessed using a content analysis measure. The Shared Priorities measure was used alongside other well-documented measures of team awareness based on self-rating. Results show that the Shared Priorities measure correlates with task performance and could also distinguish between trained and non-trained teams. However, the Shared Priorities measure did not correlate with the other team measures (cf. CARS – Crew Awareness Rating Scale – and DATMA – Distributed Assessment of Team Mutual Awareness), suggesting that it captures a different quality of teamwork than the self-rating measures. Further, the Shared Priorities measure was found to be easily administered.
14.	Berggren, Peter, 1971-, et al. (författare) Battlefield trauma care 2018 Ingår i: Proceedings of the Human Factors and Ergonomics Society 62nd Annual Meeting. - : Sage Publications. ; , s. 634-638 Konferensbidrag (refereegranskat)abstract Introduction: Rapid and structured medical care is important to increase wounded patients’ chances of survival in modern warfare. This requires a functioning medical chain. Aim: The aim of this study was to expand the knowledge of how the battlefield trauma care affects patient outcome in situations with a large number of casualties in the Swedish armed forces. Methods: An empirical study with a convergent parallel mixed methods design, which included observations and semi-structured interviews. Results: The results show that the trauma care performed at Role 1-units functioned well. The most prominent issue discovered was deficiency in transportation resources for medical evacuation throughout the entire medical chain. Conclusion: Despite that the trauma care performed at Role 1-units functions well, casualties are at risk for preventable complications or death. Improved transportation logistics are required to improve the medical capabilities of the Swedish armed forces.
15.	Berggren, Peter, 1971-, et al. (författare) Decision support systems 2008 Ingår i: NATO RESEARCH&TECHNOLOGY ORGANISATION HFM-142 SYMPOSIUM. - 9789283701736 Konferensbidrag (refereegranskat)
16.	Berggren, Peter, 1971-, et al. (författare) Developing an instrument for measuring shared understanding 2010 Ingår i: Proceedings of the 7th International ISCRAM Conference. Konferensbidrag (refereegranskat)abstract The paper discusses the need for an easy-to-use, easy-to-administer measure that can capture shared understanding in a team of professionals working together towards a successful performance. In the paper the development of such a measure is described using two empirical studies. Command-and-Control tasks are complex and often dynamic, and a way of capturing the degree of which a team of individuals have a common understanding of priorities in such a task is imperative.Two studies are presented. In the first study students participated in a microworld experiment where they tried to rank order pre-determined factors in order to measure shared understanding. In the second study officers from the Swedish Armed Forces participated in an exercise where they rank ordered self-generated factors.
17.	Berggren, Peter, 1971-, et al. (författare) Shared priorities as a measure of shared understanding 2009 Ingår i: Proceedings of the Europe Chapter Human Factors and Ergonomics Society (HFES) conference 2009. Konferensbidrag (refereegranskat)
18.	Berggren, Peter, 1971-, et al. (författare) Staff care in humanitarian interventions 2018 Ingår i: 11th European Public Health Conference Winds of change. Konferensbidrag (refereegranskat)abstract In situations requiring humanitarian interventions the contexts are demanding with hard environments. Humanitarian workers are exposed to conflict, poverty, famine or natural disasters, together with witnessing personal tragedies. This creates a demanding work context, challenging the mental health, and 30% of aid workers report symptoms of PTSD after field assignments (McDonald, 2015). Several stressors affecting also originate from organizational factors (Lopez Cardozo et al. 2012), but few studies describe how humanitarian actors work to improve staff care practices.
19.	Berggren, Peter, 1971-, et al. (författare) Statistical modelling of team training in a microworld study 2014 Ingår i: Proceedings of the Human Factors and Ergonomics Society Annual Meeting. - : Sage Publications. - 2169-5067. ; , s. 894-898 Konferensbidrag (refereegranskat)abstract A command and control environment is a dynamic and complex setting with complicated technical systems where teams of operators interact to reach shared goals. This study presents an experiment in which we, by means of Structural Equation Modeling (SEM), explain the relations between basic concepts of command and control environments: mental workload, frustration, situational awareness, and performance. This paper reports a LISREL analysis of the Baroutsi, Berggren, Nählinder, & Johansson (2013) data. From that data, a new latent variable “Frustration” emerges, which now can be included in the model.
20.	Berggren, Peter, 1971- (författare) The advance of a valid and reliable tool for assessing shared understanding 2014 Ingår i: Assessing command and control effectiveness. - Farnham : Ashgate. - 9781472436948 ; , s. 127-139 Bokkapitel (övrigt vetenskapligt/konstnärligt)
21.	Berggren, Peter, 1971-, et al. (författare) The importance of using the designated duty officers when assessing the medical response organization 2017 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract BackgroundAn important aspect of disaster medicine is to be proactive and respond quickly when disaster strikes. In Sweden, the role responsible for swift medical response on the regional level is the designated duty officer.MethodsA large exercise to assess national medical response ability was conducted. Seven medical regional staffs (a total of 93 individuals participated as tested participants) were involved in handling a large train accident scenario. The exercise was run for 5 hours, where the different regional staffs were located at their regular command posts. The exercise was organized using Emergo Train Systems.ResultsSeveral capabilities were identified during the exercise as important for the organization to maintain the ability to handle a similar event: documentation and operational picture, communication and terminology, command of resources, strategy for distribution of resources, national co-ordination, and exercise development.The designated duty officers were central to the exercise in several aspects: 1) in developing and verifying a realistic scenario and preparing background information, 2) as participants in the exercise, 3) assessors of the staffs’ behaviors, and 4) as domain experts when interpreting the exercise outcome.ConclusionsUsing subject matter experts is central to many research domains. However, the more complex a situation is the larger the demand of expertise is. The technical platform allows for coordinating complex exercises, whereas the subject matter expert in terms of the designated duty officer is required to guarantee validity and reliability in these large-scale exercises.Key messages:Running complex scenarios to train and test abilities requires subject matter experts in both planning, preparation, implementation, and assessment.Sophisticated simulator and training platforms, such as Emergo Train Systems, facilitates while the designated duty officers are necessary to guarantee validity and reliability in the exercise.
22.	Berggren, Peter, 1971-, et al. (författare) The shared priorities measure as a way of assessing team strategic awareness : a bridge between self-assessment and the deep blue sea of field recordings 2014 Ingår i: Proceedings of the 2014 European Conference on Cognitive Ergonomics. - New York, NY, USA : ACM Digital Library. - 9781450328746 ; , s. 13- Konferensbidrag (refereegranskat)abstract Objective, easy to use, easy to comprehend, high face-validity assessment methods for measuring shared awareness in teams are hard to find. This paper describes an experiment where a new measure called Shared Priorities, which is based on ranking of self-generated strategic items, is tested. Trained teams were compared to non-trained teams in a dynamic problem-solving task in terms of performance and shared awareness. The shared priorities measure was used alongside other, well-documented measures of team awareness based on self-rating. The results show that the Shared Priorities measure correlate with performance and could also distinguish between trained and non-trained teams. However, the Shared Priorities measure did not correlate with the other team measures, suggesting that it captures a different quality of team work than the self-rating measures. Further, the shared priorities measure was found to be easily administered and gained a high user acceptance.
23.	Björn, Åke, et al. (författare) From the Swedish Medevac Programme to the International Medical Program 2020 Ingår i: Partnerships for sustainable health care systems. - Linköping : Region Östergötland. - 9789151953120 - 9789151953137 ; , s. 14-24 Bokkapitel (övrigt vetenskapligt/konstnärligt)
24.	Björnqvist, Anton, 1995-, et al. (författare) An Analysis of a Swedish Medical Command and Control System’s Situation Reports from the COVID-19 Pandemic 2022 Ingår i: ISCRAM 2022 Conference Proceedings – 19th International Conference on Information Systems for Crisis Response and Management. - 9788284270999 ; , s. 334-348 Konferensbidrag (refereegranskat)abstract This paper presents an analysis of situation reports used and created by a crisis management team within the Swedish healthcare sector during the early phase of the COVID-19 pandemic. The analysis was conducted through a deductive content analysis, where categories were identified based on the concepts of common operational pictures, sensemaking, and situation awareness. In the analysis, support for all identified categories was found. Based on the analysis and the concepts, future recommendations regarding what type of information that ought to be included in situation reports were created. These recommendations include, amongst others, the categories of consequences, how it is perceived by the public, objectives, status and implications of information, future scenarios, actions, resources, and work procedures.
25.	Björnqvist, Anton, 1995-, et al. (författare) Identifying Teamwork Processes in a Medical Command and Control Team During the COVID-19 Pandemic 2023 Ingår i: Proceedings of the 20th International ISCRAM Conference. - Omaha, USA. ; , s. 711-720 Konferensbidrag (refereegranskat)abstract This paper presents an ethnographic study consisting of non-participatory observations of a Swedish regional medical command and control team during their crisis response to the COVID-19 pandemic. The field-notes from the observations were analyzed using a deductive content analysis with categories representing teamwork processes. The content analysis showed that the studied regional medical command and control team was engaged in all but one of the predefined teamwork processes. Furthermore, the content analysis also added to the understanding of the regional medical command and control teamÂ’s work procedures by emphasizing how the team was engaged in the different processes. Lastly, the content analysis also made it possible to identify potential developmental needs of the studied regional medical command and control team.
26.	Carlsson, Henrik, et al. (författare) Implementing treatment guidelines for ambulance services in a low- and middle income setting 2019 Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. Konferensbidrag (refereegranskat)abstract BackgroundThe use of clinical practice guidelines in clinical and organizational decision-making improves the care of patients and patient safety. Guidelines make healthcare consistent and efficient. In many low- and middle income countries healthcare workers depend on guidelines developed in higher income countries. For these to be useful and accepted they need to be adapted to the local setting. The aim of the study was to implement pre-hospital treatment guidelines into an organization that was not currently using guidelines. The study was partnership between a Swedish pre-hospital training organization and local ambulance service organizations in Kosovo.MethodsAn iterative process of implementing the guidelines was used:Identify guidelines appropriate for the local organization.In sets of five, have the guidelines translated into Albanian.Adapt the guidelines to the local conditions and context.Approval of guidelines by an expert group.Begin using the guidelines within the target organization.ResultsThe first set of five guidelines was translated, approved, and implemented into the organizations. To improve acceptance, both practitioners and decision-makers were involved in the process. Seven workshops were held, with a total of 104 participants. In follow-up discussions participants said they accepted the guidelines and that they would be useful in their daily work.ConclusionsIt is important to evaluate to what extent the guidelines have been accepted, understood, and used. The success and acceptance is due to the flexible procedure managing the full implementation process. Adapting guidelines to fit with local needs and requirements using local experts made the guidelines accessible and useful. The workshop discussions established justification and approval.Key messagesInvolve local experts in contextualising guidelines to increase acceptance from the start.Support building a robust local implementation organization to assist and administer change.
27.	Gonzalez, Jose, et al. (författare) Elicitation, analysis and mitigation of systemic pandemic risks 2021 Ingår i: Proceedings of the 18th ISCRAM Conference. - 9781949373615 ; , s. 581-596 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract The Covid-19 pandemic has disrupted the health care system and affected all sectors of society, including criticalinfrastructures. In turn, the impact on society’s infrastructures has impacted back on the health care sector. Theseinteractions have created a system of associated risks and outcomes, where the outcomes of risks are risksthemselves and where the resulting consequences are complex vicious cycles. Traditional risks assessmentmethods cannot cope with interdependent risks.This paper describes a novel risk systemicity approach to elicit and mitigate the systemic risks of a majorpandemic. The approach employed the internet-based software strategyfinder™ in workshops to elicit relevantrisk information from sixteen appropriately selected experts from the health care sector and major sectors impactedby and impacting back on the health care sector. The risk information was processed with powerful analyticaltools of strategyfinder to allow the experts to prioritise portfolios of strategies attacking the vicious cycles.
28.	Hindorf, Marie, et al. (författare) Workload of Swedish Special Forces Operators Experienced During Stressful Simulation Training: A Pilot Study 2022 Ingår i: Journal of Special Operations Medicine. - : Breakaway Media, LLC. - 1553-9768. ; 22:3, s. 42-48 Tidskriftsartikel (refereegranskat)abstract Introduction: Stress week was included during training of Special Forces (SF) Operators in Sweden to test their ability and limits for handling stress in different unknown situations and environments at a military training facility in Sweden. The aim of the study was to examine the effects of stress and workload experienced in various tasks during firefighting and military medicine simulation training.Methods: This pilot study was performed during the second day of stress week. The National Aeronautics and Space Administration Task Load Index (NASA-TLX) is a validated, subjective, and multidimensional assessment tool for rating perceived workload with six subscales: mental demand, physical demand, temporal demand, performance, effort, and frustration. These subscales were used as an indicator of stress experienced. The different tasks were assessed by the SF Operators by rating the NASA-TLX subscales for each task, which were then analyzed and compared using ANOVA.Results: There was a significant difference between the two simulation exercises assessed by the participants and instructors, and both groups considered firefighting to be more demanding than medical. The participants perceived the mental and physical demands as more demanding in the firefighting exercises, as well as for the level of frustration and effort. However, no differences regarding performance or temporal demands between the simulation exercises were found.Conclusion: The principle "train as you fight" implies difficult and demanding situations. When exposing Swedish SF Operators to challenging situations, assessment of perceived stress and performance are possible.
29.	Hodza-Beganovic, Ruhija, 1968-, et al. (författare) Survey-based experiential learning as a new approach to strengthening non-technical skills in LMIC health care settings 2021 Ingår i: BMC Medical Education. - : BioMed Central. - 1472-6920. ; 21:1 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: This study outlines key aspects of professional development among health professionals in low- and middle-income countries (LMIC). LMICs need support in developing their continuing medical education, and non-technical skills (NTS) that have been neglected in this respect. Given the nature of NTS, educational methods should be used experientially. This study aims to explore an interactive educational approach to increase NTS among health care professionals in an LMIC setting.METHODS: A design-based research approach was applied to develop an educational method. Key NTS concepts were identified, which directed the selection of research-based surveys. A series of workshops was designed in which a survey-based experiential approach was developed. The educational process followed a pattern of individual reflection, small group discussion and relating the concepts to the local practice in a wider group.RESULTS: An approach to increase NTS in LMIC settings emerged in iterative development through conducting workshops with health care teams in the Balkans. The topics could be grouped into individual, team, and organisational dimensions. The approach can be described as survey-based experiential learning involving steps in recurring interaction with participants. The steps include identifying concepts in individual, team and organization dimensions and contextualising them using experiential learning on the individual and group levels.CONCLUSION: An overarching approach has been developed that addresses NTS in an LMIC setting. The survey-based experiential learning approach can be beneficial for raising professional awareness and the development of sustainable healthcare settings in LMICs.
30.	Hodza-Beganovic, Ruhija, et al. (författare) The international projects 2020 Ingår i: Partnerships for sustainable health care systems. - Linköping : Region Östergötland. - 9789151953120 - 9789151953137 ; , s. 31-44 Bokkapitel (övrigt vetenskapligt/konstnärligt)
31.	Höglund, Fredrik, 1985-, et al. (författare) Using Shared Priorities to Measure Shared Situation Awareness 2010 Ingår i: Proceedings of ISCRAM 2010. ; , s. 1-5 Konferensbidrag (refereegranskat)abstract Shared situation awareness is hard to measure, especially in operative environments such as crisis management. In this paper the purpose is to develop a novel method to measure to what extent the team has shared situation awareness that can be used in operations. 20 two person teams participated in a study where a dynamic and evolving tactical decision-making task was solved. Shared situation awareness, shared priorities, and team performance were assessed. The results show that the shared priorities measure in this study did not relate to shared situation awareness. Several methodological concerns was identified which could have affected the results. The measure did relate to subjective ratings of cooperation which is very interesting and it is suggested that the measure captured aspects of teamwork. The shared priorities measure was easy to employ, required little preparation, and is a promising addition to team research
32.	Johansson, Björn, 1973-, et al. (författare) Empowering resilient crisis response training through purposefully designed boundary objects in a simulation-gaming exercise approach : Supporting ad-hoc team interaction 2021 Ingår i: ECCE 2021. - New York, NY : Association for Computing Machinery (ACM). - 9781450387576 ; , s. 1-6 Konferensbidrag (refereegranskat)abstract This paper reports on experiences of creating resilience-empowering simulation-gaming exercises concerning disruptions in the payment system. The aim of the exercises was to utilize gaming-simulation as a training environment where teams of practitioners can learn to develop in-depth understanding of systemic interaction (i.e., cascading effects of disruptions) and learn how to develop collaborative resilience across many different critical infrastructures. Interaction between different stakeholders in the payment system, such as business owners, banks, municipality crisis managers are considered as the foundation for building collaborative resilience. Designing the exercises in such a way that they encourage and support such interactions are therefore seen as a primary design goal. This paper describes lessons learned from the process of conducting the 17 exercises in terms of creating a well-balance simulation and an immersive experience.
33.	Johansson, Björn, Professor, PhD, 1973-, et al. (författare) Understanding the challenge of the energy crisis : Tackling system complexity with megagaming 2023 Ingår i: ECCE '23: Proceedings of the European Conference on Cognitive Ergonomics 2023. - New York, NY United States : ACM Digital Library. - 9798400708756 Konferensbidrag (refereegranskat)abstract Climate change is tightly coupled to the usage of energy in differentforms. Creating and using sustainable energy solutions is increasinglybeing recognized as the greatest challenge of our time. Theenergy crisis concerns everyone who consumes energy or servicesthat rely on energy to be performed, in practice almost everythingwe buy. However, the temporal and psychological distance to climatechange has led to a situation where the consequences of ourenergy usage often is considered a future problem or “someoneelse’s” problem. Current methods to increase awareness and understandingof climate change and the need to create sustainableenergy solutions are usually based on simulation or negotiationgames. Methods similar to crisis management exercises are uncommon.In this paper, we propose to use Megagames, large scale socialgames, as a method for increasing the awareness of the challengesrelated to creating sustainable energy solutions. Examples fromtwo Megagame test runs are provided and discussed.
34.	Jonson, Carl-Oscar, Docent, 1978-, et al. (författare) Identifying Core Competencies for Medical Command and Control Teams Managing Covid-19 2023 Ingår i: 2023 WADEM congress on disaster and emergency medicine. ; , s. s216-s216 Konferensbidrag (refereegranskat)
35.	Lampi, Maria, 1967-, et al. (författare) Potential benefits of triage for the trauma patient in a Kenyan emergency department 2018 Ingår i: BMC Emergency Medicine. - : Springer. - 1471-227X. ; 18 Tidskriftsartikel (refereegranskat)abstract BackgroundImproved trauma management can reduce the time between injury and medical interventions, thus decreasing morbidity and mortality. Triage at the emergency department is essential to ensure prioritization and timely assessment of injured patients. The aim of the present study was to investigate how a lack of formal triage system impacts timely intervention and mortality in a sub-Saharan referral hospital. Further, the study attempts to assess potential benefits of triage towards efficient management of trauma patients in one middle income country.MethodsA prospective descriptive study was conducted. Adult trauma patients admitted to the emergency department during an 8-month period at Moi Teaching and Referral Hospital in Eldoret, Kenya, were included. Mode of arrival and vital parameters were registered. Variables included in the analysis were Injury Severity Score, time before physician’s assessment, length of hospital stay, and mortality. The patients were retrospectively categorized according to the Rapid Emergency Triage and Treatment System (RETTS) from patient records.ResultsA total of 571 patients were analyzed, with a mean Injury Severity Score of 12.2 (SD 7.7) with a mean length of stay of 11.6 (SD 18.3) days. The mortality rate was 1.8%. The results obtained in this study illustrate that trauma patients admitted to the emergency department at Eldoret are not assessed in a timely fashion, and the time frame recommendations postulated by RETTS are not adhered to. Assessment of patients according to the triage algorithm used revealed a significantly higher average Injury Severity Score in the red category than in the other color categories.ConclusionThe results from this study clearly illustrate a lack of correct prioritization of patients in relation to the need for timely assessment. This is further demonstrated by the retrospective triage classification of patients, which identified patients with high ISS as in urgent need of care. Since no significant difference in to time to assessment regardless of injury severity was observed, the need for a well-functioning triage system is apparent.
36.	Lindhagen, Alva, et al. (författare) Supporting Instructors in Conducting Exercises 2023 Ingår i: Proceedings of the 20th International ISCRAM Conference. - Omaha, USA. ; , s. 721-731 Konferensbidrag (refereegranskat)abstract Planning, designing, facilitating, and evaluating are central activities for instructors when conducting exercises.When conducting these activities, instructors usually rely on past experiences since structured educations orguides for instructors do not exist. It is therefore evident that there is a need for such educations or guides.In this study, the contents of a guide for instructors are proposed. The contents are based on seven semi-structuredinterviews with novel and experienced instructors, where they were asked to map their procedures for conductingexercises through a journey map. The interviews resulted in material which was transcribed and analysed using athematic analysis. The thematic analysis emphasized five themes to consider when acting as an instructor, namelyroles, realism, defining purpose and goals, learning, and planning and acting.The results from the interviews, combined with past literature, resulted in proposed contents for an instructor’sguide which is currently being developed.
37.	Linhagen, Alva, et al. (författare) A Meta-evaluation of Swedish Evaluations of COVID-19 Pandemic Management 2022 Ingår i: ISCRAM 2022 Conference Proceedings – 19th International Conference on Information Systems for Crisis Response and Management. - 9788284270999 ; , s. 349-361 Konferensbidrag (refereegranskat)abstract The COVID-19 pandemic has had a global impact om society. Different countries and organizations have chosen different approaches to manage this crisis. This paper aims to describes how public Swedish actors (county administrative boards, municipalities, and regional councils) evaluated their management of the COVID-19 pandemic. Also, the paper aims to suggest improvements for crisis management strategies. Applying a meta-evaluation approach to open reports from the public organizations means collecting evaluation reports, determining if they fit the inclusion criteria, and if so, include them in the analysis. Included reports were categorized and given points indicating different types of merits. In addition, a thematic analysis of conclusions was conducted. 110 evaluation reports from 98 different organizations are included in the analysis. The importance of evaluating, having a structure for data collection, analysis, and reporting is reflected in the quality of the reports. Four identified themes offer an understanding of areas in need for development among Swedish regional councils, municipalities, and county administrative boards.
38.	Partnerships for sustainable health care systems : the International Medical Program approach 2020 Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract The International Medical Program (IMP) is unique in Region Östergötland by its contribution to better health care both locally and globally. The pro-gramme generates opportunities for individuals to gain new experience, de-velop as professionals, and at the same time, support the health care system in low- and middle-income countries. An international knowledge-sharing environment for health care contributes to an increased standard of global health and Region Östergötland is proud to be a part of that.Great value is added when Swedish health care professionals establish con-tact with other health care systems and cultures. It allows them to contribute with their knowledge and treat diseases that are uncommon in Sweden, often under conditions that can differ significantly from their usual working con-ditions.Another advantage is the gain in recruitment as a result of the stimulat-ing and educational experience for employees. Curious and knowledgeable employees find great satisfaction in the exchanges and the experiences they receive. Cooperation with our partner countries is not primarily about aid. It is a mutual exchange that generates added value for all parties.
39.	Pettersson, Jenny, et al. (författare) Functional quality indicators for assessing health care initial response to societal disturbances for education 2017 Ingår i: Prehospital and Disaster Medicine. - : Cambridge University Press. - 1049-023X .- 1945-1938. ; 32:Suppl. 1, s. 66-66 Tidskriftsartikel (refereegranskat)abstract Study/Objective: The purpose of this paper is to describe the procedure of identifying and developing quality indicators during educational activities. In addition, the steps taken to assure the validity and reliability of the indicators are presented.Background: In Sweden a national effort has been made to structure the work processes for crisis preparedness. That is, the process for regional health point of contact and the designated duty officer, has been modified in an attempt to support a shared view regarding collaboration and command during societal disturbances. The effort consists of education and training of designated duty officers, while also developing quality indicators for assessing the work process before the designated duty officer declare a major incident.Methods: The work of identifying and developing the quality indicators was carried out in focus groups with domain experts.Results: Initially the work processes of the designated duty officer were thoroughly analyzed and described. The work process was separated into three distinct phases. Focus was on the first two phases. These process steps, have thereafter been connected to concrete behaviors or products that are assessed. The quality indicators are directed towards two levels; if a process step has been carried out within the time-frame, and also the performance quality of an indicator. For example, has an operational picture been established within three minutes of the alarm call? If so, what was the quality of the decision based on, the event description, the consequence description, or the measures description?Conclusion: The aim of the quality indicators is to make sure that educational activities that are performed does in fact result in actual, and measurable impact. This approach confirms to what extent the activities are successful.
40.	Svensson, Erland, 1945-, et al. (författare) Empirical studies of command and control centres at the Swedish Air Force 2014 Ingår i: Assessing command and control effectiveness. - Farnham : Ashgate. - 9781472436948 ; , s. 103-126 Bokkapitel (övrigt vetenskapligt/konstnärligt)
41.	van Laere, Joeri, et al. (författare) Challenges for critical infrastructure resilience : Cascading effects of payment system disruptions 2017 Ingår i: Proceedings of the 14th ISCRAM Conference. - Linköping : Linköping university. ; , s. 281-292, s. 281-292, s. 281-292 Konferensbidrag (refereegranskat)abstract Critical infrastructures become more and more entangled and rely extensively on information technology. A deeper insight into the relationships between critical infrastructures enables the actors involved to more quickly understand the severity of information technology disruptions and to identify robust cross-functional mitigating actions. This study illustrates how and why disruptions in the payment system in Sweden could create cascading effects in other critical infrastructures with potentially severe consequences for many citizens, government institutions and companies. Data from document studies, interviews and workshops with field experts reveal seven challenges for collective cross-functional critical infrastructure resilience that need to be dealt with: 1) Shortage of food, fuel, cash, medicine; 2) Limited capacity of alternative payment solutions; 3) Cities are more vulnerable than the countryside; 4) Economically vulnerable groups in society are more severely affected; 5) Trust maintenance needs; 6) Crisis communication needs; 7) Fragmentation of responsibility for critical infrastructures across many actors.

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