Communication and coordination during mass casualty incidents: experiences of staff from a district-level university hospital in Ghana
4 affiliations
- 1School of Nursing and Midwifery, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
- 2KNUST Hospital, Kumasi, Ghana
- 3KNUST, Kumasi, Ghana
- 4University of Washington, Seattle, USA
Abstract
Background: Mass casualty incidents (MCI) are of significant public health concern. Most health facilities in developing countries often struggle to be fully prepared for MCI. MCI preparedness among other factors involves important processes like communication among staff on the emergency response team, patients, and the public; and the coordination of emergency care services delivery. In this study, we explored staff experiences at a district-level university hospital in Ghana regarding communication and coordination during MCI.
Methods: We conducted an exploratory descriptive qualitative study at a University Hospital between August 2024 and February 2025. We collected data through in-depth interviews. We used a purposive sample of 15 hospital staff. The interview sessions were audio-recorded and transcribed verbatim. We analyzed the data using Braun and Clarke’s (2006) thematic analysis and reflexive thematic analysis approach (2021).
Results: A total of 15 participants (doctors, nurses, pharmacists, medical laboratory scientist, and administrative staff) were interviewed. Thematic analysis of the data revealed two major themes (communication and coordination) and six sub-themes. The communication sub-theme encompassed internal and external communication as well as communication challenges. The coordination sub-theme comprised decision-making and leadership structures, human resource mobilization, and teamwork and support roles. Internal communication was mostly done through hospital landlines and mobile phones whereas external communication was achieved through Mutual Aid Agreements with other hospitals. Communication challenges included being unable to reach other wards on the landlines and the feedback received about the unavailability of beds at the external facilities. There was no clear leadership structure, leading to ad hoc decision-making by the senior-most medical officer on duty. However, teamwork within the emergency unit was effective during MCIs management. Human resource mobilization was done through staff redeployments from other wards to the emergency unit during patient surge.
Conclusions: Despite good teamwork and fast mobilization of human resources during MCI, the findings of this study identified gaps in communication networks and absence of designated leadership structures. Implementing standardized communication protocols, clearly defined leadership structures, and improving coordination mechanisms between hospitals may enhance emergency care delivery during MCIs.
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BibTeX
@article{gyamfi2026communication,
title = {{Communication and coordination during mass casualty incidents: experiences of staff from a district-level university hospital in Ghana}},
author = {Adwoa Gyamfi and Akosua Benewaa Antwi and Jacob Tetteh and Victoria Bam and Veronica Millicent Dzomeku and Charles N. Mock and Emmanuel Nakua and Christian Amoah and Osei Kwame Wusu-Ansah and Kwame Adjei Akrasi and Peter Donkor},
journal = {BMC Public Health},
year = {2026},
month = aug,
doi = {10.1186/s12889-026-28828-6},
url = {https://doi.org/10.1186/s12889-026-28828-6},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Communication and coordination during mass casualty incidents: experiences of staff from a district-level university hospital in Ghana
AU - Adwoa Gyamfi
AU - Akosua Benewaa Antwi
AU - Jacob Tetteh
AU - Victoria Bam
AU - Veronica Millicent Dzomeku
AU - Charles N. Mock
AU - Emmanuel Nakua
AU - Christian Amoah
AU - Osei Kwame Wusu-Ansah
AU - Kwame Adjei Akrasi
AU - Peter Donkor
PY - 2026
DA - 2026/08/01
JO - BMC Public Health
DO - 10.1186/s12889-026-28828-6
UR - https://doi.org/10.1186/s12889-026-28828-6
AB - Background: Mass casualty incidents (MCI) are of significant public health concern. Most health facilities in developing countries often struggle to be fully prepared for MCI. MCI preparedness among other factors involves important processes like communication among staff on the emergency response team, patients, and the public; and the coordination of emergency care services delivery. In this study, we explored staff experiences at a district-level university hospital in Ghana regarding communication and coordination during MCI. Methods: We conducted an exploratory descriptive qualitative study at a University Hospital between August 2024 and February 2025. We collected data through in-depth interviews. We used a purposive sample of 15 hospital staff. The interview sessions were audio-recorded and transcribed verbatim. We analyzed the data using Braun and Clarke’s (2006) thematic analysis and reflexive thematic analysis approach (2021). Results: A total of 15 participants (doctors, nurses, pharmacists, medical laboratory scientist, and administrative staff) were interviewed. Thematic analysis of the data revealed two major themes (communication and coordination) and six sub-themes. The communication sub-theme encompassed internal and external communication as well as communication challenges. The coordination sub-theme comprised decision-making and leadership structures, human resource mobilization, and teamwork and support roles. Internal communication was mostly done through hospital landlines and mobile phones whereas external communication was achieved through Mutual Aid Agreements with other hospitals. Communication challenges included being unable to reach other wards on the landlines and the feedback received about the unavailability of beds at the external facilities. There was no clear leadership structure, leading to ad hoc decision-making by the senior-most medical officer on duty. However, teamwork within the emergency unit was effective during MCIs management. Human resource mobilization was done through staff redeployments from other wards to the emergency unit during patient surge. Conclusions: Despite good teamwork and fast mobilization of human resources during MCI, the findings of this study identified gaps in communication networks and absence of designated leadership structures. Implementing standardized communication protocols, clearly defined leadership structures, and improving coordination mechanisms between hospitals may enhance emergency care delivery during MCIs.
SN - 1471-2458
ER -