Association between mass casualty in-situ simulation format with ongoing operational and patient care metrics in an adult emergency department: a retrospective cohort study.

In this study, there was a significant association between increased door to triage time and lower acuity triage score designation for patients treated during an ongoing mass casualty incident ISS education drill.

Secondary analysis demonstrated that these findings were only observed during unscheduled simulations, suggesting that the effects may be modifiable.