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Cohort studyBMJ quality & safety · 2026

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

Nitay Raisch, Gal Pachys, Baruch Berzon … Daniel Trotzky

Emergency MedicineCohort study

Unscheduled mass casualty simulations are associated with longer emergency department door-to-triage times.

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

Nitay Raisch et al. · BMJ quality & safety · 2026

Background

In situ simulation (ISS) has seen broad use in academic emergency medicine (EM).

Methods

We conducted a retrospective study of patients presenting to an adult tertiary academic emergency department during scheduled and unscheduled ISS MCI drills.

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Results

min

Patients during unscheduled drills had an average door-to-triage time of 29.0 minutes.

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Conclusion · 1 of 2

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 MCI ISS education drill.

Conclusion · 2 of 2

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

Post

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

Unscheduled mass casualty simulations are associated with longer emergency department door-to-triage times.

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