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Background <p>Hospitals increasingly operate at the limits of their structural and personnel capacities. During mass casualty incidents (MCI) they must establish leadership and expand treatment capacities within a short period of time. Traditional hospital emergency and contingency plans (HECP) provide an organizational framework but recurrent weaknesses persist in the rapid establishment of clear roles and communication pathways.</p> Objective <p>The aim of this work is to develop a&#xa0;strategy-oriented, rapidly deployable and self-organizing system that enables immediate operational capability and scalable capacity in MCIs, using a&#xa0;FwDV-100-compliant internal leadership organigram and position-specific personnel action cards. The Fire Service Regulation 100 (FwDV 100) describes the cross-organizational leadership and decision-making model for managing emergency and disaster situations in Germany.</p> Methods <p>Internal decision-making and communication pathways of a&#xa0;university hospital were systematically aligned with disaster management structures according to the FwDV 100 and published MCI concepts. Based on this, a&#xa0;structured leadership organigram was designed. Complementary role-based action cards were created to specify routine function, incident role, reporting hierarchy, 360° communication interfaces and prioritized tasks. A&#xa0;process plan for qualification-based personnel assignment via assembly point, registration and shift planning completed the system.</p> Results <p>The model developed links a&#xa0;hospital incident command with staff sections and treatment-oriented operational units (emergency department, operating rooms, intensive care and general wards). A&#xa0;redundant digital enhanced cordless telecommunications (DECT)-based communication concept secures accessibility in the acute phase. The action cards enable a&#xa0;low-threshold, rapid and self-organizing formation of roles and capacity, markedly accelerating the transition from routine to incident operations.</p> Conclusion <p>Combining a&#xa0;visible leadership organigram with a&#xa0;structured set of personnel action cards represents an innovative tool for rapidly establishing leadership and operational readiness in MCIs. The approach shortens the initial chaos phase, improves personnel allocation and strengthens hospital resilience. Prospective exercises and interventional studies should further evaluate the effects on process and outcome quality.</p>

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Strategieorientierter Ereignisbetrieb im Krankenhaus: schneller, selbstorganisierender Führungs- und Kapazitätsaufbau bei MAN-Lagen

  • 期刊论文

  • 发表日期：

    2026年4月29日

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  • Alexander Althammer,
  • Tobias Neidel,
  • Felix Girrbach,
  • Stephanie Müller,
  • Fabian Hensel,
  • Marc-Michael Ventzke,
  • Axel R. Heller

摘要

Background

Hospitals increasingly operate at the limits of their structural and personnel capacities. During mass casualty incidents (MCI) they must establish leadership and expand treatment capacities within a short period of time. Traditional hospital emergency and contingency plans (HECP) provide an organizational framework but recurrent weaknesses persist in the rapid establishment of clear roles and communication pathways.

Objective

The aim of this work is to develop a strategy-oriented, rapidly deployable and self-organizing system that enables immediate operational capability and scalable capacity in MCIs, using a FwDV-100-compliant internal leadership organigram and position-specific personnel action cards. The Fire Service Regulation 100 (FwDV 100) describes the cross-organizational leadership and decision-making model for managing emergency and disaster situations in Germany.

Methods

Internal decision-making and communication pathways of a university hospital were systematically aligned with disaster management structures according to the FwDV 100 and published MCI concepts. Based on this, a structured leadership organigram was designed. Complementary role-based action cards were created to specify routine function, incident role, reporting hierarchy, 360° communication interfaces and prioritized tasks. A process plan for qualification-based personnel assignment via assembly point, registration and shift planning completed the system.

Results

The model developed links a hospital incident command with staff sections and treatment-oriented operational units (emergency department, operating rooms, intensive care and general wards). A redundant digital enhanced cordless telecommunications (DECT)-based communication concept secures accessibility in the acute phase. The action cards enable a low-threshold, rapid and self-organizing formation of roles and capacity, markedly accelerating the transition from routine to incident operations.

Conclusion

Combining a visible leadership organigram with a structured set of personnel action cards represents an innovative tool for rapidly establishing leadership and operational readiness in MCIs. The approach shortens the initial chaos phase, improves personnel allocation and strengthens hospital resilience. Prospective exercises and interventional studies should further evaluate the effects on process and outcome quality.