Burn casualty preparedness: A program evaluation of the Burn Asset Resource Tracking System

Background: After 9/11 and the Rhode Island nightclub fire, the U.S. Department of Health and Human Services (HHS) realized the importance of centralized access to national burn resources in responding to emergencies and disasters. The Burn Asset Resource Tracking System (BARTS) was created in 2005 with the intent of increasing preparedness for a mass casualty event requiring national coordination in the mobilization of assets and resources for a significant number of burn victims. This web-based management system is the first national, comprehensive tracking system of its kind. It requests weekly detailed information on bed availability, surge capacity and staffing capability from 129 burn centers nationwide via a twelve question online survey tool. Implementation: Burn subject matter experts (SMEs) and the American Burn Association (ABA) were consulted during development phases. BARTS was then pilot tested among nine randomly selected U.S. burn centers to identify and strengthen operational weaknesses. Evaluation: An evaluation was conducted one year after system implementation. Evaluation methodology included administering questionnaires to selected burn centers, conducting key informant interviews with SMEs, burn center site visits, convening a stakeholder meeting with the ABA, and analysis of primary data from BARTS and secondary data from HHS Secretary's Operations Center (SOC) reports. Major findings from questionnaires, SME interviews and site visits included: identifying motivations, benefits, and barriers for reporting; operational weaknesses; reporting burn center characteristics and website integrity issues. Major findings from the tracking system and HHS SOC reports included: an increase in overall percentage of burn centers reporting since 2005, variability in interpretation of bed availability questions, and little longitudinal variability in reported surge and staffing capabilities. Conclusions: BARTS provides policy makers with centralized national burn center resource information to assist them in their decision-making processes, and disseminates information across various stakeholders. In the event of a burn related disaster, this system can assist the Federal government in efficiently identifying and allocating scarce resources while supporting secondary triage efforts. Findings from this evaluation can contribute in the development of an electronic, multi-networked situational awareness system under the purview of the Pandemic and All-Hazards Preparedness Act.