"The Alarm Was Grass Fire": Emergency Services' Perceptions of Chemical Incident Mobilization in Sweden - a Focus Group Study

Abstract Background: In chemical incidents, infrequent but potentially disastrous, the World Health Organization calls for inter-organizational coordination of actors involved. Multi-organizational studies of chemical response capacities are scarce and testable hypotheses are largely lacking. We aimed to describe chemical incident experiences and perceptions of Swedish fire and rescue services, emergency medical services, police services, and emergency dispatch services personnel.Methods: Eight emergency service organizations in two distinct and dissimilar regions in Sweden participated in one organization-specific focus group interview each. The total number of respondents was 25 (7 females and 18 males). A qualitative inductive content analysis was performed.Results: Three types of information processing were derived as emerging during acute-phase chemical incident mobilization: Unspecified (a caller communicating with an emergency medical dispatcher), specified (each emergency service obtaining organization-specific expert information), and aligned (continually updated information from the scene condensed and disseminated back to all parties at the scene). Improvable shortcomings were identified, e.g. randomness (unspecified information processing), inter-organizational reticence (specified information processing), and downprioritizing central information transmission while saving lives (aligned information processing).Conclusions: It is inferred that sensitivity, specificity and time-effectiveness in the flow of information may be improved by automation, public education, revised dispatcher education, and use of technical resources in the field. It is further inferred that inter-organizational coordination may be improved by inter-organizational training and revised standard operating procedures. We propose systematic assessments of chemical incident probabilities in Sweden.