REM, CRSEM, NORIA and TrackMi Montérégie: Long-Term Disaster Planning Initiatives in the Montérégie Area (Quebec, Canada)

Summary: As part of its responsibilities for the “Health Mission” in Montérégie (1.5 million inhabitants, 11 000km 2 ), CISSS de la Montérégie-Centre adopted a Code Orange strategy and initiated the REM project in January 2022. In collaboration with regional partners, REM is a continuous improvement project aimed at analyzing major events and their impact on hospitals, as well as identifying performance indicators and optimizing time-dependent patient trajectories during multi-casualty incidents (MCI). REM project led to the creation of the Regional Committee for the Simulation of Major Events in Montérégie (CRSEM) and the implementation of the NORIA Regional Simulation Program. In the Fall 2023, the CRSEM carried out two simulation exercises: NORIA1 (table-top) and NORIA2 (functional). The NORIA2 activity simulated exchanges between various regional partners (911 call center, police, fire department, ambulance services, regional coordination, hospitals) during a fictitious bus accident and demonstrated the added value of a real-time digital casualty traceability tool. To ensure optimal use of a digital MCI tool, it is important to train paramedic teams in its use during routine activities. As a result, in partnership with an EMT technology firm, CISSS de la Montérégie-Centre established the TrackMi Montérégie project (2024). An existing mobile tool designed for the rapid exchange of MCI information was modified to also collect routine prehospital data to optimize clinical trajectories and hospital fluidity. The application supports geolocation of patients en route to the hospital and a secure web-based platform for real-time data analysis. Optimal hospital management depends on its alignment with pre-hospital resources and the timely transfer of validated information. Technology has the potential to improve patient tracking, communications, coordination, and incident management. Simulation exercises foster communication and collaboration among different organizations. Together, the above-mentioned initiatives in the Montérégie area have improved disaster preparedness and, as a result, the resilience of responders and communities.