International Journal of Scientific and Research Publications, Volume 11, Issue 11, November 2021 497 ISSN 2250-3153 This publication is licensed under Creative Commons Attribution CC BY. http://dx.doi.org/10.29322/IJSRP.11.11.2021.p11963 www.ijsrp.org Organizational attributes that support reliable Emergency Medical Services response during Mass Casualty Incidents in Nairobi County, Kenya Evelyn Baru*, Prof. Stanley Omuterema**, Dr Janet Nabiswa*** *Department of Emergency Management Studies, Masinde Muliro University of Science & Technology Kenya **Department of Disaster Management and Sustainable Development, Masinde Muliro University of Science & Technology, Kenya ***Department of Educational Psychology, Kibabii University, Kenya DOI: 10.29322/IJSRP.11.11.2021.p11963 http://dx.doi.org/10.29322/IJSRP.11.11.2021.p11963 Abstract When disaster strikes resulting in mass casualties, the number of victims rapidly exceeds locally available intervention resources thereby necessitating exceptional response arrangements. When these tragic and traumatizing large-scale events occur, the public expects the local disaster response entities to be on hand to provide much needed assistance. Whereas the ultimate goal of any emergency medical response is to obtain the best possible intervention for the greatest number of casualties, research indicates that the efficacy of the emergency medical services (EMS) organization’s response to past major incidents in Nairobi County, Kenya, has been inefficient. The aim of this study was to address this gap by examining the organizational attributes of EMS organizations that influence reliable disaster response to Mass Casualty Incidents (MCIs) in Nairobi County Kenya. The specific objective of the study was to examine EMS personnel’s perceptions of organizational strategies that support reliable disaster response during MCIs in Nairobi County, Kenya. The study was guided by the high reliability theory as an approach for enhancing reliable emergency medical response performance in dynamic high-risk settings such as mass casualty disaster events. Non-probability convenience sampling approach was used to draw a target study population of 71, out of which a sample size of 54 study respondents comprising certified emergency medical technicians in fulltime employment by EMS agencies in Nairobi County was used. The study used the sequential explanatory quantitative method design. The data for the study was obtained through questionnaires and document analysis. Data were analyzed using descriptive statistics: frequency tables and diagrams were used to present quantitative data. The questionnaire measure of internal consistency yielded a reliability of Cronbach alpha α = .82. The study findings reveal that the EMS personnel in Nairobi County perceive that the EMS agencies’ organizational strategies manifest HRO-like attributes to support reliable disaster response during MCIs. The study findings provide a mindfulness theoretical approach that EMS organizations can adapt to maintain reliable disaster response performance when dealing with the unexpected especially during response to MCIs. The study recommends that to support reliable disaster response performance especially during MCIs, EMS agencies should consider harnessing the existing organizational strategies using mindfulness strategies supported by disaster response policies in Nairobi County, Kenya. Index terms: Mass Casualty Incidents, Emergency Medical Services, reliability, disaster response, mindfulness INTRODUCTION There is no country, no community, and no person immune to the impacts of disasters. Owing to a variety of human and natural factors such as technological advancements, increase in human population, and emergent human settlements in hazard-prone areas, disaster events have been occurring with increasing frequency, and with increasingly devastating consequences. Etkin (2016) defines a disaster as a serious disruption of the functioning of a community or a society, causing widespread human, material, economic or environmental losses which exceed the ability of the affected community or society to cope using its own resources. Disasters may be caused by hazards such as earthquakes, floods, wildfires, building fires, terrorism, or hazardous materials, and depending on the severity and magnitude of their impact on society, may result in significant human suffering. When these disaster events result in patient volume, injury severity, or both, at one time than locally available medical intervention resources can handle using routine procedures, they are referred to as Mass Casualty Incidents (MCIs) (Kluger, Coccolini, Catena, & Ansaloni, 2020). This is because the number of injured patients overwhelms the handling capacity of the local emergency response system, especially the pre-hospital Emergency Medical Services (EMS) resources at the scene of the incident, and at nearby treating facilities within a short period of time (Leow et al., 2012). When these tragic and traumatizing large-scale events occur, the public expects the local emergency services, which comprise the police (in charge of law enforcement and maintenance of public order); fire and rescue services (responsible for firefighting, technical rescue, hazardous material response); and EMS (in charge of prehospital emergency medical care), to be on hand to provide speedy and dependable assistance. EMS play a critical role in disaster response by providing timely, safe, on-scene