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Kerola A, Hirvensalo E, Franc JM. The Impact of Exposure to Previous Disasters on Hospital Disaster Surge Capacity Preparedness in Finland: Hospital disaster surge capacity preparedness. Disaster Med Public Health Prep 2024; 18:e15. [PMID: 38291961 DOI: 10.1017/dmp.2024.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
OBJECTIVE As disasters are rare and high-impact events, it is important that the learnings from disasters are maximized. The aim of this study was to explore the effect of exposure to a past disaster or mass casualty incident (MCI) on local hospital surge capacity planning. METHODS The current hospital preparedness plans of hospitals receiving surgical emergency patients in Finland were collected (n = 28) and analyzed using the World Health Organization (WHO) hospital emergency checklist tool. The surge capacity score was compared between the hospitals that had been exposed to a disaster or MCI with those who had not. RESULTS The overall median score of all key components on the WHO checklist was 76% (range 24%). The median surge capacity score was 65% (range 39%). There was no statistical difference between the surge capacity score of the hospitals with history of a disaster or MCI compared to those without (65% for both, P = 0.735). CONCLUSION Exposure to a past disaster or MCI did not appear to be associated with an increased local hospital disaster surge capacity score. The study suggests that disaster planning should include structured post-action processes for enabling meaningful improvement after an experienced disaster or MCI.
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Affiliation(s)
- Anna Kerola
- Department of Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Center for Research and Training in Disaster Medicine (CRIMEDIM), Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Eero Hirvensalo
- Department of Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jeffrey M Franc
- Center for Research and Training in Disaster Medicine (CRIMEDIM), Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
- Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada
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Farah B, Pavlova M, Groot W. Hospital disaster preparedness in sub-Saharan Africa: a systematic review of English literature. BMC Emerg Med 2023; 23:71. [PMID: 37365529 DOI: 10.1186/s12873-023-00843-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Disasters are increasing worldwide, with Sub-Saharan Africa (SSA) being one of the most prone regions. Hospitals play a key role in disasters. This study provides a systematic review of the evidence on disaster preparedness by hospitals in SSA countries based on English literature. METHODS A systematic literature review was conducted of articles published between January 2012 and July 2022. We searched PubMed, Elsevier, Science Direct, Google Scholar, the WHO depository library and CDC sites for English language publications. The key inclusion criteria were: publications should have been published in the above period, deal with hospital disaster preparedness in SSA, the full paper should have been available, and studies should have presented a comparison between hospitals and/or a single hospital. RESULTS Results indicate improvements in disaster preparedness over time. However, health systems in SSA are generally considered vulnerable, and they find it difficult to adapt to changing health conditions. Inadequately skilled healthcare professionals, underfunding, poor knowledge, the absence of governance and leadership, lack of transparency and bureaucracy are the main preparedness barriers. Some countries are in an infancy stage of their health system development, while others are among the least developed health system in the world. Finally, a major barrier to disaster preparedness in SSA countries is the inability to collaborate in disaster response. CONCLUSIONS Hospital disaster preparedness is vulnerable in SSA countries. Thus, improvement of hospital disaster preparedness is highly needed.
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Affiliation(s)
- Bashir Farah
- Department of Health Services Research, School of Care and Public Health Research Institute, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616 6200 MD, Maastricht, The Netherlands.
- , Degahbour, Somali Region, Ethiopia.
| | - Milena Pavlova
- Department of Health Services Research, School of Care and Public Health Research Institute, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616 6200 MD, Maastricht, The Netherlands
| | - Wim Groot
- Department of Health Services Research, School of Care and Public Health Research Institute, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616 6200 MD, Maastricht, The Netherlands
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A Scoping Review of the Essential Components of Emergency Medical Response Systems for Mass Casualty Incidents. Disaster Med Public Health Prep 2023; 17:e274. [PMID: 36597790 DOI: 10.1017/dmp.2022.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Emergency medical (EM) response systems require extensive coordination, particularly during mass casualty incidents (MCIs). The recognition of preparedness gaps and contextual priorities to MCI response capacity in low- and middle-income countries (LMICs) can be better understood through the components of EM reponse systems. This study aims to delineate essential components and provide a framework for effective emergency medical response to MCIs. METHODS A scoping review was conducted using 4 databases. Title and abstract screening was followed by full-text review. Thematic analysis was conducted to identify themes pertaining to the essential components and integration of EM response systems. RESULTS Of 20,456 screened citations, 181 articles were included in the analysis. Seven major and 40 sub-themes emerged from the content analysis as the essential components and supportive elements of MCI medical response. The essential components of MCI response were integrated into a framework demonstrating interrelated connections between essential and supportive elements. CONCLUSIONS Definitions of essential components of EM response to MCIs vary considerably. Most literature pertaining to MCI response originates from high income countries with far fewer reports from LMICs. Integration of essential components is needed in different geopolitical and economic contexts to ensure an effective MCI emergency medical response.
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Current Perspectives and Concerns Facing Hospital Evacuation: The Results of a Pilot Study and Literature Review. Disaster Med Public Health Prep 2021; 16:650-658. [PMID: 33531099 DOI: 10.1017/dmp.2020.391] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To analyze the evacuation preparedness of hospitals within the European Union (EU). METHOD This study consisted of 2 steps. In the first step, a systematic review of the subject matter, according to the PRISMA flow diagram, was performed. Using Scopus (Elsevier, Amsterdam, Netherlands), PubMed (National Library of Medicine, Bethesda, MD), and Gothenburg University´s search engine, 11 questions were extracted from the review and were sent to representatives from 15 European Union (EU)- and non-EU countries. RESULTS The findings indicate that there is neither a full preparedness nor a standard guideline for evacuation within the EU or other non-EU countries in this study. A major shortcoming revealed by this study is the lack of awareness of the untoward consequences of medical decision-making during an evacuation. Some countries did not respond to the questions due to the lack of relevant guidelines, instructions, or time. CONCLUSION Hospitals are exposed to internal and external incidents and require an adequate evacuation plan. Despite many publications, reports, and conclusions on successful and unsuccessful evacuation, there is still no common guide for evacuation, and many hospitals lack the proper preparedness. There is a need for a multinational collaboration, specifically within the EU, to establish such an evacuation planning or guideline to be used mutually within the union and the international community.
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Rattanakanlaya K, Sukonthasarn A, Wangsrikhun S, Chanprasit C. Flood disaster preparedness experiences of hospital personnel in Thailand: A qualitative study. Australas Emerg Care 2019; 21:87-92. [PMID: 30998883 DOI: 10.1016/j.auec.2018.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/16/2018] [Accepted: 07/25/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Nurses, as well as other health personnel and health systems, worldwide need to be adequately prepared for disasters because it is often difficult to predict where and when disasters strike. The 2011 Thailand flood disaster caused significant damage, including to hospitals. The purpose of this study was to investigate the experiences of hospital personnel regarding flood disaster preparedness in the central region of Thailand. METHODS This qualitative study was conducted using content analysis. Purposive sampling was used to select the participants. Semi-structured interviews were conducted with 15 participants who were doctors, nurses, and persons involved in flood disaster preparedness. Content analysis was used for data analysis. FINDINGS Two themes and ten subthemes were extracted with regard to flood disaster preparedness. The two themes were maintaining the function of care provision and struggle with preparedness. Personnel realized that preparation levels of their hospital were inadequate and identified the challenges in providing care during and after floods. CONCLUSIONS The finding identified several areas to improve the current state of preparedness of all hospitals that experienced service disruption due to flood disasters. This can help healthcare personnel, hospitals, and healthcare system to enhance flood disaster preparedness so that they can be better prepared.
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Affiliation(s)
- Kanittha Rattanakanlaya
- Division of Surgical Nursing, Faculty of Nursing, Chiang Mai University, 110 Inthawaroros Road, Muang Chiang Mai 50200, Thailand
| | - Achara Sukonthasarn
- Division of Surgical Nursing, Faculty of Nursing, Chiang Mai University, 110 Inthawaroros Road, Muang Chiang Mai 50200, Thailand.
| | - Suparat Wangsrikhun
- Division of Surgical Nursing, Faculty of Nursing, Chiang Mai University, 110 Inthawaroros Road, Muang Chiang Mai 50200, Thailand
| | - Chawapornpan Chanprasit
- Division of Public Health Nursing, Faculty of Nursing, Chiang Mai University, 110 Inthawaroros Road, Muang Chiang Mai 50200, Thailand
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Koka PM, Sawe HR, Mbaya KR, Kilindimo SS, Mfinanga JA, Mwafongo VG, Wallis LA, Reynolds TA. Disaster preparedness and response capacity of regional hospitals in Tanzania: a descriptive cross-sectional study. BMC Health Serv Res 2018; 18:835. [PMID: 30400927 PMCID: PMC6219171 DOI: 10.1186/s12913-018-3609-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/07/2018] [Indexed: 11/27/2022] Open
Abstract
Background Tanzania has witnessed several disasters in the past decade, which resulted in substantial mortality, long-term morbidity, and significant socio-economic losses. Health care facilities and personnel are critical to disaster response. We assessed the current state of disaster preparedness and response capacity among Tanzanian regional hospitals. Methods This descriptive cross-sectional survey was conducted in all Tanzanian regional hospitals between May 2012 and December 2012. Data were prospectively collected using a structured questionnaire based on the World Health Organization National Health Sector Emergency Preparedness and Response Tool. Trained medical doctors conducted structured interviews and direct observations in each hospital. Results We surveyed 25 regional hospitals (100% capture) in mainland Tanzania, in which interviews were conducted with 13-hospital doctors incharge, 9 matrons and 4 heads of casualty. All the hospitals were found to have inadequate numbers of all cadres of health care providers to support effective disaster response. 92% of hospitals reported experiencing a disaster in the past 5 years; with the top three being large motor vehicle accidents 22 (87%), floods 7 (26%) and infectious disease outbreaks 6 (22%). Fifteen hospitals (60%) had a disaster committee, but only five (20%) had a disaster plan. No hospital had all components of surge capacity. Although all had electricity and back-up generators, only 3 (12%) had a back-up communication system. Conclusion This nationwide survey found that hospital disaster preparedness is at an early stage of development in Tanzania, and important opportunities exist to better prepare regional hospitals to respond to disasters.
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Affiliation(s)
- Philip M Koka
- Emergency Medicine Department, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Hendry R Sawe
- Emergency Medicine Department, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania. .,Emergency Medicine Department, Muhimbili National Hospital, Dar es Salaam, Tanzania.
| | - Khalid R Mbaya
- Emergency Department, Al-Zahra Hospital Sharjah, Sharjah, United Arab Emirates
| | - Said S Kilindimo
- Emergency Medicine Department, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.,Emergency Medicine Department, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Juma A Mfinanga
- Emergency Medicine Department, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.,Emergency Medicine Department, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Victor G Mwafongo
- Emergency Medicine Department, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.,Emergency Medicine Department, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Lee A Wallis
- Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa
| | - Teri A Reynolds
- Department for the Management of NCDs, Disability, Violence and Injury Prevention, World Health Organization (WHO), Geneva, Switzerland
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Health System Response and Adaptation to the Largest Sandstorm in the Middle East. Disaster Med Public Health Prep 2016; 11:227-238. [PMID: 27539443 DOI: 10.1017/dmp.2016.111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The State of Qatar experienced a sandstorm on the night of April 1, 2015, lasting approximately 12 hours, with winds of more than 100 km/h and average particulate matter of approximately 10 μm in diameter. The emergency department (ED) of the main tertiary hospital in Qatar managed 62% of the total emergency calls and those of higher triage order. The peak load of patients during the event manifested approximately 6 hours after the onset. The Major Emergency Command Centre of the hospital ensured the department was maximally organized in terms of disaster management, and established protocols were brought into action. Multiple timely meetings were convened in efforts to effectively execute plans that included rapid emergency medical services handover time, resourcing staff, maximizing bed space, preventing dust entry in the ED, bypassing certain administrative processes, canceling day-surgeries that did not affect inpatient morbidity, and procuring additional respiratory equipment. Patients arrived mainly with exacerbations of asthma and respiratory distress, ophthalmic emergencies, and vehicular trauma; surprisingly, the incidence of pedestrian injuries did not vary. (Disaster Med Public Health Preparedness. 2017;11:227-238).
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Impact of the 2011 Revolution on Hospital Disaster Preparedness in Yemen. Disaster Med Public Health Prep 2015; 9:396-402. [DOI: 10.1017/dmp.2015.30] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveHospitals are expected to serve the medical needs of casualties in the face of a disaster or other crisis, including man-made conflicts. The aim of this study was to evaluate the impact of the 2011 Yemeni revolution on hospital disaster preparedness in the capital city of Sana’a.MethodsThe study was conducted in September 2011 and 2013. For evaluation purposes, the hospital emergency response checklist published by the World Health Organization (WHO) was used. Additional information was also obtained to determine what steps were being taken by hospital authorities to improve hospital preparedness.ResultsThe study selected 11 hospitals. At the time of the first evaluation, 7 hospitals were rated “unacceptable” for level of preparedness and 4 were rated “insufficient,” receiving a WHO checklist rating of 10 to 98. At the second evaluation, 5 hospitals were rated “unacceptable,” 3 “insufficient,” and 1 “effective,” receiving a rating of 9 to 134.ConclusionsUnfortunately, this study shows that between 2011 and 2013, no significant progress was made in hospital disaster preparedness in Sana’a. In a disaster-prone country like Yemen, the current situation calls for drastic improvement. Health system authorities must take responsibility for issuing strategic plans as well as standards, guidelines, and procedures to improve hospital disaster preparedness. (Disaster Med Public Health Preparedness. 2015;9:396–402)
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Hospital Disaster Preparedness as Measured by Functional Capacity: a Comparison between Iran and Sweden. Prehosp Disaster Med 2013; 28:454-61. [DOI: 10.1017/s1049023x13008807] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractIntroductionHospitals are expected to continue to provide medical care during disasters. However, they often fail to function under these circumstances. Vulnerability to disasters has been shown to be related to the socioeconomic level of a country. This study compares hospital preparedness, as measured by functional capacity, between Iran and Sweden.MethodsHospital affiliation and size, and type of hazards, were compared between Iran and Sweden. The functional capacity was evaluated and calculated using the Hospital Safety Index (HSI) from the World Health Organization. The level and value of each element was determined, in consensus, by a group of evaluators. The sum of the elements for each sub-module led to a total sum, in turn, categorizing the functional capacity into one of three categories: A) functional; B) at risk; or C) inadequate.ResultsThe Swedish hospitals (n = 4) were all level A, while the Iranian hospitals (n = 5) were all categorized as level B, with respect to functional capacity. A lack of contingency plans and the availability of resources were weaknesses of hospital preparedness. There was no association between the level of hospital preparedness and hospital affiliation or size for either country.ConclusionThe results suggest that the level of hospital preparedness, as measured by functional capacity, is related to the socioeconomic level of the country. The challenge is therefore to enhance hospital preparedness in countries with a weaker economy, since all hospitals need to be prepared for a disaster. There is also room for improvement in more affluent countries.DjalaliA, CastrenM, KhankehH, GrythD, RadestadM, OhlenG, KurlandL. Hospital disaster preparedness as measured by functional capacity: a comparison between Iran and Sweden. Prehosp Disaster Med.2013;28(5):1-8.
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