Basics of Hospital Response

Abstract

Hospitals that are not prepared to respond effectively to public health emergencies may risk increased morbidity and mortality of casualties, reduced ability to protect their own staff and facilities, and a prolonged recovery phase resulting in financial losses and negative publicity within the community.

The main objective of a hospital emergency/disaster plan is to optimally prepare the staff and institutional resources of the hospital for effective performance in different disaster situations. Such plans should address not only the mass casualties which may result from an incident that has occurred away from the hospital but should also address those situations where the hospital itself has been affected by a disaster.

The purpose of this chapter is to identify the basic principles of disaster planning and emergency preparedness of a health care facility that can be adjusted in several contexts and capacities.

Functioning Plans of Response: Goals and Structure, Functions of Critical Importance for the Capacity of the Hospital, The Content of the Disaster Plan, What Every Staff Member Should Know, The Alert Process, Decision About the Level of Alert, Coordination and Command, Communication with the Command on Regional Level, Communication with the Command on National Level, Preparing the Hospital, Receiving Casualties, Registration of Patients, Hospital Information Center and Management of Media)

If you fail to plan, you are planning to fail!

—Benjamin Franklin

Glossary

Compound (Combination) Disaster

Disasters are not always limited to a single hazard. Sometimes two or more completely independent disasters occur at the same time—an earthquake strike during a flood, for instance. More commonly, however, one disaster triggers a secondary hazard. Some secondary hazards only occur as result of a primary hazard, such as a tsunami (from earthquakes), while others can occur either because of or independent of other disasters. Compound disasters, which can occur either sequentially or simultaneously with one or more disasters, have a tendency to exacerbate consequences, and increase victims’ issues [25].

Coping Capacity

The ability of people, organizations, and systems, using available skills and resources, to face and manage adverse conditions, emergencies, or disasters.

Disaster

A serious disruption of the functioning of a community or a society involving widespread human, material, economic, or environmental losses and impacts, which exceeds the ability of the affected community or society to cope using its own resources. Disasters are often described as a result of the combination of: the exposure to a hazard; the conditions of vulnerability that are present; and insufficient capacity or measures to reduce or cope with the potential negative consequences [22].Disaster impacts may include loss of life, injury, disease, and other negative effects on human physical, mental, and social well-being, together with damage to property, destruction of assets, loss of services, social and economic disruption, and environmental degradation.

Early Warning System

The set of capacities needed to generate and disseminate timely and meaningful warning information to enable individuals, communities, and organizations threatened by a hazard to prepare and to act appropriately and in sufficient time to reduce the possibility of harm or loss.

Emergency Preparedness Plan versus Contingency Plan

Contingency planning means making a plan to respond to a potential crisis or emergency. This includes developing scenarios (anticipating the crisis), determining the objectives of the organization in these situations, and defining what will be needed to reach those objectives [23]. Contingency planning is one tool of emergency preparedness, but it is not emergency preparedness itself. Emergency preparedness consists of all activities taken in anticipation of a crisis to expedite effective emergency response. This includes contingency planning, but is not limited to it: it also covers stockpiling, the creation and management of stand-by capacities, and training staff and partners in emergency response.

Emergency

A crisis or emergency is a threatening condition that requires urgent action. Effective emergency action can avoid the escalation of an event into a disaster.

Hazards

A dangerous phenomenon, substance, human activity, or condition that may cause loss of life, injury or other health impacts, property damage, loss of livelihoods and services, social and economic disruption, or environmental damage.

Risk

Risk is the likelihood of an event occurring multiplied by the negative consequence of that event, were it to occur. Risk = Likelihood x Negative Consequence Likelihood is expressed either as a probability (e.g., 0.15; 50%) or as a frequency (e.g., 1 in 1,000,000; 5 times per year). Consequences are a measure of the effect of the hazard on people or property.

Vulnerability

Vulnerability is a measure of the propensity of an object, area, individual, group, community, country, or other entity to incur the consequences of a hazard. This measurement results from a combination of physical, social, economic, and environmental factors or processes. Resilience, the opposite of vulnerability, is a measure of propensity to avoid loss [24].