Evacuation and Sheltering of Hospitals in Emergencies: A Review of International Experience

Abstract

Objective: A scoping exercise to establish how common hospital evacuations are, identify hospital evacuation policies and review case studies to identify triggers, processes and challenges involved in the evacuation of hospitals globally. Design: A systematic search of PubMed and disaster agency online resources, search of grey literature and media reports. Results: This study showed that hospitals are vulnerable to both natural and man made disasters and that hospital evacuations do occur globally. It highlighted the paucity of published data and policy on hospital evacuation and emphasised the vital need to collect data on triggers, reasons for evacuation, sheltering facilities and the process of evacuation.

A meta‐analysis of hospital evacuations: Overcoming barriers to effective planning

“…There are numerous barriers that prevent Hospital Emergency Coordinators (HECs) from being able to effectively plan for and execute hospital evacuations. A review of the literature of the last 30 years shows that the evacuation literature breaks down into 6 broad categories: General case reports; Specialized case reports; Review articles that summarize an aspect of hospital evacuation such as why hospitals evacuate; Simulated drills; Simulation models; and Broad guidelines …”

“…), earthquakes, wildfires, flooding, or terrorism. For example, in the United Kingdom alone, 70% of their hospitals are at risk for a flood . Domestically, this is evident due to earthquakes in California and multiple severe weather events (ie, Tropical Storm Allison, Hurricane Katrina, Hurricane Sandy) that have triggered evacuations.…”

“…Relationships with first responders, particularly the fire department, are critical . Since fires and hazardous materials incidents tend to be some of the most common causes of an evacuation, lines of communication and working relationships must be established prior to an evacuation. This was illustrated during a vertical evacuation simulation drill where miscommunication between incident command and fire command led to teams being in the wrong stairwell as they were conducting their drill …”

Review article: Evacuating hospitals in Australia: What lessons can we learn from the world literature?

“…The World Health Organization commissioned a review of hospital evacuations in 2009, with particular emphasis on policy‐making. They reported 38 cases of mostly partial evacuations . Sternberg et al .…”

Evacuation of a Neonatal Intensive Care Unit in a Disaster: Lessons From Hurricane Sandy

“…Despite this fact, published data on hospital evacuations are scarce. 2 Bagaria et al 2 found only 69 cases of hospital evacuation published globally between 1979 and 2009, 15 of these occurring in response to hydrometeorologic events. The published data on evacuation of NICUs are even fewer and have come almost exclusively from experiences during Hurricanes Katrina [3][4][5][6] and Rita 7,8 …”