Mass Transfer of Pediatric Tertiary Care Hospital Inpatients to a New Location in Under 12 Hours: Lessons Learned and Implications for Disaster Preparedness

Fuzak, Julia K.; Elkon, Benjamin D.; Hampers, Louis C.; Polage, Kathleen J.; Milton, Jerrod; Powers, Linda K.; Percell-de'Shong, Karen; Wathen, Joseph

doi:10.1016/j.jpeds.2010.01.047

Cited by 19 publications

(25 citation statements)

References 18 publications

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“…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 …”

Section: Introductionmentioning

confidence: 99%

“…Communication is the one item cited more than any other as a major contributor to evacuation success or failure. As Paul Lambrecht, VP of clinical and support services at Underwood Memorial Hospital said, “you can never overcommunicate” in a disaster situation .…”

Section: Introductionmentioning

confidence: 99%

“…Examples of these patient populations include patients in any type of intensive care unit (eg, ICU, NICU, SICU, PICU), bariatric patients, pediatric patients, geriatric patients, and psychiatric patients. In regards to evacuation of these Special Patient Populations, there are scattered case reports, several simulated drills, and a few guidelines that are available, but there are still many unknowns in regards to the specifics of how to best evacuate these patients. For example, Gallagher et al described the successful evacuation of a burn center during Hurricane Katrina, but failed to discuss any of the specific considerations that went into evacuating these burn patients compared to a general medical/surgical patient .…”

Section: Introductionmentioning

confidence: 99%

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

Hicks

Glick

2015

J of Healthc Risk Manag

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A hospital evacuation is a significant disaster scenario facing today's Hospital Emergency Coordinators (HECs) and Risk Managers. In this work we explore the numerous barriers that prevent HECs from being able to effectively plan for and execute hospital evacuations based on a review of the pertinent literature of the last 30 years. We discuss the finding that the reasons for the success or failure generally fall into 1 or more of 8 broad categories: Predisaster Assessment, Logistics, Communications, Community Relationships, Manual Records and Tracking, Resource Management, Special Patient Populations, and Postevacuation Return.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Hicks

Glick

2015

J of Healthc Risk Manag

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“…31 , 35 -39 Centralized regional real-time tracking and communication are essential to match available facilities' resources to patients and minimize transportation duration and mishaps. 7 Close coordination with specialty centers can minimize adverse outcomes during transport. 36 , 40 Designate a Critical Care Team Leader 4a.…”

Section: C We Suggest Hospital Exercises Should Simulate a Mass Crimentioning

confidence: 99%

Evacuation of the ICU

King

Niven

Beninati

et al. 2014

Chest

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BACKGROUND: Despite the high risk for patient harm during unanticipated ICU evacuations, critical care providers receive little to no training on how to perform safe and eff ective ICU evacuations. We reviewed the pertinent published literature and off er suggestions for the critical care provider regarding ICU evacuation. Th e suggestions in this article are important for all who are involved in pandemics or disasters with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government offi cials. METHODS: Th e Evacuation and Mobilization topic panel used the American College of ChestPhysicians (CHEST) Guidelines Oversight Committee's methodology to develop seven key questions for which specifi c literature searches were conducted to identify studies upon which evidence-based recommendations could be made. No studies of suffi cient quality were identifi ed. Th erefore, the panel developed expert opinion-based suggestions using a modifi ed Delphi process.RESULTS: Based on current best evidence, we provide 13 suggestions outlining a systematic approach to prepare for and execute an eff ective ICU evacuation during a disaster. Interhospital and intrahospital collaboration and functional ICU communication are critical for success. Pre-event planning and preparation are required for a no-notice evacuation. A Critical Care Team Leader must be designated within the Hospital Incident Command System. A threestage ICU Evacuation Timeline, including (1) no immediate threat, (2) evacuation threat, and (3) evacuation implementation, should be used. Detailed suggestions on ICU evacuation, including regional planning, evacuation drills, patient transport preparation and equipment, patient prioritization and distribution for evacuation, patient information and tracking, and federal and international evacuation assistance systems, are also provided. CONCLUSIONS:Successful ICU evacuation during a disaster requires active preparation, participation, communication, and leadership by critical care providers. Critical care providers have a professional obligation to become better educated, prepared, and engaged with the processes of ICU evacuation to provide a safe continuum of critical care during a disaster. Requesting Assistance for Evacuation 6a. We suggest during a disaster or pandemic that overwhelms local and regional resources and requires large-scale hospital evacuations assistance, from national and/or international government medical support and evacuation agencies should be requested. 6b. We suggest the CCTL should be aware of the process for requesting evacuation assistance and the resources available at a regional and national level. Ensure Adequate Power and Transport Ventilation Equipment7a. We suggest surge ventilators with fl exible electrical power and oxygen requirements should be available to support patients with respiratory failure that can maintain function while either (1) sheltering in place or (2) evacuating to an outside facility. Th...

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“…No matter the documentation system chosen, some medical documentation is essential to prevent duplication of work, ensure timely medication delivery without overdose, track patient progress or deterioration, and provide for hand-off of patient care in the face of rapid turn-over of responder volunteers. 31,32 …”

Section: Organization Of a Disaster Responsementioning

confidence: 99%