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

Abstract

The creation of hospitals safe from disaster is an area of increasing public policy. The vulnerability of hospitals to damage and destruction during an event has profound implications for the health of a community. Although hospital evacuations do occur in Australia, their prevalence is unknown and what leads to a successful evacuation is poorly understood. This article reviewed the worldwide hospital evacuation literature to determine the prevalence of hospital evacuations and common precipitants for evacuation. Factors leading to safe evacuation and areas of ongoing challenge were identified. The findings highlight the need for more structured and detailed reporting of hospital responses to disaster. A number of lessons can be learned from hospitals that have experienced evacuation. Most critically, all hospitals must have a practised, detailed hospital evacuation plan existing before an impending threat. There are also areas for improvement in the areas of assessing the risk to the facility, communications, leadership, logistics, staffing and planning. These lessons should be included into comprehensive, detailed evacuation plans for all Australian hospitals, supported by a national framework that standardises planning and response.

浸水被害による病院避難でのDMAT現場活動指揮の経験(Disaster Medical Assistance Team (DMAT) field activity in hospital evacuation during great flood)

“…災害時の活動をスムーズに行うためには，平時からのシステム構築と訓練が鍵を握る。本邦ではいまだ災害時における病院単位での避難計画，地域行政単位での避難計画を策定している病院や自治体は少ないものと思われるが，欧米ではハリケーンなどの被害経験からシミュレーションを行って避難計画を継続的に見直している , 。災害種別による被災範囲によって病院避難に割ける医療チーム数，利用可能な車輛数と種別，周囲の医療施設の避難患者受け入れ能力，通信手段，物流などにより避難計画は規定されていくが，いずれにせよ平時に事前訓練を行い各行政単位，また各組織における利用可能資源のボトルネックを同定し，災害に向けて補強しておくことが肝要である。…”

Decision-making on Hospital Emergency Evacuation in Disasters and Emergencies: Findings From a Systematic Review

“…The vulnerability of hospitals in disasters results in instabilities in providing health care (7). Hundreds of hospitals and other health care facilities are destroyed or lose their function in natural disasters worldwide every year (8) centers have been evacuated urgently due to fire, incidents related to Hydro-meteorological changes, terrorist threats, and other natural disasters (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

“…In several review papers on the lesson learned of the hospital emergency evacuation, support, equipment, human resources, information management, communications, removing patient devices, transportation, resources such as staff and intersector and interinstitutional coordination were emphasized in the success of an emergency evacuation (6,7,9,23,35,36,43,46,68,69). The mentioned factors are perquisites for hospital evacuation.…”

The role of hazard vulnerability assessments in disaster preparedness and prevention in China

“…Because hospitals and other health care facilities are always at the forefront to prepare for and respond to disastrous events, they are now expected to be community organizations instead of standalone institutions. We usually rely on hospitals to treat disaster victims, provide ongoing health care to the community, and prevent secondary disease outbreaks caused by the loss of infrastructure and/or sanitation [ 11 ]. An HVA is the key step in the emergency response to a disaster.…”