The Feasibility of Increasing Hospital Surge Capacity in Disasters through Early Patient Discharge

Abstract

Objective: Hospitals are expected to be able to provide quality services during disasters. However, hospital capacity is limited and most hospital beds are almost always occupied. The aim of this study was to determine the feasibility of increasing hospital surge capacity during disasters through identification of patients suitable for safe early discharge. Methods: This cross-sectional study was conducted from May 2017 to February 2018 in two phases. In phase I, the Early Discharge Checklist was developed by a multidisciplinary panel of experts. Then in phase II, the checklist was used to assess the dischargeability of 396 in-patients in general wards of hospitals in Alborz province, Iran. Data were analyzed through the SPSS software (v. 22.0) and the results were presented by descriptive and analytical statics at a significance level of less than 0.05. Results: Of 396 patients, (64.65%) were male, (68.9%) were married, and (38.6%) aged more than 54. Moreover, (34.6%) patients were dischargeable. Patients in cardiology wards were more dischargeable. At follow-up assessment, 33.3% of patients had been discharged after 48 hours. There was a significant relationship between patient dischargeability and 48-hour hospitalization status ( p =0.001). Dischargeability had no significant relationships with patients’ demographic characteristics ( p >0.05). Conclusion: A considerable percentage of in-patients are dischargeable during disasters. The Early Discharge Assessment Checklist, developed in this study, is an appropriate tool to provide reliable data about early dischargeability in disasters.

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“…In contrast, only a few included articles presented data linking process improvements to improved health outcomes. 38,107,156,176,190 This suggests that further research is needed to explore how health and other impact outcomes are affected by improvements in process indicators.…”

“…At the local level, a physical emergency operations center (EOC) with well-defined jurisdictional responsibility is mandated for MCI management. 13,21,22,28,31,34,36,47,50,[55][56][57][58][59]61,62,[64][65][66]73,82,88,89,99,110,111,118,119,129,135,142,145,149,[151][152][153][154][155][156][157][158] EOCs play an important role by coordinating amongst organizations that need medical resources with those that can provide medical resources and delegating various emergent tasks among different entities. 39,50,54,118,151,152,155,157...…”

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