scholarly journals Development and Implementation of First Hospital-Based Epidemic Outbreak Management Plan: Lessons Learned from Nepal

2019 ◽  
Vol 34 (s1) ◽  
pp. s56-s56
Author(s):  
Ashis Shrestha ◽  
Michael Khouli ◽  
Sumana Bajracharya ◽  
Rose House ◽  
Joshua Mugele
Keyword(s):  
National Level ◽  
Disaster Medicine ◽  
Lessons Learned ◽  
World Health ◽  
High Fidelity ◽  
Disaster Plan ◽  
Outbreak Management ◽  
Incident Command ◽  
Hospital Systems ◽  
Response Plan

Introduction:Patan Hospital, located in Kathmandu Valley, Nepal is a 400-bed hospital that has a long history of responding to natural disasters. Hospital personnel have worked with the Ministry of Health (MOH) and the World Health Organization (WHO) to develop standardized disaster response plans that were implemented in multiple hospital systems after the earthquake of 2015. These plans focused primarily on traumatic events but did not account for epidemics despite the prevalence of infectious diseases in Nepal.Aim:To develop and test a robust epidemic/pandemic response plan at Patan Hospital in Kathmandu that would be generalizable to other hospitals nationwide.Methods:Using the existing disaster plan in conjunction with public health and disaster medicine experts,we developed an epidemic response plan focusing on communication and coordination (between the hospital and MOH, among hospital administration and staff), logistics and supplies including personal protective equipment (PPE), and personnel and hospital incident command (IC) training. After development, we tested the plan using a high-fidelity, real-time simulation across the entire hospital and the hospital IC using actors and in conjunction with the MOH and WHO. We adjusted the plan based on lessons learned from this exercise.Results:Lessons learned from the high-fidelity simulation included the following: uncovering patient flow issues to avoid contamination/infection; layout issues with the isolation area, specifically accounting for donning/doffing of PPE; more sustained duration of response compared to a natural disaster with implications for staffing and supplies; communication difficulties unique to epidemics; need for national and regional surveillance and inter-facility planning and communication. We adjusted our plan accordingly and created a generalizable plan that can be deployed at an inter-facility and national level.Discussion:We learned that this process is feasible in resource-poor hospital systems. Challenges discovered in this process can lead to better national and system-wide preparedness.

scholarly journals Resilient Health System and Hospital Disaster Planning

2020 ◽  
Author(s):  
Stephen C. Morris
Keyword(s):  
Emergency Management ◽  
Significant Risk ◽  
Disaster Planning ◽  
Disaster Medicine ◽  
Lessons Learned ◽  
Financial Investment ◽  
Incident Command ◽  
Security Planning ◽  
Administrative Participation ◽  
Security Incidents

Disaster planning is integral component of hospital operations and management, and hospital resiliency is critical to society and health systems following a disaster. Additionally, hospitals, like all public institutions have significant risk of security incidents including terrorism, isolated and mass violence, social unrest, theft and vandalism, natural and human made disasters. Security and disaster planning are cumbersome, expensive and easy to deprioritize. When a hospital disaster is defined as anything that exceeds the limits of the facility to function at baseline, disasters and security incidents are intertwined: disasters create security problems and vice-versa. Hospital resiliency to disasters and security incidents stems from a systems-based approach, departmental and administrative participation, financial investment and flexibility. Significant best practices and lessons learned exist regarding disaster and security planning and ignorance or lack of adoption is tantamount to dereliction of duty on the part of responsible entities. This chapter consists of a review of the concepts of hospital disaster and security planning, response and recovery, as well as hospital specific disaster and security threats (risk) and their associated mitigations strategies. Risks will be presented follow a hazard vulnerability analysis (HVA), a common framework in emergency management, disaster planning and disaster medicine. As such, each element of risk is defined in terms of likelihood and impact of an event. Concepts of disaster medicine that are also addressed, as are administrative concerns, these elements are designed to be applicable to non-experts with an emphasis on cross disciplinary understanding. Additionally, elements are presented using incident and hospital incident command terminology and those not familiar should learn these concepts though free online training on the incident command system provided by several sources including The United States Federal Emergency Management Agency (FEMA), prior to reading.

scholarly journals Kuala Lumpur train collision during the COVID-19 pandemic

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Alzamani M. Idrose ◽  
Fikri M. Abu-Zidan ◽  
Nurul Liana Roslan ◽  
Khairul Izwan M. Hashim ◽  
Saiyidi Mohd Azizi Mohd Adibi ◽  
...  
Keyword(s):  
Hospital Management ◽  
Standard Operating Procedure ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Base Station ◽  
Lessons Learned ◽  
Kuala Lumpur ◽  
Disaster Plan ◽  
Incident Command ◽  
Green Zone

Abstract Background Two city trains collided in an underground tunnel on 24 May 2021 at the height of COVID-19 pandemic near the Petronas Towers, Kuala Lumpur, Malaysia, immediately after the evening rush hours. We aim to evaluate the management of this mass casualty incident highlighting the lessons learned to be used in preparedness for similar incidents that may occur in other major cities worldwide. Methods Information regarding incident site and hospital management response were analysed. Data on demography, triaging, injuries and hospital management of patients were collected according to a designed protocol. Challenges, difficulties and their solutions were reported. Results The train's emergency response team (ERT) has shut down train movements towards the incident site. Red zone (in the tunnel), yellow zone (the station platform) and green zone (outside the station entrance) were established. The fire and rescue team arrived and assisted the ERT in the red zone. Incident command system was established at the site. Medical base station was established at the yellow zone. Two hundred and fourteen passengers were in the trains. Sixty-four of them were injured. They had a median (range) ISS of 2 (1–43), and all were sent to Hospital Kuala Lumpur (HKL). Six (9.4%) patients were clinically triaged as red (critical), 19 (29.7%) as yellow (semi-critical) and 39 (60.9%) as green (non-critical). HKL's disaster plan was activated. All patients underwent temperature and epidemiology link assessment. Seven (10.9%) patients were admitted to the hospital (3 to the ICU, 3 to the ward and 1 to a private hospital as requested by the patient), while the rest 56 (87.5%) were discharged home. Six (9.4%) needed surgery. The COVID-19 tests were conducted on seven patients (10.9%) and were negative. There were no deaths. Conclusions The mass casualty incident was handled properly because of a clear standard operating procedure, smooth coordination between multi-agencies and the hospitals, presence of a 'binary' system for 'COVID-risk' and 'non-COVID-risk' areas, and the modifications of the existing disaster plan. Preparedness for MCIs is essential during pandemics.

scholarly journals COVID-19 in the Gulf Cooperation Council Member States: An Evidence of Effective Response

2021 ◽  
Vol 36 (5) ◽  
pp. e300-e300
Author(s):  
Salah T. Al Awaidy1*, ◽  
Faryal Khamis ◽  
Fatma Al Attar ◽  
Najiba Abdul Razzaq ◽  
Laila Al Dabal ◽  
...  
Keyword(s):  
Secondary Data ◽  
Gulf Cooperation Council ◽  
Lessons Learned ◽  
World Health ◽  
Effective Response ◽  
Member States ◽  
Strategic Response ◽  
Vaccine Introduction ◽  
Response Plan ◽  
The Impact

Objectives: The World Health Organization (WHO) published a global strategic response plan in February 2020 aiming to mitigate the impact of the novel coronavirus disease 2019 (COVID-19) outbreak. It identified immediate activities required for global preparedness and response to the outbreak and set eight priority areas (pillars) essential for scaling up countries’ operational readiness and response. Despite a semi-annual progress report on implementing the Global Strategic Plan in June 2020, there is limited granular information available on the extent of the national plan’s content and implementation, particularly in the Member States of the Gulf Cooperation Council (GCC). Therefore, we sought to review the preparedness and responsiveness towards the COVID-19 outbreak in the GCC in the first phase of the pandemic and to document lessons learned for improving the ongoing response efforts and preparedness for future pandemics. Methods: A rapid appraisal was conducted in June 2020 according to the WHO Strategic Preparedness and Response Plan and the accompanying Operational Planning Guidelines. The survey was administered to public health professionals or/and infectious disease experts in the states. The findings were cross-triangulated with secondary data that was publicly available for each country. Results: The preparedness and response efforts of Bahrain, Saudi Arabia, and the UAE were fully compliant with all 11 (100%) pillars of the modified strategic response measures. Kuwait, Oman, and Qatar complied with eight of the pillars. The component on conducting COVID-19 related research was the lowest-performing across all the six states. Conclusions: All GCC states demonstrated an effective response to the pandemic, enhanced existing infrastructures, and accelerated reforms that would have otherwise taken longer. The lessons learned through the early phase of the pandemic continue to steer the states in realigning their strategies and resetting their goals of controlling the outbreak, particularly in the current context of vaccine introduction and increasing preparedness capacities for future pandemics.

scholarly journals Kuala Lumpur Train Collision During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Alzamani M. Idrose ◽  
Fikri M. Abu-Zidan ◽  
Nurul Liana Roslan ◽  
Khairul Izwan M. Hashim ◽  
Saiyidi Mohd Azizi Mohd Adibi ◽  
...  
Keyword(s):  
Hospital Management ◽  
Standard Operating Procedure ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Base Station ◽  
Lessons Learned ◽  
Kuala Lumpur ◽  
Disaster Plan ◽  
Incident Command ◽  
Green Zone

Abstract Background: Two city trains collided in an underground tunnel on 24th May 2021 at the height of Covid-19 pandemic near the Petronas Towers, Kuala Lumpur, Malaysia immediately after the evening rush hours. We aim to evaluate the management of this mass casualty incident highlighting the lessons learned to be used in preparedness for similar incidents that may occur in other major cities worldwide. Methods: Information regarding incident site and hospital management response were analysed. Data on demography, triaging, injuries and hospital management of patients were collected according to a designed protocol. Challenges, difficulties and their solutions were reported. Results: The train's emergency response team (ERT) has shut down train movements towards the incident site. Red zone (in the tunnel), yellow zone (the station platform) and green zone (outside the station entrance) were established. The fire and rescue team arrived and assisted the ERT in the red zone. Incident command system was established at the site. Medical base station was established at the yellow zone. 214 passengers were in the trains. 64 of them were injured. They had a median (range) ISS of 2 (1-43) and all were sent to Hospital Kuala Lumpur (HKL). Six (9.4%) patients were clinically triaged as red (critical), 19 (29.7%) as yellow (semi-critical) and 39 (60.9%) as green (non-critical). HKL's disaster plan was activated. All patients underwent temperature and epidemiology link assessment. Seven (10.9 %) patients were admitted to the hospital (3 to the ICU, 3 to the ward, and 1 to a private hospital as requested by the patient), while the rest 56 (87.5%) (56) were discharged home. Six (9.4%) needed surgery. The Covid-19 tests were conducted on seven patients (10.9%) and was negative There were no deaths. Conclusions: The mass casualty incident was handled properly because of a clear standard operating procedure, smooth coordination between multi-agencies and the hospitals, presence of a'binary' system for 'Covid risk' and 'non-Covid risk' areas, and the modifications of the existing disaster plan. Preparedness for MCIs is essential during pandemics.

scholarly journals Command and control in hospitals during SARS-CoV-2 pandemic: The windmill model of disaster response

2020 ◽  
Vol 18 (7) ◽  
pp. 19-22
Author(s):  
Thomas Wurmb, MD ◽  
Georg Ertl, MD ◽  
Ralf-Ingo Ernestus, MD ◽  
Patrick Meybohm, MD
Keyword(s):  
Disaster Response ◽  
Command And Control ◽  
Disaster Medicine ◽  
Crisis Leadership ◽  
Incident Command System ◽  
Incident Command ◽  
Complex Processes ◽  
Response Plan ◽  
Improve Hospital ◽  
And Control

Hospitals are the focus of the fight against SARSCoV-2 pandemic. To meet this challenge hospitals need a Disaster Response Plan and a Hospital Incident Command System (HICS) as a crisis leadership tool. The complex dependency between the systems staff, supplies, and space during the SARS-CoV-2 pandemic is a major problem for hospitals. To take the appropriate countermeasures, the effects of the crisis on these systems must be detected, analyzed, and displayed. The presentation and interpretation of such complex processes often poses serious problems for the hospitals’ incident commanders.In this article, we describe a new model that is able to display these complex interrelationships within the command process. The model was developed and deployed during the disaster response to SARS-CoV-2 pandemic in order to facilitate the entire command process and to improve hospital disaster response. The approach of the model is as simple as it is innovative. It perfectly symbolizes the basic principle of disaster medicine: keep is safe and simple. It will help hospitals to improve command and control and to optimize the disaster response during SARS-CoV-2 pandemic.

scholarly journals LO094: Mass casualty incident training for rural Canadian municipalities: a mobile education unit initiative

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S62-S63
Author(s):  
F. Besserer ◽  
M. Hogan ◽  
T. Oliver ◽  
J. Froh
Keyword(s):  
Disaster Preparedness ◽  
Flipped Classroom ◽  
National Level ◽  
Pilot Project ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Disaster Plan ◽  
Mobile Education

Introduction / Innovation Concept: The Shock Trauma Air Rescue Society (STARS®) is a charitable, non-profit organization that is dedicated to providing a safe, rapid, highly specialized emergency medical transport system for the critically ill and injured. The STARS® Mobile Education Unit (MEU) is comprised of a high fidelity simulation suite that mimics a hospital emergency room, installed in a specially equipped motorhome (SEM) that can wirelessly operate a high fidelity human mannequin. The MEU provides an excellent opportunity to combine continuing medical education for resuscitation and MCI management. At present, no formal MCI education process exists in Saskatchewan. Curriculum, Tool, or Material: The Saskatchewan STARS® MEU delivers a phased MCI education initiative to rural and regional centers within the province. The educational initiative is sub-divided into three stages: 1. pre-exercise knowledge translation using a flipped classroom approach, 2. on-site tabletop exercise (TTX) and, 3. high-fidelity simulation session with a review of MCI management principles . Sites perform a Hazard Vulnerability Analysis (HVA) following stage 2 and the highest identified site-specific risks are utilized during the development of the simulated scenarios for stage 3. During stage 2, participants also complete a pre and post-exercise survey. The survey evaluates the educational component, the tabletop exercise component and the perceived pre and post tabletop exercise competencies for the management of MCI. In the pilot project, two regional sites completed the tabletop exercise. The pre-exercise survey evaluated perceived MCI and disaster preparedness for the region. Only 8% and 25% of participants at each site respectively, reported that their disaster plan had been trialed in tabletop, full exercise or real activation within the past three years. Participants strongly agreed that the tabletop exercise was a valuable experience (86% and 88% respectively). More robust data will become available as the initiative transitions out of the pilot stage to formal operations. Conclusion: A formal MCI training program implemented through the STARS® MEU for rural Saskatchewan municipalities enables participants and their organizations to both review and enhance their current emergency management plans. This initiative will aim to establish a foundation for future collaboration at the provincial and national level for rural MCI training and preparedness.

Lessons Learned from Deepwater Horizon Incident - Adapting an Integrated Command System with Governmental Takeover of the Incident Command

2014 ◽  
Vol 2014 (1) ◽  
pp. 361-372 ◽  
Author(s):  
Johan Marius Ly ◽  
Kathrine Idas ◽  
Rune Bergstrøm ◽  
Egil Dragsund
Keyword(s):  
Oil Spill ◽  
Pollution Control ◽  
National Level ◽  
Oil Industry ◽  
Deepwater Horizon ◽  
Lessons Learned ◽  
Added Value ◽  
Incident Command ◽  
Offshore Oil ◽  
Operating Company

ABSTRACT Both the Norwegian authorities and the oil industry have completed assessments and evaluations with respect to the lessons learned and experiences gained from the Deepwater Horizon incident in 2010. This paper will focus on the establishment of a national system for handling very large oil spills and governmental takeover of the incident command from the responsible operating company. The Norwegian oil industry is subject to preparedness requirements following the Health, Safety and Environment (HSE) regulations for petroleum related activities. Based on this, all offshore operating companies must have contingency plans and be able to respond to an oil spill resulting from their own activities. The Norwegian Coastal Administration (NCA) has a duty on behalf of the government to maintain preparedness and respond to major instances of acute pollution and, by law, has the obligation to take command and direct major response operations. On the Norwegian Continental Shelf there have only been two incidents involving the offshore oil industry with the release of crude oil estimated at more than 4,000 m3. The Bravo blow-out occurred in 1977, with a release of oil of approximately 12,700 m3. The Statfjord A release occurred in 2007 during a shuttle tanker loading with a release of oil of approximately 4,400 m3. The Bravo blowout lasted for eight days and resulted in a high focus on oil spill response both within the oil industry and for the authorities. The Norwegian Clean Seas Association for Operating Companies (NOFO) was established in 1978 as the industry's operational organization within oil spill contingency. In 2013 an updated national risk picture was presented with fourteen defined scenarios. One of these is an offshore oil and gas blow-out spilling approximately 300,000 tonnes and resulting in approximately 3,000 km of polluted shoreline. Together with the lessons identified from the Deepwater horizon response in 2010 there was a need to assess and improve how spills with an extreme nature and magnitude were organized on a national level. Within the framework of the Pollution Control act and HSE regulations a system has been developed in a joint effort between the oil industry and the authorities. The system is based on the already existing integrated command structure in Norway and will be part of the national contingency plan. The system for governmental takeover of the incident command, how the takeover is organized, and how the responsibilities are distributed is described in a bridging document. One of the main issues is how to be prepared to make full use of the Pollution Control Act and international agreements to bring added value to the spill response operations. A decision for governmental takeover will be based on a holistic assessment of the actual oil spill and the environmental consequences, and will build upon the already existing spill response organization established by the responsible operating company.

A(H1N1)v cases of the 2009/2010 and 2010/2011 influenza seasons in the Medical and Health Sciences Centre of Debrecen University

2012 ◽  
Vol 153 (17) ◽  
pp. 649-654
Author(s):  
Piroska Orosi ◽  
Judit Szidor ◽  
Tünde Tóthné Tóth ◽  
József Kónya
Keyword(s):  
High Risk ◽  
Influenza Season ◽  
National Level ◽  
Organ Transplant ◽  
High Risk Patient ◽  
Risk Groups ◽  
Health Sciences ◽  
World Health ◽  
Transplant Patients ◽  
Health Organization

The swine-origin new influenza variant A(H1N1) emerged in 2009 and changed the epidemiology of the 2009/2010 influenza season globally and at national level. Aims: The aim of the authors was to analyse the cases of two influenza seasons. Methods: The Medical and Health Sciences Centre of Debrecen University has 1690 beds with 85 000 patients admitted per year. The diagnosis of influenza was conducted using real-time polymerase chain reaction in the microbiological laboratories of the University and the National Epidemiological Centre, according to the recommendation of the World Health Organization. Results: The incidence of influenza was not higher than that observed in the previous season, but two high-risk patient groups were identified: pregnant women and patients with immunodeficiency (oncohematological and organ transplant patients). The influenza vaccine, which is free for high-risk groups and health care workers in Hungary, appeared to be effective for prevention, because in the 2010/2011 influenza season none of the 58 patients who were administered the vaccination developed influenza. Conclusion: It is an important task to protect oncohematological and organ transplant patients. Orv. Hetil., 2012, 153, 649–654.

How India Fights with COVID-19 with Learning from Highly Affected Countries

2020 ◽  
Vol 15 ◽  
Author(s):  
Pooja Sharma ◽  
Karan Veer
Keyword(s):  
Risk Assessment ◽  
Gene Sequencing ◽  
Lessons Learned ◽  
World Health ◽  
Global Risk ◽  
The World ◽  
Global Risk Assessment ◽  
Health Organization ◽  
Very High ◽  
Breathing Problem

: It was 11 March 2020 when the World Health Organization (WHO) declared the name COVID-19 for coronavirus disease and also described it as a pandemic. Till that day 118,000 cases were confirmed of pneumonia with breathing problem throughout the world. At the start of New Year when COVID-19 came into knowledge a few days later, the gene sequencing of the virus was revealed. Today the number of confirmed cases is scary, i.e. 9,472,473 in the whole world and 484,236 deaths have been recorded by WHO till 26 June 2020. WHO's global risk assessment is very high [1]. The report is enlightening the lessons learned by India from the highly affected countries.

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