Resilience of the Canterbury Hospital System to the 2011 Christchurch Earthquake

2014 ◽  
Vol 30 (1) ◽  
pp. 533-554 ◽  
Author(s):  
Caitlin C. Jacques ◽  
Jason McIntosh ◽  
Sonia Giovinazzi ◽  
Thomas D. Kirsch ◽  
Thomas Wilson ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Fault Tree Analysis ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Contributing Factors ◽  
Hospital System ◽  
Nonstructural Components ◽  
Survey Tool ◽  
Future Performance ◽  
Hospital Safety

The paper analyzes the performance of a hospital system using a holistic and multidisciplinary approach. Data on impacts to the hospital system were collected using a standardized survey tool. A fault-tree analysis method is adopted to assess the functionality of critical hospital services based on three main contributing factors: staff, structure, and stuff. Damage to utility networks and to nonstructural components was found to have the most significant effect on hospital functionality. The functional curve is integrated over time to estimate the resilience of the regional acute-care hospital with and without the redistribution of its major services. The ability of the hospital network to offer redundancies in services after the earthquake increased the resilience of the Christchurch Hospital by 12%. The resilience method can be used to assess future performance of hospitals, and to quantify the effectiveness of seismic retrofits, hospital safety legislation, and new seismic preparedness strategies.

A Functional Loss Assessment of a Hospital System in the Bío-Bío Province

2012 ◽  
Vol 28 (1_suppl1) ◽  
pp. 473-502 ◽  
Author(s):  
Judith Mitrani-Reiser ◽  
Michael Mahoney ◽  
William T. Holmes ◽  
Juan Carlos de la Llera ◽  
Rick Bissell ◽  
...  
Keyword(s):  
Structural Damage ◽  
Hospital Performance ◽  
Lessons Learned ◽  
Loss Of Function ◽  
Loss Assessment ◽  
Physical Damage ◽  
Hospital System ◽  
Nonstructural Components ◽  
Survey Tool ◽  
The Impact

The objectives of this study were to introduce a damage and loss-of-function survey tool that can be used to standardize future assessment of hospital performance, to assess the impact of the 2010 Chilean earthquake on the functions of the public hospital system in the Bío-Bío Province, and to translate these results as lessons that can be applied to U.S. hospitals. This study focused on damage to structural and nonstructural components, utility services, and equipment, as well as loss of supplies and personnel. Structural engineers completed a visual inspection of facilities, and hospital administrators were surveyed to assess the overall impact on operations. All hospitals lost communications, electrical power, and water for several days. All hospitals reported some physical damage although only one suffered significant structural damage. The lessons learned from Chile are applied to U.S. practice of hospital seismic mitigation.

Readmission Risk Assessment Using Random Forest Modeling in an Acute Care Hospital System

2018 ◽  
Vol 227 (4) ◽  
pp. S161-S162
Author(s):  
Phillip Dowzicky ◽  
Ehab Hanna ◽  
Ian Berger ◽  
Latesha Colbert-Mack ◽  
Chris Wirtalla ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Random Forest ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Hospital System ◽  
Forest Modeling ◽  
Readmission Risk

scholarly journals Contributing Factors to Acute Care Hospital Flow: International Ideas

2021 ◽  
Vol 1 (12) ◽  
Author(s):  
Sean Secord
Keyword(s):  
Acute Care ◽  
Patient Flow ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Contributing Factors ◽  
Roles And Responsibilities ◽  
Process Theories ◽  
The Us ◽  
The Uk ◽  
The Right

High-functioning acute care hospitals enable efficient patient flow from admission to discharge with the right care from the right providers at the right time. Barriers to patient flow can result in cascading events and contribute to patient harm and caregiver burnout. Quality improvement endeavours in the UK, Switzerland, Finland, and the US have shown success through addressing workplace culture, utilizing management and process theories, altering roles and responsibilities, and taking advantage of technologies. Successful and sustainable improvements tend to involve substantial planning along with engagement of stakeholders in the design and implementation of a tailored approach.

scholarly journals Surveillance of ICU Patients for Candida auris in a Suburban Chicago Hospital System: Results of a Limited Trial

2020 ◽  
Vol 41 (S1) ◽  
pp. s399-s400
Author(s):  
Mary Alice Lavin ◽  
Donna Schora ◽  
Adrienne Fisher ◽  
Bridget Kufner ◽  
Rachel Lim ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Medical Record ◽  
Acute Care ◽  
Clinical Case ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Candida Auris ◽  
Hospital System ◽  
Screening Criteria ◽  
Record Review

Background:Candida auris prevalence in Illinois, particularly in the metropolitan Chicago area, is high. The Illinois Department of Public Health recommends empiric contact precautions for patients with a tracheostomy or requiring mechanical ventilation from skilled nursing facilities (vSNFs) or long-term acute-care hospitals (LTACHs) who are admitted to an acute-care hospital. Cases of C. auris infection and colonization are reportable to the Illinois Extensively Drug Resistant Organism Registry (XDRO Registry). NorthShore University HealthSystem (NSUHS) actively screens adult intensive care unit (ICU) admissions from LTACHs and vSNFs for CA. Methods: NSUHS is a 4-hospital system located north of Chicago with 750 beds, 4 ICUs and ∼64,000 annual admissions. Beginning in April 2019, a composite axilla–groin swab was collected from all ICU LTACH or vSNF admissions. Composite swabs are cultured on Inhibitory Mold Agar. In July 2019, an ICU clinical case of C. auris was identified from a ventilated patient admitted from an outside hospital prompting the expansion of screening to include acute-care hospital transfers. To evaluate the value of screening criteria, a medical record review and retrospective query of the XDRO Registry was performed for all screened patients. Because cocolonization with carbapenemase-producing organisms (CPO) has been reported, CPO status was also queried. Results: Between April 1 and October 31, 2019, 70 patients were screened. Two screened patients did not meet the screening criteria (Fig. 1). No patients, with the exception of the clinical case, were found to be colonized with CA. The XDRO Registry query identified no patients with C. auris. Of the 70 patients, 9 (13%) had a CPO. Of those screened, 14 (20%) had a tracheostomy and/or mechanical ventilation (Table 1). Conclusions: Querying the XDRO registry at admission in combination with a medical record review appears adequate to identify patients admitted to a NSUHS ICU with C. auris and CPOs. Targeting patients admitted with a tracheostomy and/or mechanical ventilation may further reduce the number of screening cultures performed.Funding: NoneDisclosures: None

scholarly journals Fully Vaccinated and Boosted Patients Requiring Hospitalization for COVID-19: an Observational Cohort Analysis

2022 ◽  
Author(s):  
Nicholas Mielke ◽  
Steven Johnson ◽  
Amit Bahl
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Mortality ◽  
Cohort Analysis ◽  
Acute Care Hospital ◽  
Baseline Risk ◽  
Common Symptom ◽  
Care Hospital ◽  
Real World Data ◽  
Hospital System ◽  
Observational Cohort

Objective: Real-world data on the effectiveness of boosters against COVID-19, especially as new variants continue to emerge, is limited. It is our objective to assess demographic, clinical, and outcome variables of patients requiring hospitalization for severe SARS-CoV-2 infection comparing fully vaccinated and boosted (FV&B) and unvaccinated (UV) patients. Methods: This multicenter observational cohort analysis compared demographic, clinical, and outcome variables in FV&B and UV adults hospitalized for COVID-19. A sub-analysis of FV&B patients requiring intensive care (ICU) care versus non-ICU care was performed to describe and analyze common symptom presentations, initial vital signs, initial laboratory workup, and pertinent medication use in these two groups. Results: Between August 12th, 2021 and December 6th, 2021, 4,571 patient encounters had a primary diagnosis of COVID-19 and required inpatient treatment at an acute-care hospital system in Southeastern Michigan. Of the 4,571 encounters requiring hospitalization, 65(1.4%) were FV&B and 2,935(64%) were UV. FV&B individuals were older (74 [67, 81] vs 58 [45, 70]; p <0.001) with a higher proportion of immunocompromised individuals (32.3% vs 10.4%; p<0.001). Despite a significantly higher baseline risk of in-hospital mortality in the FV&B group compared to the UV (Elixhauser 16 vs 8 (p <0.001)), there was a trend toward lower in-hospital mortality (7.7% vs 12.1%; p=0.38) among FV&B patients. Other severe outcomes followed this same trend, with 7.7% of FV&B vs 11.1% UV patients needing mechanical ventilation and 4.6% vs 10.6% of patients needing vasopressors in each group, respectively (p=0.5 and 0.17). Conclusions: Fully vaccinated and boosted individuals requiring hospital-level care for breakthrough COVID-19 tended to have less severe outcomes despite appearing to be higher risk at baseline when compared to unvaccinated individuals during the same time period. Specifically, there was a trend that FV&B group had lower rates of mechanical ventilation, use of vasopressors, and in-hospital mortality. As COVID-19 continues to spread, larger expansive trials are needed to further identify risk factors for severe outcomes among the FV&B population.

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