Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-23T21:24:41.813Z Has data issue: false hasContentIssue false
  • English
  • Français

Surge Capacity Crisis and Mitigation Plan in Trauma Setting Based on Real-Time National Trauma Registry Data

Published online by Cambridge University Press:  17 March 2021

Hassan Al-Thani ,
Tim Frazier ,
Attila J Hertelendy Open the ORCID record for Attila J Hertelendy [Opens in a new window] ,
Mohammad Asim  and
Ayman El-Menyar Open the ORCID record for Ayman El-Menyar [Opens in a new window]
Hassan Al-Thani
Affiliation:
Department of Surgery, Trauma and Vascular Surgery, Hamad General Hospital, Doha, Qatar
Tim Frazier
Affiliation:
Emergency and Disaster Management Program, Georgetown University, Washington, DC, USA
Attila J Hertelendy
Affiliation:
Department of Decision Sciences and Business Analytics, College of Business, Florida International University, Miami, USA
Mohammad Asim
Affiliation:
Department of Surgery, Trauma and Vascular Surgery, Hamad General Hospital, Doha, Qatar
Ayman El-Menyar*
Affiliation:
Department of Surgery, Trauma and Vascular Surgery, Hamad General Hospital, Doha, Qatar Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar
*
Corresponding author: Ayman El-Menyar, Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

The objective of this study was to assess the current breaking point of crisis surge capacity of trauma services in Qatar and to develop a mitigation plan.

Methods:

The study utilized real-time data from the National Trauma Registry. Data was explored cumulatively by weeks, months and a year’s interval and all trauma admissions within this time frame were considered as 1 ‘Disaster Incident.’

Results:

A total of 2479 trauma patients were included in the study over 1 year. The mean age of patients was 31.5 ± 15.9 and 84% were males. The number of patients who sustained severe trauma which necessitated Level 1 activation was 16%. The emergency medical services (EMS) surge attained crisis of operational capacity at 5 months of disaster incident for priority 1 cases. Bed capacity at the floor was the first to reach operational crisis followed by the ICU and operating room. The gap in the surge for surgical interventions was specific to the specialty and surgery type which reached operational crisis at 3 months.

Conclusion:

The study highlights the surge capacity and capability of the healthcare system at a Level 1 trauma center. The identified gaps in surge capacity require several key components of healthcare resources to be addressed across the continuum of care.

Keywords

surge capacitymitigationplanresource management
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 16 , Issue 2 , April 2022 , pp. 689 - 697
Copyright
© 2021 Society for Disaster Medicine and Public Health, Inc.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baker, MS. Creating order from chaos: Part II: Tactical planning for mass casualty and disaster response at definitive care facilities. Mil Med. 2007;172(3):237–243.10.7205/MILMED.172.3.237CrossRefGoogle ScholarPubMed
Hick, JL, Barbera, JA, Kelen, GD. Refining surge capacity: Conventional, contingency, and crisis capacity. Disaster Med Public Health Prep. 2009;3(2 Suppl):S59–S67.10.1097/DMP.0b013e31819f1ae2CrossRefGoogle ScholarPubMed
Davis, DP, Poste, JC, Hicks, T, Polk, D, Rymer, TE, Jacoby, I. Hospital bed surge capacity in the event of a mass-casualty incident. Prehosp Disaster Med. 2005;20(3):169–176.CrossRefGoogle ScholarPubMed
Kaji, A, Koenig, KL, Bey, T. Surge capacity for healthcare systems: a conceptual framework [published correction appears in Acad Emerg Med. 2007;14(1):22]. Acad Emerg Med. 2006;13(11):1157–1159.CrossRefGoogle Scholar
Watson, SK, Rudge, JW, Coker, R. Health systems’ “surge capacity”: State of the art and priorities for future research. Milbank Q. 2013;91(1):78–122.CrossRefGoogle ScholarPubMed
Ball, CG, Kirkpatrick, AW, Mulloy, RH, Gmora, S, Findlay, C, Hameed, SM. The impact of multiple casualty incidents on clinical outcomes. J Trauma. 2006;61(5): 1036–1039.CrossRefGoogle ScholarPubMed
Peleg, K, Rozenfeld, M, Stein, M. Poorer outcomes for mass casualty events victims: Is it evidence based? J Trauma. 2010;69(3):653–8; discussion 659.Google ScholarPubMed
World Population Review. Qatar population 2020 (Live). Retrieved from https://worldpopulationreview.com/countries/qatar-population/. Accessed on June 20, 2020.Google Scholar
Hamad Medical Corporation (HMC). Health: Operational Performance. Automation of HMC Warehouses through Oracle E-Business Suite. https://www.hamad.qa/EN/About-Us/Stars-of-Excellence/Stars-of-Excellence-2017/Pages/Health-Operational-Performance.aspx. Accessed on June 18, 2020.Google Scholar
Lerner, EB, Schwartz, RB, Coule, PL, et al. Mass casualty triage: an evaluation of the data and development of a proposed national guideline. Disaster Med Public Health Prep. 2008;2 Suppl 1:S25–S34.CrossRefGoogle Scholar
Kupas, DF, Melnychuk, EM, Young, AJ. Glasgow Coma Scale Motor Component (“Patient Does Not Follow Commands”) performs similarly to total Glasgow Coma Scale in predicting severe injury in trauma patients. Ann Emerg Med. 2016;68(6):744–750.e3.CrossRefGoogle ScholarPubMed
Hick, JL, Einav, S, Hanfling, D, et al. Surge capacity principles: Care of the critically ill and injured during pandemics and disasters: CHEST consensus statement. Chest. 2014;146 (4 Suppl):e1S–e16S.CrossRefGoogle ScholarPubMed
Wilson, P, Alinier, G, Reimann, T, Morris, B. Influential factors on urban and rural response times for emergency ambulances in Qatar. Med Emergency. 2018;26:8–13.Google Scholar
Morley, C, Unwin, M, Peterson, GM, Stankovich, J, Kinsman, L. Emergency department crowding: A systematic review of causes, consequences and solutions. PLoS One. 2018;13(8):e0203316.CrossRefGoogle ScholarPubMed
Yarmohammadian, MH, Rezaei, F, Haghshenas, A, Tavakoli, N. Overcrowding in emergency departments: A review of strategies to decrease future challenges. J Res Med Sci. 2017; 22:23.Google ScholarPubMed
Ebrahimian, A, Ghasemian-Nik, H, Ghorbani, R, Fakhr-Movahedi, A. Development of a reverse triage system based on modified sequential organ failure assessment for increasing the critical care surge capacity. Indian J Crit Care Med. 2018;22(8):575–579.Google ScholarPubMed
Kelen, GD, Sauer, L, Clattenburg, E, Lewis-Newby, M, Fackler, J. Pediatric disposition classification (reverse triage) system to create surge capacity. Disaster Med Public Health Prep. 2015;9(3):283–290.10.1017/dmp.2015.27CrossRefGoogle ScholarPubMed
Kelen, GD, Troncoso, R, Trebach, J, et al. Effect of reverse triage on creation of surge capacity in a pediatric hospital. JAMA Pediatr. 2017;171(4):164829.CrossRefGoogle Scholar
World Health Organization (WHO) Regional Office for Europe. Strengthening health-system emergency preparedness. Toolkit for assessing health-system capacity for crisis management: Part 1. User manual; 2012. Denmark, EU. http://www.euro.who.int/__data/assets/pdf_file/0008/157886/e96187.pdf. Accessed 1 February 2020.Google Scholar
United Nations Development Programme (UNDP), European Commission Humanitarian Office (ECHO). Community-based best practices for disaster risk reduction. Mozambique: The Disaster Preparedness Programme (DIPECHO) Regional Initiative in Disaster Risk Reduction; 2010. Google Scholar
Terndrup, TE, Leaming, JM, Adams, RJ, Adoff, S. Hospital-based coalition to improve regional surge capacity. West J Emerg Med. 2012;13(5):445–452.CrossRefGoogle ScholarPubMed
Hershkovich, O, Gilad, D, Zimlichman, E, Kreiss, Y. Effective medical leadership in times of emergency: A perspective. Disaster Mil Med. 2016;2:4.CrossRefGoogle ScholarPubMed
Verson, J, Dyga, N, Agbayani, N, Serafin, F, Hondros, L. Design and implementation of a medical student hazardous materials response team: The Medical Student HazMat Team. Int J Emerg Med. 2018;11(1):38.10.1186/s12245-018-0195-6CrossRefGoogle Scholar
Bahrami, M, Aliakbari, F, Aein, F. Investigation of competencies of nurses in disaster response by utilizing objective structured clinical examination. Iran J Nurs Midwifery Res. 2014;19(7 Suppl 1):S1–S6.Google ScholarPubMed
Berger, FH, Körner, M, Bernstein, MP, et al. Emergency imaging after a mass casualty incident: Role of the radiology department during training for and activation of a disaster management plan. Br J Radiol. 2016;89(1061):20150984.CrossRefGoogle ScholarPubMed
Hick, JL, Nelson, J, Fildes, J, Kuhls, D, Eastman, A, Dries, D. Triage, trauma, and today’s mass violence events. J Am Coll Surg. 2020;230(2):251–256.CrossRefGoogle ScholarPubMed
Kearns, RD, Cairns, BA, Cairns, CB. Surge capacity and capability. A review of the history and where the science is today regarding surge capacity during a mass casualty disaster. Front Public Health. 2014;2:29.10.3389/fpubh.2014.00029CrossRefGoogle ScholarPubMed
Ministry of Public Health (MoPH). National Health Strategy 2018-2022. https://www.moph.gov.qa/HSF/Documents/short%20report%20eng%2020.03.2018.pdf. Accessed November 18, 2019.Google Scholar