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Evacuation and Sheltering of Hospitals in Emergencies: A Review of International Experience

Published online by Cambridge University Press:  28 June 2012

Jayshree Bagaria ,
Caroline Heggie ,
Jonathan Abrahams  and
Virginia Murray
Jayshree Bagaria
Affiliation:
Specialist Registrar Public Health, Oxford Post Graduate Medical Deanery, seconded to Chemical Hazards and Poisons Division, Health Protection Agency, London
Caroline Heggie
Affiliation:
Emergency Medicine Trainee on second-ment to Chemical Hazards and Poisons Division, Health Protection Agency, London
Jonathan Abrahams
Affiliation:
Coordinator, Risk Reduction & Emergency Preparedness EPC/HAC WHO, Geneva
Virginia Murray*
Affiliation:
Consultant Medical Toxicologist, Chemical Hazards and Poisons Division, Health Protection Agency, London, UK
*
Consultant Medical Toxicologist, Chemical Hazards and Poisons Division, Health Protection Agency, 7th floor Holborn Gate, 330 High Holborn, London WC1V 7PP, UK E-mail: [email protected]
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Abstract

Objective:

A scoping exercise to establish how common hospital evacuations are, identify hospital evacuation policies and review case studies to identify trig-gers, processes and challenges involved in the evacuation of hospitals globally.

Design:

A systematic search of PubMed and disaster agency online resources, search of grey literature and media reports.

Results:

This study showed that hospitals are vulnerable to both natural and man made disasters and that hospital evacuations do occur globally. It highlighted the paucity of published data and policy on hospital evacuation and emphasised the vital need to collect data on triggers, reasons for evacuation, sheltering facilities and the process of evacuation.

Conclusions:

This study recommends the collection of case studies and the development of a database to assist with the research and development of well tailored hospital evacuation plans. These recommendations reflect and support the 2008-2009 World Disaster Reduction Campaign on Hospitals Safe from Disasters and the timely 2009 Global Platform priority that, ‘Critical services and infrastructure such as health facilities and schools must be safe from disasters.

Keywords

chemical spilldisasterevacuationfirefloodhospitalinternational
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 24 , Issue 5 , October 2009 , pp. 461 - 467
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

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References

1.International Strategy for Disaster Risk Reduction (ISDR): Hospitals Safe from Disasters 2008-2009 World Disaster Reduction Campaign Available at http://www.unisdr.org/eng/public_aware/world_camp/2008-2009/wdrc-2008-2009.html. Accessed April 2009.Google Scholar
2.WHO, PAHO, ISDR, World Bank: Hospitals safe from disasters: Reduce Risk, Protect Health Facilities, Save Lives. 2008. 2008-2009 World Disaster Reduction Campaign. (Report) Available at http://www.safehospitals.info/ or http://safehospitals.info/images/stories/1WhySafeHosp/wdrc-2008-2009-information-kit.pdf. Accessed April 2009.Google Scholar
3.WHO, PAHO, ISDR, World Bank: What is the hospital safety index? 2009. Available at http://safehospitals.info/index.php?option=com_content&task=view&id=30&Itemid=103. Accessed April 2009.Google Scholar
4.Environment Agency: Investing for the future flood and coastal risk management in England. A long term investment strategy. 2009. Bristol. (Report), Available at http://www.environment-agency.gov.uk/research/library/publications/108673.aspx. Accessed April 2009.Google Scholar
5.PAHO: Do we evacuate our hospitals prematurely? Disasters: Preparedness and Mitigation (85). 2001. Available at http://www.paho.org/Project.asp?SEL=TP&LNG=ENG&ID=85&PRGRP=periodicals. Accessed August 2009.Google Scholar
6.PAHO: Should a hospital be evacuated? Hospitals in disaster: Handle with Care Conference. San Salvador 8-10 July 2003. Available at http://www.disaster-info.net/hospital_disaster/background.htm. Accessed April 2009.Google Scholar
7.Sternberg, E, Lee, GC, Huard, D: Counting crises: US hospital evacuations, 1971–1999. Prehosp Disaster Med 2004;19:150–157.CrossRefGoogle ScholarPubMed
8.Burgess, JL: Hospital evacuations due to hazardous materials incidents. Am J Emerg Med 1999;17:50–52.CrossRefGoogle ScholarPubMed
9.Chavez, CW, Binder, B: A hospital as victim and responder: the Sepulveda VA Medical Center and the Northridge earthquake. J Emerg Med 1996;14:445–454.CrossRefGoogle Scholar
10.Martchenke, J, Pointer, JE: Hospital disaster operations during the 1989 Loma Prieta earthquake. Prehosp Disaster Med 1994;9:146–153.CrossRefGoogle ScholarPubMed
11.Schultz, CH, Koenig, KL, Lewis, RJ: Implications of hospital evacuation after the Northridge, California, earthquake. N Engl J Med 2003;348:1349–1355.CrossRefGoogle ScholarPubMed
12.Blumhagen, DW: Evacuation of patients during a fire at a general hospital. Ann Emerg Med 1987;16:209–214.CrossRefGoogle ScholarPubMed
13.Hogan, C: Responding to a fire at a pediatric hospital. AORN J 2002;75:793–800.CrossRefGoogle Scholar
14.Bernard, M, Mathews, PR: Evacuation of a maternal-newborn area during Hurricane Katrina. MCN Am J Matern Child Nurs 2008;33:213–23.CrossRefGoogle ScholarPubMed
15.Gray, BH, Hebert, K. Hospitals in Hurricane Katrina: Challenges facing custodial institutions in a disaster. J Health Care Poor Underserved 2007;18:283–298.CrossRefGoogle ScholarPubMed
16.Norcross, ED, Elliott, BM, Adams, DB, Crawford, FA: Impact of a major hur-ricane on surgical services in a university hospital. Am Surg 1993;59:28–33.Google Scholar
17.Sexton, KH, Alperin, LM, Stobo, JD: Lessons from Hurricane Rita: the University of Texas Medical Branch Hospital's evacuation. Acad Med 2007;82:792–796.CrossRefGoogle ScholarPubMed
18.Taylor, IL: Hurricane Katrina's impact on Tulane's teaching hospitals. Trans Am Clin Climatol Assoc 2007;118:69–78.Google Scholar
19.Thomas, J, Lackey, N: How to evacuate a psychiatric hospital: a Hurricane Katrina success story. J Psychosoc Nurs Ment Health Serv 2008;46:35–40.CrossRefGoogle ScholarPubMed
20.Augustine, J, Schoettmer, J: Evacuation of a rural community hospital: lessons learned from an unplanned event. Disaster Manag Response 2005;3:68–72.CrossRefGoogle ScholarPubMed
21.Blaser, MJ, Ellison, RT3rd: Rapid night time evacuation of a veterans hospital. J Emerg Med 1985;3:387–394.CrossRefGoogle Scholar
22.Cocanour, CS, Allen, SJ, Mazabob, J, Sparks, JW, Fischer, CP, Romans, J, et al. : Lessons learned from the evacuation of an urban teaching hospital. Arch Surg 2002;137:1141–1145.CrossRefGoogle ScholarPubMed
23.Cybulski, P: Evacuation of a critical care unit. Dynamics 2003;14:21–23.Google ScholarPubMed
24.Fisher, HL: Emergency evacuation of the Denver Veteran's Administration Medical Center. Mil Med 1986;151:154–161.CrossRefGoogle ScholarPubMed
25.Henderson, J, Gamble, D: Evacuation. Nurs BC 1998;30:18–20.Google ScholarPubMed
26.Henry, S: Mississauga Hospital: largest evacuation in Canada's history. CMA Journal 1980;122:582–586.Google ScholarPubMed
27.Vasudevan, P, Wade, K: Total facility evacuation at Helena Regional Medical Center. J Ark Med Soc 1997;94:76–77.Google ScholarPubMed
28.Maxwell, C: Hospital organizational response to the nuclear accident at Three Mile Island: implications for future-oriented disaster planning. Am J Public Health 1982;72:275–279.CrossRefGoogle Scholar
29.MacLeod, JA, Blazey, M, Johnson, F, MacMullen, JA: It's not a drill, it's for real! J Nurs Staff Dev 1994;10:293–299.Google Scholar
30.Gallagher, JJ, Jaco, M, Marvin, J, Herndon, DN: Can burn centers evacuate in response to disasters? J Burn Care Res 2006;27:596–599.CrossRefGoogle ScholarPubMed
31.Bushfires force evacuation of two hospitals in western NSW. Available at http://www.abc.net.au/news/newsitems/200112/s445532.htm. Accessed 06 August 2009.Google Scholar
32.Abelson, R, Feuer, A: 10,000 Patients and Staff Members Await Evacuation From Barely Functional Hospitals. Available at http://www.nytimes.com/2005/09/01/national/nationalspecial/01hospital.html. Accessed 06 August 2009.Google Scholar
33.Cooper, A, Koch, K, Mattingley, D: New Orleans shelters to be evacuated. Available at www.cnn.com/2005/WEATHER/08/30/katrina/index.html. Accessed 06 August 2009.Google Scholar
34.Poison sparks evacuation at hospital. Available at http://tvnz.co.nz/view/news_national_story_skin/703375. Accessed 06 August 2009.Google Scholar
35.AFP: One dead, dozens hurt in Indonesian earthquakes. Available at http://www.asiaone.com/News/Latest+News/Asia/Story/A1Story20090105-112267.html. Accessed on 06 August 2009.Google Scholar
36.Mater Hospital A&E closed. Availabe at http://www.irishtimes.com/newspaper/breaking/2009/0702/breaking15.htm. Accessed 06 August 2009.Google Scholar
37.Hooper, J, Kington, T, Addley, E: Italy earthquake leaves 150 dead and scores more trapped under rubble. Available http://www.guardian.co.uk/world/2009/apr/06/italy-earthquake-victims. Accessed 06 August 2009.Google Scholar
38.West, D: London hospital fire: 250 evacuated. Available at http://www.hsj.co.uk/london-hospital-fire-250-evacuated/1988985.article. Accessed 06 August 2009.Google Scholar
39.Firemen Wounded At Hospital Blaze. Available at http://news.sky.com/skynews/Home/UK-News/Fire-At-Great-Ormond-Street-Hospital-For-Children-MassEvacuation/Article/200809415109087. Accessed 06 August 2009.Google Scholar
40.Fire forces hospital's evacuation. Available at http://news.bbc.co.uk/1/hi/england/london/7168206.stm. Accessed 06 August 2009.Google Scholar
41.Staines, R: Patients evacuated following mental health unit fire. Available at http://www.nursingtimes.net/whats-new-in-nursing/patients-evacuated-following-mental-health-unit-fire/1898709.article. Accessed 06 August 2009.Google Scholar
42.Savage, M: Great Ormond Street evacuated after fire. Available at http://www.independent.co.uk/news/uk/home-news/great-ormond-streetevacuated-after-fire-946105.html. Accessed 06 August 2009.Google Scholar
43.Willey, D: Sicilian hospital 'a quake risk'. Available at http://news.bbc.co.uk/1/hi/world/europe/8173680.stm. Accessed 06 August 2009.Google Scholar
44.WHO, SEARO: Counting the losses. Available at http://www.searo.who.int/worldhealthday2009/focus/Counting_losses.htm. Accessed 06 August 2009.Google Scholar
45.Zhiling, H: Buddhist temple acts as emergency maternity unit. Available at http://www.chinadaily.com.cn/china/2008-07/04/content_6819089.htm. Accessed 06 August 2009.Google Scholar
46.Survivors of cyclone left with nothing. Available at http://www.theaustralian.news.com.au/story/0,25197,23652207-25837,00.html. Accessed 06 August 2009.Google Scholar
47.UNISDR: Hyogo Framework for Action 2005-2015. Available at http://www.unisdr.org/eng/hfa/hfa.htm. Accessed 20 April 2009.Google Scholar
48.High Level Plenary Panel 4 “Safer Schools and Hospitals”. Available at http://www.preventionweb.net/globalplatform/2009/programme/plenary/v.p hp?id=110. Accessed 06 August 2009.Google Scholar
49.The Cabinet Office. Evacuation and Shelter Guidance: Non-statutory guidance to complement Emergency Preparedness and Emergency Response & Recovery. Available at http://www.cabinetoffice.gov.uk/media/132739/evac_shelter_guidance.pdf. Accessed 23 July 2009.Google Scholar
50.DH Emergency Preparedness Division: NHS Emergency Planning Guidance 2009 Planning for the evacuation and sheltering of people in health sector settings: Interim strategic national guidance. Available at http://www.dh.gov.uk/en/Managingyourorganisation/Emergencyplanning/DH_470. Accessed 31 May 2009.Google Scholar
51.Government Accountability Office: Disaster preparedness limitations in federal evacuation assistance for health facilities should be addressed. Available at http://www.gao.gov/cgi-bin/getrpt?GAO-06-826. Accessed 23 July 2009.Google Scholar
52.Centre for Bioterrorism Preparedness and Planning: Evacuation Planning for Hospitals draft document. Bioterrorism Hospital Preparedness Program. Available at http://www.nyc.gov/html/doh/downloads/pdf/bhpp/bhpp-hospital-evac-plan.pdf. Accessed 23 July 2009.Google Scholar
53.Aguirre, B, Dynes, R, Kendra, J, Connell, R: Institutional Resilience and Disaster Planning for New Hazards: Insights from Hospitals. Journal of Homeland Security and Emergency Management 2005;2:1–17.CrossRefGoogle Scholar
54.Heggie, C., Bagaria, J, Murray, V, Philpott, C: UK Hospital Evacuations: Building a Database of Lessons Learned. Global Platform for Disaster Risk Reduction. 18–6–2009. (Poster)Google Scholar
55.Schultz, CH, Koenig, KL, Auf der Heide, E, Olson, R: Benchmarking for hos-pital evacuation: a critical data collection tool. Prehosp Disaster Med 2005;20:331–342.CrossRefGoogle Scholar
56.ISDR Scientific and Technical Committee: Reducing disaster risks through science, issues and actions. Available at http://www.preventionweb.net/globalplatform/2009/background/documents/SD-03-ENG-ScientificTechnical-Committee.pdf. Accessed 01 August 2009.Google Scholar