Graduate Institute of Data Science, Health Policy and Care Research Center, Taipei Medical University, Taipei, Taiwan.
Department of Integrated Systems Engineering, The Ohio State University, Columbus, Ohio.
Disaster Med Public Health Prep. 2020 Aug;14(4):467-476. doi: 10.1017/dmp.2019.69. Epub 2019 Aug 23.
The study provides a comprehensive insight into how an initial receiving hospital without adequate capacity adapted to coping with a mass casualty incident after the Formosa Fun Coast Dust Explosion (FFCDE).
Data collection was via in-depth interviews with 11 key participants. This was combined with information from medical records of FFCDE patients and admission logs from the emergency department (ED) to build a detailed timeline of patients flow and ED workload changes. Process tracing analysis focused on how the ED and other units adapted to coping with the difficulties created by the patient surge.
The hospital treated 30 victims with 36.3% average total body surface area burn for over 5 hours alongside 35 non-FFCDE patients. Overwhelming demand resulted in the saturation of ED space and intensive care unit beds, exhaustion of critical materials, and near-saturation of clinicians. The hospital reconfigured human and physical resources differently from conventional drills. Graphical timelines illustrate anticipatory or reactive adaptations. The hospital's ability to adapt was based on anticipation during uncertainty and coordination across roles and units to keep pace with varying demands.
Adapting to beyond-surge capacity incident is essential to effective disaster response. Building organizational support for effective adaptation is critical for disaster planning.
本研究全面深入地探讨了一家初始接收医院在面对“福尔摩沙欢乐世界粉尘爆炸事件”（FFCDE）后，如何在没有足够能力的情况下适应大量伤员的情况。
通过对 11 名关键参与者进行深入访谈收集数据。将 FFCDE 患者的病历信息和急诊科入院记录与访谈信息相结合，构建了一个详细的患者流程和急诊科工作量变化时间表。过程追踪分析侧重于急诊科和其他单位如何适应因患者大量涌入而产生的困难。
该医院在 5 个多小时的时间里治疗了 30 名平均总体表烧伤面积 36.3%的 FFCDE 患者和 35 名非 FFCDE 患者。巨大的需求导致了急诊科空间和重症监护室床位饱和、关键物资耗尽以及临床医生接近饱和。医院在人员和物资配置方面的调整与常规演习不同。图形时间线说明了预期或反应性的适应。医院的适应能力基于不确定性期间的预期以及角色和单位之间的协调，以适应不断变化的需求。
适应超出能力极限的事件对于有效的灾害应对至关重要。为有效的适应能力建立组织支持对于灾害规划至关重要。
