Klokman Vincent W, Barten Dennis G, Peters Nathalie A L R, Versteegen Marieke G J, Wijnands Jaap J J, van Osch Frits H M, Gaakeer Menno I, Tan Edward C T H, Boin Arjen
Department of Emergency Medicine, VieCuri Medical Center, Venlo, The Netherlands.
North Limburg Safety Region, Limburg, The Netherlands.
PLoS One. 2021 Apr 26;16(4):e0250551. doi: 10.1371/journal.pone.0250551. eCollection 2021.
Internal hospital crises and disasters (IHCDs) are events that disrupt the routine functioning of a hospital while threatening the well-being of patients and staff. IHCDs may cause hospital closure, evacuations of patients and loss of healthcare capacity. The consequences may be ruinous for local communities. Although IHCDs occur with regularity, information on the frequency and types of these events is scarcely published in the medical literature. However, gray literature and popular media reports are widely available. We therefore conducted a scoping review of these literature sources to identify and characterize the IHCDs that occurred in Dutch hospitals from 2000 to 2020. The aim is to develop a systematic understanding of the frequency of the various types of IHCDs occurring in a prosperous nation such as the Netherlands.
A systematic scoping review of news articles retrieved from the LexisNexis database, Google, Google News, PubMed and EMBASE between 2000 and 2020. All articles mentioning the closure of a hospital department in the Netherlands were analyzed.
A total of 134 IHCDs were identified in a 20-year time period. Of these IHCDs, there were 96 (71.6%) emergency department closures, 76 (56.7%) operation room closures, 56 (41.8%) evacuations, 26 (17.9%) reports of injured persons, and 2 (1.5%) reported casualties. Cascading events of multiple failures transpired in 39 (29.1%) IHCDs. The primary causes of IHCDs (as reported) were information and communication technology (ICT) failures, technical failures, fires, power failures, and hazardous material warnings. An average of 6.7 IHCDs occurred per year. From 2000-2009 there were 32 IHCDs, of which one concerned a primary ICT failure. Of the 102 IHCDs between 2010-2019, 32 were primary ICT failures.
IHCDs occur with some regularity in the Netherlands and have marked effects on hospital critical care departments, particularly emergency departments. Cascading events of multiple failures transpire nearly a third of the time, limiting the ability of a hospital to stave off closure due to failure. Emergency managers should therefore prioritize the risk of ICT failures and cascading events and train hospital staff accordingly.
医院内部危机与灾难（IHCDs）是扰乱医院日常运作并威胁患者和工作人员健康的事件。IHCDs可能导致医院关闭、患者疏散以及医疗服务能力丧失。其后果可能对当地社区造成毁灭性影响。尽管IHCDs时有发生，但关于这些事件的频率和类型的信息在医学文献中鲜有发表。然而，灰色文献和大众媒体报道却广泛可得。因此，我们对这些文献来源进行了一项范围综述，以识别和描述2000年至2020年期间荷兰医院发生的IHCDs。目的是系统地了解在像荷兰这样的繁荣国家中各类IHCDs发生的频率。
对2000年至2020年期间从LexisNexis数据库、谷歌、谷歌新闻、PubMed和EMBASE检索到的新闻文章进行系统的范围综述。分析了所有提及荷兰医院科室关闭的文章。
在20年的时间里共识别出134起IHCDs。在这些IHCDs中，有96起（71.6%）是急诊科关闭，76起（56.7%）是手术室关闭，56起（41.8%）是疏散，26起（17.9%）有人员受伤报告，2起（1.5%）有人员伤亡报告。39起（29.1%）IHCDs发生了多重故障的连锁事件。IHCDs的主要原因（如报道）是信息和通信技术（ICT）故障、技术故障、火灾、停电以及危险物质警报。每年平均发生6.7起IHCDs。2000年至2009年有32起IHCDs，其中1起涉及主要的ICT故障。在2010年至2019年的102起IHCDs中，32起是主要的ICT故障。
IHCDs在荷兰时有发生，对医院重症监护科室，尤其是急诊科有显著影响。近三分之一的时间会发生多重故障的连锁事件，限制了医院因故障避免关闭的能力。因此，应急管理人员应优先考虑ICT故障和连锁事件的风险，并相应地培训医院工作人员。
