Graduate Institute of Data Science, Taipei Medical University, Taipei, Taiwan.
TMU Research Center of Health and Welfare Policy, Taipei Medical University, 12F, No. 172-1, Sec. 2 Keelung Rd. Da an Dist., Taipei City, Taiwan.
World J Emerg Surg. 2021 Nov 29;16(1):59. doi: 10.1186/s13017-021-00403-x.
Large-scale burn disasters can produce casualties that threaten medical care systems. This study proposes a new approach for developing hospital readiness and preparedness plan for these challenging beyond-surge-capacity events.
The Formosa Fun Coast Dust Explosion (FFCDE) was studied. Data collection consisted of in-depth interviews with clinicians from four initial receiving hospitals and their relevant hospital records. A detailed timeline of patient flow and emergency department (ED) workload changes of individual hospitals were examined to build the EDs' overload patterns. Data analysis of the multiple hospitals' responses involved chronological process-tracing analysis, synthesis, and comparison analysis in developing an integrated adaptations framework.
A four-level ED overload pattern was constructed. It provided a synthesis of specifics on patient load changes and the process by which hospitals' surge capacity was overwhelmed over time. Correspondingly, an integrated 19 adaptations framework presenting holistic interrelations between adaptations was developed. Hospitals can utilize the overload patterns and overload metrics to design new scenarios with diverse demands for surge capacity. The framework can serve as an auxiliary tool for directive planning and cross-check to address the insufficiencies of preparedness plans.
The study examined a wide-range spectrum of emergency care responses to the FFCDE. It indicated that solely depending on policies or guidelines for preparedness plans did not contribute real readiness to MCIs. Hospitals can use the study's findings and proposal to rethink preparedness planning for the future beyond surge capacity events.
大规模烧伤灾难可能会造成危及医疗系统的伤亡。本研究提出了一种新方法，用于制定医院应对这些具有挑战性的超能力事件的准备和预备计划。
研究了台湾美丽华尘爆事件。数据收集包括对来自四家初始接收医院的临床医生进行深入访谈以及他们的相关医院记录。详细检查了各个医院的患者流量时间表和急诊部（ED）工作量变化，以建立 ED 的过载模式。对多家医院的反应进行数据分析涉及在开发综合适应框架时进行时间顺序过程追踪分析、综合和比较分析。
构建了四级 ED 过载模式。它综合了患者负荷变化的具体情况以及医院随着时间的推移超量能力被淹没的过程。相应地，开发了一个综合的 19 项适应框架，展示了适应之间的整体相互关系。医院可以利用过载模式和过载指标来设计具有不同超能力需求的新场景。该框架可以作为指令性规划和交叉检查的辅助工具，以解决准备计划的不足。
本研究考察了对台湾美丽华尘爆事件的广泛范围的紧急护理反应。它表明，仅依靠政策或准备计划指南并不能为重大事故中的医疗需求提供真正的准备。医院可以使用研究结果和建议重新思考未来超能力事件的准备计划。
