An integrated decision model for managing hospital evacuation in response to an extreme flood event: A case study of the Hawkesbury‐Nepean River, NSW, Australia

Abstract

The frequency and severity of floods is increasing in many countries, and hospitals play an essential role in protecting the community from their potentially devastating impacts. However, many hospitals are vulnerable to flooding having been designed and located without these risks in mind. In such situations, evacuation of vulnerable patients to safer alternative healthcare facilities might be the most reasonable response. However, there has been little research into hospital evacuation, and to address this research gap, this paper presents an innovative hospital evacuation model that can facilitate the optimal scheduling and sequencing of hospital evacuation under indeterministic flooding conditions. The proposed model combines a flood simulator and a mathematical model. Assuming the high levels of complexity of a realistic hospital evacuation system, a Benders-Decomposition approach is developed to cope with large size problems. A case study in New South Wales (NSW), Australia, is used to illustrate the proposed model, and results confirm that the model can generate effective plans to evacuate hospitals in the shortest time possible in flood emergency conditions. The findings of this study contribute new theoretical and practical insights to a growing body of knowledge about disaster response strategies in hospitals and have implications for health service management and health policymakers in countries where health infrastructures are vulnerable to increasing climate change risks.