Plan the evacuation of a hospital at imminent risk: A multimodal assessment for each hospital

Abstract

BackgroundThe increasing frequency and intensity of climatic events and the number of infrastructures involved require standardization and multiplication of the evaluation of hospital evacuation plans. This article presents an automated simulation method dedicated to guiding experts in the development of a hospital selective evacuation plan. MethodsA pragmatic adaptation of the 13 principles of the international guidelines by a local operational expert working group led to the implementation of a computer-assisted simulation model. An application for a public hospital at significant risk of flooding is provided. ResultsThe expert group classifies each patient to be transferred according to 3 priorities (P1 to P3), 3 age categories (adult, paediatric, neonatal), specific transfer equipment and team required, and type of reception unit in hospitals. Ten specific profiles for transport conditions or destination hospitals were considered. The model can be used either to evaluate the minimal number of evacuation means necessary to proceed with the evacuation in a few hour of all the patients who require evacuation (output) or alternatively, the number of patients out of delay considering the number of evacuation means available (constraint). The model can be adapted with real-time constraints or optimization strategies such as traffic conditions, convoys, ephemeral proximity units, and reinforcements. ConclusionThe definition of the criteria that impact hospital intensive care unit evacuation, followed by the identification of these elements in the case of each hospital concerned, allows the construction of a homogeneous and transposable planning model and identifies the best evacuation strategies for each hospital.