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How can private hospitals be used as a solution to provide outflow surge capacity to public hospitals during mass casualty incidents
Affiliations- Vrije University, Boulevard de la Plaine 2, 1050 Ixelles, Belgium, Belgium
- Beacon Hospital, Sandyford, Dublin 16, Ireland
- Johns Hopkins Aramco Healthcare, Almond Ln, Najmah, Ras Tanura 32814, Saudi Arabia, Saudi Arabia
open access
Abstract
INTRODUCTION: Private hospitals are not utilised as a part of a solution in Ireland in the event of Mass Casualty Incidents (MCI) in Ireland. While disaster planning is evident in each hospital and there is also a national plan in place, no plan details the difficulties public hospitals are facing on a daily basis with overcrowding in both Emergency Departments (ED) and throughout the hospital. The aim of this study is to look at how private hospitals may be used as part of the greater solution in providing Outflow Surge Capacity (OSC) to the public hospitals, and: are private hospitals able to deliver outflow surge capacity in times of great need.
MATERIAL AND METHODS: This study was conducted from October 2018 – May 2019 in a selection of public and private hospitals in the greater Dublin (Ireland) region. Ethics approval was obtained and purposive sampling was employed. Semi-structured interviews following a Straussian Grounded Theory (SGT) design were conducted following the recruitment of 16 high-level key stakeholders in 4 hospitals of interest representing both public and private sectors. No demographic data was collected, ensuring anonymity. Data was analysed manually using grounded theory principles, which involved open, axial and selective coding.
RESULTS: All participants were found to be open to utilising private hospitals as OSC. Private hospitals were recognised by public hospitals as having the ability, skills and expertise to assist public hospitals with OSC. High awareness of the need for additional space in acute hospitals was evident. All participants showed concern for current overcrowding hospital wide nationally.
CONCLUSIONS: Public hospitals identified a number of approaches to utilise private hospitals as OSC. Private hospitals showed readiness and agreement to provide OSC, however, willingness was not assessed due to the number of private hospitals included in the study Further research is required to ascertain Government willingness to participate and establish financial accountability should this finding be introduced.
Abstract
INTRODUCTION: Private hospitals are not utilised as a part of a solution in Ireland in the event of Mass Casualty Incidents (MCI) in Ireland. While disaster planning is evident in each hospital and there is also a national plan in place, no plan details the difficulties public hospitals are facing on a daily basis with overcrowding in both Emergency Departments (ED) and throughout the hospital. The aim of this study is to look at how private hospitals may be used as part of the greater solution in providing Outflow Surge Capacity (OSC) to the public hospitals, and: are private hospitals able to deliver outflow surge capacity in times of great need.
MATERIAL AND METHODS: This study was conducted from October 2018 – May 2019 in a selection of public and private hospitals in the greater Dublin (Ireland) region. Ethics approval was obtained and purposive sampling was employed. Semi-structured interviews following a Straussian Grounded Theory (SGT) design were conducted following the recruitment of 16 high-level key stakeholders in 4 hospitals of interest representing both public and private sectors. No demographic data was collected, ensuring anonymity. Data was analysed manually using grounded theory principles, which involved open, axial and selective coding.
RESULTS: All participants were found to be open to utilising private hospitals as OSC. Private hospitals were recognised by public hospitals as having the ability, skills and expertise to assist public hospitals with OSC. High awareness of the need for additional space in acute hospitals was evident. All participants showed concern for current overcrowding hospital wide nationally.
CONCLUSIONS: Public hospitals identified a number of approaches to utilise private hospitals as OSC. Private hospitals showed readiness and agreement to provide OSC, however, willingness was not assessed due to the number of private hospitals included in the study Further research is required to ascertain Government willingness to participate and establish financial accountability should this finding be introduced.
Keywords
surge capacity; disaster planning; disaster management; public-private partnership; mass casualty incident; disaster preparedness
About this articleTitle
How can private hospitals be used as a solution to provide outflow surge capacity to public hospitals during mass casualty incidents
Journal
Disaster and Emergency Medicine Journal
Issue
Article type
Research paper
Pages
158-165
Published online
2019-11-13
Page views
1045
Article views/downloads
591
DOI
Bibliographic record
Disaster Emerg Med J 2019;4(4):158-165.
Keywords
surge capacity
disaster planning
disaster management
public-private partnership
mass casualty incident
disaster preparedness
Authors
Arlene Minnock
Hany Ebeid
References (23)- Hospital preparedness checklist for pandemic influenza. Focus on pandemic (H1N1) 2009. http://www.euro.who.int/__data/assets/pdf_file/0004/78988/E93006.pdf (3.06.2019).
- Ryan T. 'Inconceivable' that health system would be able to deal with mass casualty event. https://www.thejournal.ie/health-service-warning-mass-casualty-event-3786029-Jan2018/ (3.06.2019).
- Wall M. HSE has ‘no capacity’ to deal with nuclear or biological incident. The Irish Times. 2018. https://www.irishtimes.com/news/ireland/irish-news/hse-has-no-capacity-to-deal-with-nuclear-or-biological-incident-1.3363111 (3.06.2019).
- O'Regan E. Hospitals 'at full capacity' and could not cope with a major disaster, HSE told. Independent.ie. 2017. https://www.independent.ie/irish-news/health/hospitals-at-full-capacity-and-could-not-cope-with-a-major-disaster-hse-told-36389442.html (14.03.2019).
- Gantly D. It’s the bed numbers, stupid. Irish Medical Times 2017. https://www.imt.ie/news/bed-numbers-stupid-06-10-2017 (03.06.2018).
- Ben-Ishay O, Mitaritonno M, Catena F, et al. Mass casualty incidents - time to engage. World J Emerg Surg. 2016; 11: 8.
- Veenema TG, Boland F, Patton D, et al. Analysis of Emergency Health Care Workforce and Service Readiness for a Mass Casualty Event in the Republic of Ireland. Disaster Med Public Health Prep. 2019; 13(2): 243–255.
- Welzel TB, Koenig KL, Bey T, et al. Effect of hospital staff surge capacity on preparedness for a conventional mass casualty event. West J Emerg Med. 2010; 11(2): 189–196.
- National Risk Assessment for Ireland 2017 | Emergency Planning. https://www.emergencyplanning.ie/en/news/national-risk-assessment-ireland-2017 (3.06.2019).
- Private Hospitals Association. 2017. http://privatehospitals.ie/private-hospitals-in-ireland/ (3.06.2019).
- Fitzgerald C. Private hospital beds to be used to ease emergency department overcrowding. https://www.thejournal.ie/trolley-crisis-3787352-Jan2018/ (3.09.2019).
- ED Trolley Watch/Ward Watch Figures below for 31st August 2016. https://www.inmo.ie/Trolley_Ward_Watch (3.06.2019).
- Health Service Capacity Review 2018 Executive Report; Review of Health and Capacity Requirements in Ireland to 2031-Findings and Recommendations. https://health.gov.ie/wp-content/uploads/2018/02/71580-DoH-Dublin-Report-v6.pdf (3.06.2019).
- Ring E. Number of patients on hospital trolleys hits 668. https://www.irishexaminer.com/ireland/number-of-patients-on-hospital-trolleys-hits-668-466194.html (3.06.2019).
- Purposive Sampling. The SAGE Encyclopedia of Qualitative Research Methods. 2008.
- Kenny M, Fourie R. Contrasting Classic, Straussian, and Constructivist Grounded Theory: Methodological and Philosophical Conflicts. http://nsuworks.nova.edu/tqr/vol20/iss8/9 (24.05.2019).
- Lawrence J, Tar U. The use of Grounded Theory Technique as a Practical Tool for Qualitative Data Collection and Analysis. The Electronic Journal of Business Research Methods. 2013; 11(1): 29–40.
- Thai M, Chong L, Agrawal N. Straussian Grounded-Theory Method: An Illustration. NSUWorks. 2012. https://nsuworks.nova.edu/tqr/vol17/iss26/2/ (22.05.2019).
- Condon D. Chronic capacity problems in acute hospitals . www.irishhealth.com/article.html?id=25953-Chronic capacity problems in acute hospitals (14.06.2019).
- Joint Commission InternationalAccreditation Standards forHospitals. https://www.jointcommissioninternational.org/assets/3/7/JCI_Standards_Only_6th_Ed_Hospital.pdf (25.05.2019).
- Karim Z. JCI ‘Facility Management and Safety (FMS)’ standards are crafting safest hospital buildings’ equipment and systems, with disaster readiness(!). https://www.linkedin.com/pulse/jci-facility-management-safety-fms-standards-crafting-zakirul/ (21.06.2019).
- Reidy M, Ryan F, Hogan D, et al. Preparedness of Hospitals in the Republic of Ireland for an Influenza Pandemic, an Infection Control Perspective. BMC Public Health. 2015; 15: 847.
- Dayton C, Ibrahim J, Augenbraun M, et al. Integrated plan to augment surge capacity. Prehosp Disaster Med. 2008; 23(2): 113–119.