Extensive data collection in an in-hospital disaster response exercise for evaluating disaster resilience

Abstract: Hospitals need to prepare for disasters. For this purpose, they need to formulate a BCP and a response plan and conduct training and exercise. Through training and exercise, they are expected to learn necessary actions and procedures, as well as to find problems in the BCP and response plan. It is, however, not easy to comprehend and evaluate the entire training and exercise process, particularly as the scale of the training and exercise becomes larger. Besides, it also becomes more difficult to find important problems and their causes in training and exercise. To solve this problem, it is necessary to record the events and activities during training and exercise as much detail as possible and analyze them from various viewpoints. This paper describes the comprehensive data recordings in a disaster response exercise in a big hospital in Kanagawa Prefecture, Japan. This hospital is one of the largest hospitals in the region and is designated as a disaster-base hospital which is expected to play a central role in disaster medicine in the area. The target exercise is an annual exercise for a mass casualty incident assuming a big earthquake, in which 46 injured patients are transported to the hospital. We collected data on the following three aspects of the exercise: judgment and decision-making, such as triage and diagnosis and treatment, the in-hospital flow of patients and medical instruments, and the flow of information in and among different areas and rooms. Regarding the data on judgment and decision-making, we collected the documents used in actual disaster medicine, such as triage tags and medical charts. For the other data, we used action cameras attached to hospital staff, station cameras to observe the activities in specific areas, IC recorders attached to patients and several important hospital staff, PHS-IC recorders attached to area leaders to record inter-area communication, Zoom recordings for online communications, and several observers to record inter-area transfer of patients.This paper also describes preliminary analyses of the data recorded in the exercise, including the accuracy of 1st and 2nd triage, the details of patient flow, and the length of stay in each area.Finally, this paper describes the data analysis planned in the next step, such as network analysis of inter-area communication, task analysis of the activities in each area, and so on. In addition, we will discuss the possibility of utilizing the study to reproduce the exercise using the agent-based simulation we developed for a deeper understanding of the entire process of the in-hospital disaster medicine process.

Keywords: Business Continuity Plan, Disaster, Medicine Process, Task Analysis, Agent, based Simulation

DOI: 10.54941/ahfe1003068

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