Hospital preparedness for major incidents in Sweden: a national survey with focus on mass casualty incidents

Eur J Trauma Emerg Surg. 2023 Apr;49(2):635-651. doi: 10.1007/s00068-022-02170-z. Epub 2022 Dec 8.

Abstract

Introduction: Mass-casualty incidents, MCI, pose a constant threat on societies all over the world. It is essential that hospital organizations systematically prepare for such situations. A method for repeated follow-up and evaluation of hospital disaster planning is much needed.

Aims: To evaluate Swedish hospitals´ disaster preparedness with focus on MCI through a web-based survey to highlight areas in need of improvement to ensure better preparedness and resilience.

Materials and methods: An online survey was sent to all Swedish emergency hospitals (n = 87, 49 emergency hospitals). One respondent per hospital answered questions about the hospital's disaster planning, training, key functions, and preparedness. The survey was developed based on current knowledge on key areas of interest for all-hazard preparedness, including the WHO's guidelines. The survey was open between September 6th and November 1st, 2021.

Results: 39 hospitals (34 emergency hospitals) from 18/21 regions participated. Main findings included marked differences between regions and hospital types regarding contingency plans, organization, formal education for key functions, disaster training and triage systems.

Conclusions: Generally, Swedish hospitals cover most key areas in disaster preparedness, but no hospital appears to have a full all-hazards coverage, which leaves room for improvement. There are large variations between the different hospitals' preparedness, which need to decrease. Several hospitals expressed a need of national guidelines for developing equivalent contingency plans. The study-method could be used for monitoring compliance with current laws and guidelines.

Keywords: Disaster medicine; Disaster planning; Hospital preparedness; Mass casualty incident; Surge capacity; Sweden.

MeSH terms

  • Disaster Planning*
  • Emergency Service, Hospital
  • Hospitals
  • Humans
  • Mass Casualty Incidents* / prevention & control
  • Sweden