Use of simulation models when developing and testing hospital evacuation plans: a tool for improving emergency preparedness

Monica Rådestad; Cecilia Holmgren; Ellinor Linde Blidegård; Kristina Lennquist Montán

doi:10.1186/s13049-023-01105-w

Use of simulation models when developing and testing hospital evacuation plans: a tool for improving emergency preparedness

Scand J Trauma Resusc Emerg Med. 2023 Aug 29;31(1):43. doi: 10.1186/s13049-023-01105-w.

Authors

Monica Rådestad^{1

2}, Cecilia Holmgren³, Ellinor Linde Blidegård⁴, Kristina Lennquist Montán⁵

Affiliations

¹ Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sjukhusbacken 10, Stockholm, SE-118 83, Sweden. monica.radestad@capiostgoran.se.
² Capio S:t Görans sjukhus, Sankt, Göransplan 1, Stockholm, SE-112 81, Sweden. monica.radestad@capiostgoran.se.
³ Capio S:t Görans sjukhus, Sankt, Göransplan 1, Stockholm, SE-112 81, Sweden.
⁴ , Södersjukhuset, Sjukhusbacken 10, Stockholm, SE-118 83, Sweden.
⁵ Department of Global Public Health, Karolinska Institutet, Stockholm, SE-171 77, Sweden.

Abstract

Background: In recent decades, analyses of hospitals evacuations have generated valuable knowledge. Unfortunately, these evacuation case studies often lack crucial details and policies that would be helpful in evacuation preparedness. The aim of this study was to use a simulation model to illustrate how it can aid emergency planners in the development, testing, and revising of hospitals evacuation plans. This study includes evacuation exercises at two emergency hospitals in Region Stockholm, Sweden.

Methods: A scientifically validated simulation system for "table top" exercises was used for interactive training of hospital medical staff, prehospital staff and collaborating agencies. All participants acted in their usual professionals' roles. The exercises were run in real-time and mirrored actual hospital resources with the aid of moveable magnetic symbols illustrating patients, staff and transport, presented on whiteboards. During the exercises, observers and independent instructors documented actions taken and post-exercise surveys were conducted to obtain reactions and compare results.

Results: The simulation system allowed the emergency planner to test the whole evacuation process, making it possible to train and evaluate the important functions of management, coordination, and communication. Post-exercise surveys explored participants perception of the exercises. Analysis of open-ended questions included areas for improvement and resulted in five main categories: (1) management and liaison; (2) communication; (3) logistics; (4) medical care and patient prioritisation; and (5) resource utilisation.

Conclusions: This study has shown that "table top" exercises using a validated simulation system can serve to guide emergency planners when developing evacuation plans, procedures, and protocols as well in training of all medical staff. The system also served to train adaptive thinking, leadership, communication, and clarification of critical functions.

Keywords: Decision making; Emergency planning; Emergency preparedness; Hospital evacuation; Simulation exercise.

MeSH terms

Civil Defense*
Communication
Computer Simulation
Hospitals
Humans
Leadership