The rates of recorded mass casualties and of emergencies are constantly increasing at both the global and national levels. Hospitals around the world are involved in dealing with such crises. The key to successful management is to be well prepared. To achieve this requires a modern, realistic and adequately tested readiness plan.
The cooperation of different authorities is necessary to deal with potential disasters. In every country, dealing with mass disasters is based on the existence of a readiness plan, the taking of the necessary protective measures and the proper informing of the population. These combined with the proper training of the personnel contribute to the best confrontation of disasters. A high degree of readiness of hospital units is considered essential for an effective emergency response.
A safe hospital is a facility whose services remain accessible and functioning at maximum capacity and within the same infrastructure immediately following a natural disaster. The term 'safe hospital' encompasses all health facilities, regardless of their level of complexity. A hospital is 'safe' when it enjoys the highest level of protection possible, when access routes to the health facility are open and when the water supply and electric power and telecommunications can continue supplying the health facility, thus guaranteeing continuity of operations and the ability to absorb the additional demand for medical care.
The role of hospitals is vital and includes:
Collection and analysis of epidemic data and prevention of possible outbreaks.
Provision of health care before and after the 'emergency' to vulnerable population groups (mothers, children, the elderly, and patients with chronic diseases).
Vaccinations to prevent disease.
Providing critical services such as blood bank, laboratories, and ambulances.
Psychological support for those affected
Providing care to the injured.
Cephalonia is the largest island of the Ionian Islands and is characterized by the largest seismicity in Europe. Earthquakes are frequent and often disastrous. A striking example are the earthquakes of 1953 that destroyed the entire island.
The present study was carried out to investigate and evaluate the readiness of the Regional General Hospital of Cephalonia in response to emergencies and natural disasters. The study is structured in two main parts. The general section provides basic definitions, analyzes the concepts of emergency and crisis, and then presents the role of civil protection. The special part refers to the special emergency management plans, the historical data concerning the Cephalonia Hospital, followed by the editing of the hospital blueprints, as well as the results of the questionnaire analysis. Finally, the conclusions are presented and proposals for measures implemented.
It is noteworthy that on 13/4/2018 the partial evacuation of the Cephalonia General Hospital under the name "KEFALOS" was successfully completed by implementing the "SOSTRATOS" and "PERSEAS" Plans. The exercise was successful and absolutely necessary due to the high seismicity of the area. During the exercise, shortcomings and weaknesses in materials and infrastructure were identified and recorded for resolution
The methodology that was used includes reviewing the existing legislation and Operational Plans, recording the current situation in relation to building infrastructure, non-structural vulnerability, equipment, personnel, critical functions and uses of the hospital. Also questionnaires that were collected by the permanent staff of the Cephalonia General Hospital were processed and analyzed.
According to the existing emergency plans, it is necessary to have an accurate description of the Hospital Unit with blueprints and a detailed description of the uses and services per room - floor. The purpose of the description - visualization is:
Facilitate coordination between the Hospital Crisis Management Team with all necessary authorities
Facilitate and accelerate the work of Rescue Teams
Reduce the number of potential victims through faster intervention. That is, in the event of a total disaster, Rescue Teams should be aware of the need to intervene in the assessment of the degree of danger to the sites and places where patients, staff and visitors must move, reside or accumulate.
Evaluate the damage caused to buildings and floors as well as existing problems in exits (building materials fall)
In this study, the blueprints provided by the Hospital Technical Service were used to visualize the uses and functions of the Hospital. At the same time, different colors and symbols were used to depict the uses and functions of the Hospital in order to enable the Intervention Agencies to intervene faster in an emergency.
The questionnaires included demographics and other variables related to knowledge of crisis management plans and views on assessing hospital readiness.
The staff readiness questionnaires revealed that a large number of staff are not familiar with emergency contingency plans and hospital disaster relief plans. It is important to note that many of the comments emphasized the lack of staff training which means that staff want to be informed and trained so that they can cope with emergencies and disasters.
Even a large proportion of respondents were unaware of hospital safety data (emergency exits, fire safety, etc.) and what public services they should contact in case of a natural disaster. Equally important is the fact that most of the staff has not received first aid training.
The seismicity of the area and the results of the research have led to the proposal of additional measures to improve the existing situation of hospital readiness. These measures concern the administrative, technical and financial sectors.
1. Technical measures:
Checking of the electricity supply networks for possible failures
Checking for the safe operation and support of medical equipment
Check windows and other glass objects that may be damaged and cause injury,
Make sure that all major electrical appliances, machinery etc. are supported to prevent them from falling as well as libraries, shelves, refrigerators and other furniture that can be overturned
Check for objects that can block the stairways and escape exits
Inspect for defects, wooden or metal partitions, suspended ceilings, plaster ornaments, etc.
Check and preventive maintenance of mechanical equipment (e.g. lifts, boilers)
Provision of adequate rescue means.
2. Administrative measures:
Informing and training of employees
Early scheduling and programming
Proper organization and frequent examination
Simulation exercises to ensure readiness.
3. Financial measures, such as:
Creating reserves by the organization to be able to face potential risks.
In conclusion, continuous training and preparation of the hospital staff for the implementation of readiness plans is critical. The proper education of the staff, the cooperation of the authorities and the availability of financial resources are key prerequisites for the best possible response to emergencies.