Hospital Evacuation; Learning from the Past? Flooding of Bangkok 2011

Aims: To evaluate hospital evacuation in light of recent hospital evacuations in Bangkok and surrounding areas. This information was compared with results reported in the literature.
Study Design: Retrospective and qualitative.
Place and Duration of Study: Bangkok, Thailand, December 1 to December 11, 2011.
Methodology: Four facilities were included in this study, three hospitals and one “prehospital” facility, each of which had either experienced evacuation or had been receiving facilities during disaster response operations. Data were obtained using questionnaires and interviews to characterize facility backgrounds and capacities. Responses were obtained from one representative of each of the four Thai facilities. The questionnaire was designed for this study following recommendations by an earlier Swedish study that employed “risk and vulnerability analysis” (RVA), and was further adapted according to results of a literature review.
Results: Overall, consistent results in the literature, as well as in the recent Thai disaster experience, about hospital evacuation indicate shortcomings in planning (including training), command and control, communication, support, resources and transportation. Patient safety, transfer of medical data, care and treatment of patients during transportations showed positive outcomes in recent Thai evacuations.
Conclusion: Despite numerous previous findings and recommendations found in the literature, the need exists for continuous improvement in evacuating a hospital, especially in improving planning (coordinated emergency plans and synchronized exercises), leadership, communications and collaboration and implementation of best medical facility response to disasters.