• Need more information on these or other topics? Ask an information specialist at (312) 422-2050 or rc@aha.org

  • Enter your email address to subscribe to this blog and receive notifications of new posts by email.

    Join 312 other followers

  • Share this blog

    Share |
  • Note:

    Information posted in this blog does not necessarily represent the views of the American Hospital Association
  • Archives

  • Categories

  • Top Posts

  • Top Rated Posts

DISASTER PLANNING: What is hospital reverse triage?

With consideration of multiple strategies, pediatric hospital surge capacity may be considerably more robust than currently appreciated.

In a disaster situation, there is the need to free up space in hospitals to care for newly injured patients.  Reverse triage provides a way to estimate how much capacity might be made available by discharging inpatients earlier than had been planned.  This study, conducted at Johns Hopkins Hospital, studied pediatric patients during the period December 2012 through December 2013 to model the extent of possible reverse triage. The researchers found that using reverse triage as well as all other possible strategies to increase capacity could free up over 50 percent of capacity nearly immediately and 84 percent by the fourth day of a disaster.  Most of the pediatric patients who were considered appropriate for early discharge were in the child and adolescent psychiatric unit.

Source: Kelen, G.D., and others. (2017, February 6). Effect of reverse triage on creation of surge capacity in a pediatric hospital. JAMA Pediatrics. Click here: https://www.researchgate.net/profile/Gai_Cole/publication/313361752_Effect_of_Reverse_Triage_on_Creation_of_Surge_Capacity_in_a_Pediatric_Hospital/links/589cce42a6fdcc3e8bea401c/Effect-of-Reverse-Triage-on-Creation-of-Surge-Capacity-in-a-Pediatric-Hospital.pdf

How many active shooter incidents occur in hospitals?

Here are some statistics showing an increase in the number of active shooter incidents that have occurred in hospitals.

Number of Incidents in Hospitals: Total US

  •   9 per year (for the period 2000-2005)
  • 16.7 per year (for the period 2006-2011)

The definition of an active shooter incident, and the security measures that a hospital might consider are discussed in this commentary.

Source: Adashi, E.Y., and Cohen, I.G. (2015, Feb. 26). Hospital-based active shooter incidents: sanctuary under fire. JAMA. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=2174624 Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Active Shooter Incident Planning for Health Facility Emergency Preparedness

A sign of the times, unfortunately. The Departments of Health and Human Services; Homeland Security; and Justice have jointly issued a new planning guide for dealing with active shooters in health care facilities. It’s recommended that active shooter planning be included as part of a facility’s overall emergency preparedness operations covering everything from fires to floods to infectious disease pandemics.

As in other preparedness planning, the guide addresses prevention, protection, mitigation, response, and recovery issues as they relate to active shooter emergencies within health care settings.

Source: Incorporating active shooter incident planning into health care facility emergency operation plans. U.S. Dept. of Health and Human Services, Assistant Secretary for Preparedness and Response, 2014. http://www.phe.gov/Preparedness/planning/Documents/active-shooter-planning-eop2014.pdf


Chu E. How to survive a hospital shooting. MedPage Today, May 2014 [republished Jan. 20, 2015]. http://www.medpagetoday.com/EmergencyMedicine/EmergencyMedicine/45535

Diamond D. When patients kill doctors: the horrifying murder of Michael Davidson. Forbes, Jan. 21, 2015. http://www.forbes.com/sites/dandiamond/2015/01/21/when-patients-kill-doctors-the-horrifying-murder-of-michael-davidson/

Posted by AHA Resource Center (312) 422-2050 rc@aha.org

EBOLA: How can hospitals prepare?

NOTE ABOUT UPDATES: Information about this topic continues to be updated.  Good places to monitor changes include:

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

DISASTER PREPAREDNESS: How to get the hospital ready for bad weather

This white paper presents a model for thinking about the components of a comprehensive strategy to get hospitals ready for destructive weather.  There are four layers of resilience outlined in this model:

  • Usable information for decision-making
  • Ensure continuity of health services
  • Create durable/resilient facilities (hardening structures, incremental adaptations, innovative practices)
  • Risk management (Joint Commission accreditation standards, insurance)

Each of these components, as well as the broader concept of community resilience, is discussed in this report.

Source: American Meteorological Society.  A Prescription for the 21st Century: Improving Resilience to High-Impact Weather for Healthcare Facilities and Services, Apr. 2014.  Click here for access to this white paper:  http://www2.ametsoc.org/ams/assets/File/health_workshop_report.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org


DISASTER READINESS: Evacuating NYC hospitals

This is a fascinating, detailed account of how North Shore-Long Island Jewish Health System (Great Neck, NY, 16 hospitals) responded to Hurricane Katrina in 2005 by revamping disaster preparedness plans.  Of particular value were evacuation simulations, including a full-scale exercise in 2006, which led to the realization that the commonly-used method of matching patients to beds in a 1:1 way was not the best approach.  Rather, it was determined that hospitals would be designated to receive certain types of patients, based on their service line strengths.  All of this planning paid off in August 2011, when Hurricane Irene hit the East Coast and the health system successfully evacuated over 900 patients from facilities in flood-prone areas.

Source: Verni, C.  A hospital system’s response to a hurricane offers lessons, including the need for mandatory interfacility drill.  Health Affairs;31(8):1814-1821, Aug. 2012.  Click here for access to an abstract on the publisher’s website: http://content.healthaffairs.org/content/31/8/1814.short Posted by AHA Resource Center, (312) 422-2050, rc@aha.org


Future of health care construction

Health Facilities Management and the American Society of Healthcare Engineering have released the results of the 2012 hospital construction survey.  The double whammy of an economy still in recession and the uncertainty of how health care reform will play out have left many projects on the drawing board with no immediate plans for execution this year.  The bulk of construction activity is tied up in expansions and renovations, as opposed to new or replacement facilities.

Data are provided for the following:

  • Projects by service line
  • Projects involving building services equipment
  • Projects involving building services systems
  • Impact of reform on projects by service type
  • Prevalence and budgeting for commissioning
  • Construction budgets
  • Patient room design

The full article, complete with charts, is available online.

Carpenter, Dave, and Hoppszallern, Suzanna.  Time to build: 2012 hospital construction survey.  Health Facilities Management.  25(2):12-18, 20, February 2012.    http://www.hfmmagazine.com/hfmmagazine_app/jsp/articledisplay.jsp?dcrpath=HFMMAGAZINE/Article/data/02FEB2012/0212HFM_FEA_CoverStory&domain=HFMMAGAZINE