How can we manage crisis in big hospitals?

In order to answer this question we have to know what we mean by major incident, crises or disaster

In health services terms a major incident can be defined as any incident where the location, number, severity or type of live Casualties requires extraordinary resources or exceed the capacity of specific health care facility

So a major incident for one emergency service may not apply to all emergency services

An example if you receive a call about the presence of dead body (group suicidal) is this a major incident to your hospital?

The answer is No because you don’t need any resources to save this two hundred bodies ,they already dead, but it is a major incident for police because of :

• In disaster management , the dead bodies is always the responsibility of police

• These bodies require extra ordinary resources (more manpower, more vehicles, and more investigations etc.

So let’s go back to your original question, how can we manage crisis in big hospitals?

Each facility, discrete, city, country should have their own disaster plan which determine the responsibility of each sector (Local authority, medical private & governmental, police, civil defense, army, society establishments, and volunteers) in the country in case of disaster

So your hospital will be just a small part in this Plan or situation and it doesn’t matter that you are a big or small hospital because you can work only within the maximum resources you can offer orprovide and your responsibility will be determined according to that

Now first of all you as a hospital should be a part of the country disaster plan, so your responsibilities will be determine by the incident commanders committee or the national committee for risk and disaster management according to your maximum available resources

On the level of your facility you should have an internal disaster plan, which set the guidelines, policies and procedures in dealing with a crises situation

• You should define the maximum resources you can provide or make available during the major incident like manpower, how many staff (nursing, physician, technicians …etc. you can make available immediately at the moment of major incident by calling all the staff of the hospital at once

• What is the space you can provide to receive the cases, you can utilize every space available to accommodate the situation, you may discharge the patient with cold cases or those whom are possible to complete their treatment at home and move the beds to the emergency department if possible to receive the patients etc.

• How far the consistency and  Continuity of the logistic support you can provide

The most important thing in what I mentioned above is the planning and the mentality to be proactive not reactive:

• Prepare the disaster plan guidelines, polices and procedure suitable to you facility.

• Determine the commanders whom will lead and direct the resources effort

• Determine each person role and responsibilities according to his capabilities

• Conduct a mock drill, maneuvers from time to time to insure the preparedness and effectiveness of the designed plan

• Team work and adherence to the effective team dynamics  

  There is much more to add but I hope I answered your question by what I brief above.

Regards

Ibrahim Fraihat