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Assessment of hospital surge capacity using the MACSIM simulation system: a pilot study
University of Gothenburg, Sweden; Regionens Hus, Sweden; Asevagen 1, Sweden.
Karolinska Institute, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Disaster Medicine and Traumatology.
Karolinska University Hospital, Sweden.
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2017 (English)In: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, E-ISSN 1863-9941, Vol. 43, no 4, 525-539 p.Article in journal (Refereed) Published
Abstract [en]

Aim The aim of this study was to use a simulation model developed for the scientific evaluation of methodology in disaster medicine to test surge capacity (SC) in a major hospital responding to a simulated major incident with a scenario copied from a real incident. Methods The tested hospital was illustrated on a system of magnetic boards, where available resources, staff, and patients treated in the hospital at the time of the test were illustrated. Casualties were illustrated with simulation cards supplying all data required to determine procedures for diagnosis and treatment, which all were connected to real consumption of time and resources. Results The first capacity-limiting factor was the number of resuscitation teams that could work parallel in the emergency department (ED). This made it necessary to refer severely injured to other hospitals. At this time, surgery (OR) and intensive care (ICU) had considerable remaining capacity. Thus, the reception of casualties could be restarted when the ED had been cleared. The next limiting factor was lack of ventilators in the ICU, which permanently set the limit for SC. At this time, there was still residual OR capacity. With access to more ventilators, the full surgical capacity of the hospital could have been utilized. Conclusions The tested model was evaluated as an accurate tool to determine SC. The results illustrate that SC cannot be determined by testing one single function in the hospital, since all functions interact with each other and different functions can be identified as limiting factors at different times during the response.

Place, publisher, year, edition, pages
SPRINGER HEIDELBERG , 2017. Vol. 43, no 4, 525-539 p.
Keyword [en]
Surge capacity; Major incident; Simulation system; Hospital preparedness; MACSIM system
National Category
Surgery
Identifiers
URN: urn:nbn:se:liu:diva-139905DOI: 10.1007/s00068-016-0686-1ISI: 000406690600015PubMedID: 27334386OAI: oai:DiVA.org:liu-139905DiVA: diva2:1135754
Note

Funding Agencies|Stockholm County Council, Sweden; Laerdal foundation, Norway [2908]

Available from: 2017-08-24 Created: 2017-08-24 Last updated: 2017-08-24

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