Hospitals can coordinate to save lives after the earthquake

A new method is helping hospitals prepare for immediate treatment for patients most affected after a major earthquake.

Written by Elizabeth Goldbaum, Science Writer (EFGoldbaum)

Quote: Goldbaum, E, 2020, Hospitals Can Coordinate to Save Lives After Earthquake, Tumbledor, http://doi.org/10.32858/temblor.140

When Luis Severino was a teenager in 2007, an 8.0-magnitude earthquake struck the central coast of Peru. “In the aftermath, I saw for myself how the hospitals had lost all their ability to function,” Cefrino said.

More than a decade later, as a PhD student in civil engineering at Stanford University, Ceferino published a scientific paper aimed at helping hospitals not only operate after a major earthquake, but effectively coordinate with each other to ensure that the most affected patients receive timely treatment. He and his aides found that if hospitals were very coordinated, they could reduce patient waiting times by more than half.

The team devised a method to help hospitals achieve maximum coordination. It takes into account how a large earthquake causes casualties and the consequent increase in demand for buildings, ambulances and other aspects of the healthcare system, as well as the ability of each side to withstand significant damage and continue to operate.

The team method recommends that city officials first use a statistical risk analysis model to estimate where deaths are most likely to occur. Next, they need to apply building performance evaluation techniques to estimate the extent of damage to hospitals. Finally, they need to determine the best inter-hospital approaches so that patients can receive treatment in a timely manner.

“One of the major contributions to our research paper is that we look at what is happening regionally, rather than focusing on what is happening to a single hospital,” Cefrino said. He said the paper highlights how cities and local governments need to create a framework for hospitals to coordinate their response to emergencies after a major earthquake.

A comprehensive approach to emergency management

In 2010, two to three thousand patients had to be hospitalized after an 8.8-magnitude earthquake in Chile. In 1999, the 7.6 magnitude Izmit earthquake in Turkey caused 50,000 injuries and affected 10 major hospitals, forcing those hospitals to transport their patients. Not only can severe earthquakes injure thousands of people, but they can also destroy infrastructure designed to care for the wounded.

Damage from the 2010 earthquake in Chile. Credit: Walter Mooney, USGS

If hospitals do not coordinate with each other by sharing information and resources, they are vulnerable to making deadly decisions. For example, after the 1994 Northridge earthquake of 6.7 in southern California, two hospitals transferred their patients to a hospital that was not working, which resulted in another transfer.

Ceferino said that when studying past responses to earthquakes and simulating possible future scenarios in Lima, Peru, the team learned that there is a spatial mismatch between where people live and where hospitals are. While many people live on the outskirts of the city in sprawling suburban neighborhoods, hospital resources are generally in the city center.

Lima, Peru, is a sprawling city, and hospitals are concentrated in the middle. Credit: youleks from Pixabay

This ‘islands’ effect is not unique to Lima. In Seattle, Washington, for example, some neighborhoods are far from hospitals that are primarily concentrated in the city center. Residents may not be able to access emergency medical services after a major earthquake, especially if there is damage to transportation infrastructure, Nicole Ehret, an assistant professor who researches disaster policy and public health at the University of Washington in Seattle who was not affiliated with this study, said.

“This is one of the first efforts to really think about this outside of a single hospital,” said Irit. If an entire community is to be hit by an event, Irit said, local decision-makers need to look at the entire hospital system and plan together to shape a response that ensures the community gets the healthcare it needs.

An effective business plan

To create a way for the city’s network of hospitals to respond effectively to earthquakes, the team simulated four alternative emergency response plans to treat patients in Lima, a city of nearly 10 million people, after an 8.0-magnitude earthquake at night, when most people were doing so. Be inside residential buildings at risk.

The team included city-wide data on the seismic vulnerability of more than 1.5 million buildings in Lima, including more than 700 buildings in 41 public hospitals. The team used a probabilistic model that takes into account high-resolution seismic vulnerability data for buildings, population distribution and soil conditions to estimate that, on average, about 4,700 people would need surgical procedures in operating rooms for injuries such as perforated organs and composite bone fractures after the earthquake. The team also predicted that 87 of the hospital’s 182 operating theaters would operate based on past experience as well as the WHO Hospital Safety Index for each of Lima’s 41 healthcare campuses.

Each of the four simulation contingency plans have a different level of coordination between hospitals. In the first plan, hospitals would use their ambulances to transport their patients to the nearest functioning hospital only if all of their operating rooms were not working. The average waiting time to receive treatment under this plan will range from 29 to 64 days. In the second plan, everything remains the same, but hospitals will send their patients to the hospital with the most functional operating rooms, reducing the average waiting time range to between 24 and 44 days.

Ambulances and coordinated efforts between hospitals are key to transporting patients after the earthquake. Credit: Camilo Jimenez via Unsplash

The third and fourth plans move to higher levels of coordination. In the third plan, hospitals will share ambulances, reducing waiting times to between 11 and 20 days. In the fourth plan, hospitals will share ambulances and deploy 15 additional mobile operating rooms to treat high-demand areas, reducing wait times to between eight and 16 days.

“We looked at these four scenarios as extreme cases,” Cefrino said. Although it represents the best and worst case scenarios, in reality, the emergency response is likely something in between, he said.

For example, after the 2010 earthquake in Chile, hospitals deployed operating rooms near existing hospitals to take advantage of additional resources such as staff, power generators and backup water, similar to what was illustrated in the fourth scenario, Best Case. However, in their simulations in Lima, the team found that strategically locating additional operating rooms in the vicinity of the city allowed the hospital to treat more patients.

A first step for many

“This paper is fundamental to a lot of the work that we need to do in the future,” said Eret. The more information we have, the better we can prepare.

In the future, Ceferino plans to see how his team’s method will work in other urban layouts, including cities in the United States. He plans to expand his simulations to include less powerful earthquakes and less severe impacts at different times of the day. He is also interested in adding additional layers to see how patient waiting times correlate with socioeconomic variables.

Although this study is an excellent first step to understanding the system, we need to continue down this path to improve it, says Erette.

“It takes an extra effort to get out of your environment and work with people [at other hospitals] “You’re usually in competition,” Ereet said. However, the Ceferino paper demonstrates the benefit of formatting. “This gives you an incentive to get out and do the hard work,” said Eret.

Further reading

Ceferino, L., Mitrani-Reiser, J., Kiremidjian, A., Deierlein, G., & Bambarén, C. (2020). Effective hospital system response plans for earthquake emergencies. Nature Communications, 11 (1), 1-12. https://doi.org/10.1038/s41467-020-18072-w

What Are The Main Benefits Of Comparing Car Insurance Quotes Online

LOS ANGELES, CA / ACCESSWIRE / June 24, 2020, / Compare-autoinsurance.Org has launched a new blog post that presents the main benefits of comparing multiple car insurance quotes. For more info and free online quotes, please visit https://compare-autoinsurance.Org/the-advantages-of-comparing-prices-with-car-insurance-quotes-online/ The modern society has numerous technological advantages. One important advantage is the speed at which information is sent and received. With the help of the internet, the shopping habits of many persons have drastically changed. The car insurance industry hasn't remained untouched by these changes. On the internet, drivers can compare insurance prices and find out which sellers have the best offers. View photos The advantages of comparing online car insurance quotes are the following: Online quotes can be obtained from anywhere and at any time. Unlike physical insurance agencies, websites don't have a specific schedule and they are available at any time. Drivers that have busy working schedules, can compare quotes from anywhere and at any time, even at midnight. Multiple choices. Almost all insurance providers, no matter if they are well-known brands or just local insurers, have an online presence. Online quotes will allow policyholders the chance to discover multiple insurance companies and check their prices. Drivers are no longer required to get quotes from just a few known insurance companies. Also, local and regional insurers can provide lower insurance rates for the same services. Accurate insurance estimates. Online quotes can only be accurate if the customers provide accurate and real info about their car models and driving history. Lying about past driving incidents can make the price estimates to be lower, but when dealing with an insurance company lying to them is useless. Usually, insurance companies will do research about a potential customer before granting him coverage. Online quotes can be sorted easily. Although drivers are recommended to not choose a policy just based on its price, drivers can easily sort quotes by insurance price. Using brokerage websites will allow drivers to get quotes from multiple insurers, thus making the comparison faster and easier. For additional info, money-saving tips, and free car insurance quotes, visit https://compare-autoinsurance.Org/ Compare-autoinsurance.Org is an online provider of life, home, health, and auto insurance quotes. This website is unique because it does not simply stick to one kind of insurance provider, but brings the clients the best deals from many different online insurance carriers. In this way, clients have access to offers from multiple carriers all in one place: this website. On this site, customers have access to quotes for insurance plans from various agencies, such as local or nationwide agencies, brand names insurance companies, etc. "Online quotes can easily help drivers obtain better car insurance deals. All they have to do is to complete an online form with accurate and real info, then compare prices", said Russell Rabichev, Marketing Director of Internet Marketing Company. CONTACT: Company Name: Internet Marketing CompanyPerson for contact Name: Gurgu CPhone Number: (818) 359-3898Email: [email protected]: https://compare-autoinsurance.Org/ SOURCE: Compare-autoinsurance.Org View source version on accesswire.Com:https://www.Accesswire.Com/595055/What-Are-The-Main-Benefits-Of-Comparing-Car-Insurance-Quotes-Online View photos