Seismic Risk Assessment of an Emergency Department of a Chilean Hospital Using a Patient-Oriented Performance Model

Abstract

After an earthquake, hospital emergency departments need to provide continuous health care services to respond to the eventual sudden increase in injured people. The service performance of an emergency department is influenced by internal factors, such as physical damage and staff availability, and external factors, such as an increased patient arrival rate and disruptions in its supply chain. This research presents a quantification methodology for the performance of the emergency department. The novelty of the proposed approach lies in the explicit integration of the inelastic structural and nonstructural response of the building and damage with its loss of functionality, downtime, and emergency patient treatment rate. A discrete event simulation model is used to model the flow of patients within the different units of the emergency department. The seismic risk is expressed as return periods of exceeding different levels of patient waiting times. Results show that 1,000 and 30,000 accumulated waiting hours correspond to return periods of 100 and 1,000 years, respectively. It is concluded that this model may contribute to improving the risk management of critical emergency department infrastructure.

A challenge for healthcare system resilience after an earthquake: The crowdedness of a first-aid hospital by non-urgent patients

“…Based on Favier et al [ 16 ] and Côté [ 10 ] as well as some modifications made to approximate the emergency care procedure in Taiwan, the patient flow paths throughout first-aid hospitals were modelled, as shown in Fig 1 .…”

“…Based on real data and estimation, Favier et al [ 16 ] proposed the percentage of each triage category and the probability of each category being assigned to one of three paths. This study primarily adopted their figures, but some changes were made.…”

“…After an earthquake, patients arrive at an emergency care facility in a pattern different from normal ways. Favier et al [ 16 ] considered both regular patient visits and seismic casualties, and their dispersion over time to estimate patient arrival rates within four days after earthquakes, which will be referred to as the busy phase hereafter. This study adapted the estimated arrival rates to generate patients over time.…”

“…Other studies narrowed down their research focuses and emphasized on the failure analyses within hospitals, analysing functionality loss either in one single healthcare facility or multiple facilities in a region. This type of study involves dynamic modelling of patient arrivals and trajectories, fragility study of hospital structures and non-structural components, and examination of the efficiency of different repair strategies considering time and money invested in (e.g., [ 16 – 19 ] for one single hospital; [ 20 ] for multiple hospitals).…”

A Framework to Assess the Seismic Resilience of Urban Hospitals

“…e indicators, such as the quality of service and life [10], patient waiting time [11], and functional downtime [12], have been separately adopted to assess the seismic resilience of hospitals. Cimellaro et al [13] proposed a fast methodology for disaster resilience quantification where factor analysis was used to identify representative factors from varieties of dimensions.…”