Modeling Evacuation of a Hospital without Electric Power

Vugrin ED, Verzi SJ, Finley PD, Turnquist MA, Griffin AR, Ricci KA, Wyte-Lake T. Prehosp Disaster Med. 2015 Jun;30(3):279-87. doi: 10.1017/S1049023X15000230. Epub 2015 Apr 14.

Hospital evacuations that occur during, or as a result of, infrastructure outages are complicated and demanding. Loss of infrastructure services can initiate a chain of events with corresponding management challenges. This report describes a modeling case study of the 2001 evacuation of the Memorial Hermann Hospital in Houston, Texas (USA). The study uses a model designed to track such cascading events following loss of infrastructure services and to identify the staff, resources, and operational adaptations required to sustain patient care and/or conduct an evacuation. The model is based on the assumption that a hospital's primary mission is to provide necessary medical care to all of its patients, even when critical infrastructure services to the hospital and surrounding areas are disrupted. Model logic evaluates the hospital's ability to provide an adequate level of care for all of its patients throughout a period of disruption. If hospital resources are insufficient to provide such care, the model recommends an evacuation. Model features also provide information to support evacuation and resource allocation decisions for optimizing care over the entire population of patients. This report documents the application of the model to a scenario designed to resemble the 2001 evacuation of the Memorial Hermann Hospital, demonstrating the model's ability to recreate the timeline of an actual evacuation. The model is also applied to scenarios demonstrating how its output can inform evacuation planning activities and timing.

Key Words: ICU intensive care unit; NTICU Neurosciences/Trauma Intensive Care Unit; hospital evacuation; infrastructure disruption; modeling