HOSPITAL RESPONSE AND NATURAL DISASTERSRoberto MiniatiPhD studentInternational Program on Risk MitigationUniversity of Florence
NATO ATCADVANCED TRAINING COURSE
Integrated Emergency Management For Mass Casualty Emergencies
26th – 29th October 2011, Florence - Italy
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSHOSPITAL RESPONSE DURING DISASTERS
A disaster is a serious disruption of the functioning of a community or system in a given spatial area causing widespread losses which exceed the ability of the affected system or community to cope with, using its own resources.
HOSPITAL RESPONSE AND NATURAL DISASTERSHOSPITAL RESPONSE DURING DISASTERS
AN INTEGRATION OF COMPLEX SYSTEMS
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSCONTENT OF THE PRESENTATION3 CASE STUDIES
HOSPITAL RESPONSE DURING EARTHQUAKES
HOSPITAL RESPONSE DURING FLOODS
SEISMIC RISK ASSESSMENT OF HOSPITAL SYSTEM RESPONSE
RISK MITIGATION OF HOSPITAL RESPONSE
VULNERABILITY ASSESSMENT
FLORENCE HOSPITAL SYSTEM
SANTA CLARA VALLEY MEDICAL CENTER
FLORENCE HOSPITAL SYSTEM
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERS1. SEISMIC RISK ASSESSMENT OF HOSPITAL SYSTEM RESPONSE
Province of Florence
• ASF- Florence Health System
• AOUC – main Florence Hospital
• Provincial Civil Protection Office of Florence
• National Civil Protection Department
www.move-fp7.eu
STAKEHOLDERS INVOLVED IN THE PROJECT
MULTIDISCIPLINARY APPROACH
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSGENERAL FRAMEWORK
ENVIRONMENT
Inte
rnati
onal
↔N
ation
al↔
Subn
ation
alsc
ale
RISKEconomic / social / environmental potential impact
RISK
REDUCTI
ON
PREPAREDNESS
DISASTER
MANAGE
MENT
PREVENTI
ON
MITIGATI
ON
TRANSFER
Hazard intervention
Vulnerability intervention
Susceptibilityreduction
Exposure reduction
Resilience improvement
RISK GOVERNANCEOrganization / planning /
implementation
Subn
ation
al↔
loca
lsca
leLo
cal s
cale
Interactions COUPLING ADAPTATION
EXPOSURE
Temporal
Spatial
VULNERABILITY
Social
Physical
LACK OFRESILIENCECapacity to anticipate
Capacity to cope
Capacity to recover
SUSCEPTIBILITYand FRAGILITY
ENVIRONMENT
RISK
MANAGEMENT
SOCIETY
HAZARDSNatural events / socio-natural events
Ecological
Social
Institutional
CulturalEconomic
SYSTEM VULNERABILIT
Y
RISK ASSESSMENT
HAZARD IMPACT
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSHAZARD IMPACT
ENVIRONMENT
Inte
rnati
onal
↔Na
tiona
l↔Su
bnati
onal
scal
e
RISKEconomic / social / environmental potential impact
RISK
REDUCTI
ON
PREPAREDNESS
DISASTER
MANAGE
MENT
PREVENTI
ON
MITIGATI
ON
TRANSFER
Hazard intervention
Vulnerability intervention
Susceptibilityreduction
Exposure reduction
Resilience improvement
RISK GOVERNANCEOrganization / planning /
implementation
Subn
ation
al↔
loca
lsca
leLo
cal s
cale
Interactions COUPLING ADAPTATION
EXPOSURE
Temporal
Spatial
VULNERABILITY
Social
Physical
LACK OFRESILIENCECapacity to anticipate
Capacity to cope
Capacity to recover
SUSCEPTIBILITYand FRAGILITY
ENVIRONMENT
RISK
MANAGEMENT
SOCIETY
HAZARDSNatural events / socio-natural events
Ecological
Social
Institutional
CulturalEconomic
Mugello earthquake (Florence) 1919, 29th June - M=6.2.
SIGE numerical simulation by the National Civil Protection Dept.
HTD = 130
HTDevent = 2.6
Actual conditions• Age of Buildings;• Type of structures;• Population.
Instrumental seismicity Province of Florence
Real past event (seismic conditions)
HTDevent= [(HTD ÷ h) ÷ n° of hospitals]
[n°patients with surgical needs/h per hospital]
HOSPITAL TREATMENT DEMANDEVENT
HTD = 1/3 * N[n°patients with surgically needs]
N- Number of red triaged casualties
Scenario development
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSSYSTEM VULNERABILITY
HOSPITAL TREATMENT CAPACITY
HOSPITAL INTRINSIC SECURITY
ENVIRONMENT
Inte
rnati
onal
↔Na
tiona
l↔Su
bnati
onal
scal
e
RISKEconomic / social / environmental potential impact
RISK
REDUCTI
ON
PREPAREDNESS
DISASTER
MANAGE
MENT
PREVENTI
ON
MITIGATI
ON
TRANSFER
Hazard intervention
Vulnerability intervention
Susceptibilityreduction
Exposure reduction
Resilience improvement
RISK GOVERNANCEOrganization / planning /
implementation
Subn
ation
al↔
loca
lsca
leLo
cal s
cale
Interactions COUPLING ADAPTATION
EXPOSURE
Temporal
Spatial
VULNERABILITY
Social
Physical
LACK OFRESILIENCECapacity to anticipate
Capacity to cope
Capacity to recover
SUSCEPTIBILITYand FRAGILITY
ENVIRONMENT
RISK
MANAGEMENT
SOCIETY
HAZARDSNatural events / socio-natural events
Ecological
Social
Institutional
CulturalEconomic
HTC – Hospital Treatment Capacity
[number of treated patients per hour]
IS – Intrinsic Security
[0-1]
IS = α x β x [(γ3 x Γ2) + (γ4 x ρ2)] / (γ3 + γ4)
HTC = α x β x (γ1 x γ2)/tm
α = (0-1) -Organizational
β = (0-1) -Staff
γ1 -Number of Surgery tables
γ2 = (0-1) -Surgery room performance
How to estimate the performance during an earthquake?
Γ2 = (0-1) -Hospital beds performance
ρ2 = (0-1) -ICU beds performance
γ3 -Number of Hospital beds
γ4 -Number of ICU beds
Tm = 2 -Surgical operation duration.
OR, ICU and HB
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSCOMPLEX SYSTEM THEORYLEONTIEF MODEL
3
2
1
01
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X= Output vectorI = Identity MatrixA = Dependencies matrixC = Input failures vector
Seismic effect on single systems with a
specific magnitude
How the systems are functionally connected to each others
BIDIRECTIONALLY
Modern Hospital inoperability level to a specific magnitude
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSWHICH ELEMENTS TO CONSIDER?
Importance of medical services for health response to a seismic event. WHO.
Power system
Back-up generator
Medical gas
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSHOW TO DEFINE THE COEFFICIENTSFUZZY LOGIC INTERVIEW
Every opinion depends on the value, confidence and expertize level.
Considering element ‘M’ 100% inoperable - what’s the effect on element ‘A’?
EXPERTIZE WEIGHT:1 - Hospital technical expert0.9 - Hospital medical expert 0.8 - Hospital engineer0.6 - Hospital physician
33323130
23222120
13121110
03020100
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‘M’ Medica gas system
‘A‘ Emergency department
0,3 0.8 0.85 0.9 0.95 1.0 0,1 0.8 0.85 0.9 0.95 1.0
0,08 0.8 0.85 0.9 0.95 1.0 0,03 0.8 0.85 0.9 0.95 1.0
0 0.8 0.85 0.9 0.95 1.0
Complete stop
Significant
Negligible
Almost nothing
No effect
Strongly disagree…...…..Completely agree
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSHOW TO DEFINE THE COEFFICIENTSFUZZY LOGIC INTERVIEW
Opinion reliability: ANOVA
Expert reliability: ANOVA
Interview validation
33323130
23222120
13121110
03020100
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NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSINPUT FAILURES VECTOR
Structural Non structural Organizational Fire Safety
Rapid Assessment
4 different evaluation forms designed for the data
collection
2 specific forms for equipment and basic lifelines
Fixing a specific seismic intensity
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERS
BIG DEVICES Total N° N° fixedRadiology Linear accelerator TAC ……
LIFE SUPPORT Total N° N° fixedHyperbaric chamber Anesthesia system Pulmonary Ventilator …..
EMERGENCY CARE Total N° N° fixedScialitic lamp Operating table Defibrillator …..
INPUT FAILURES VECTOR
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSINPUT FAILURES VECTOR
VULNERABILITY LEVELS
Structural Non Structural Organizational
N. Architect EquipmenFurnishing
Basic installations Capability Services
distribution
1A M M H M M L1B M M H M M L1C M M H M M L
N. Number of surgery tables
Number of ICU beds
Number of hospital beds
1A 0 0 1301B 0 0 01C 6 70 131
1a
1b1c
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSOUTPUT VECTOR
43%
29%
39%
36%
31%
10%
15%
9%
12%
5%
13%
7%5%
7%
21%
[γ2 , Γ2, ρ2]
The most dependent system
The most influent system
M = 6
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSHOSPITAL TREATMENT CAPACITY
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSHOSPITAL INTRINSIC SECURITY
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSRISK ASSESSMENT
ENVIRONMENT
Inte
rnati
onal
↔Na
tiona
l↔Su
bnati
onal
scal
e
RISKEconomic / social / environmental potential impact
RISK
REDUCTI
ON
PREPAREDNESS
DISASTER
MANAGE
MENT
PREVENTI
ON
MITIGATI
ON
TRANSFER
Hazard intervention
Vulnerability intervention
Susceptibilityreduction
Exposure reduction
Resilience improvement
RISK GOVERNANCEOrganization / planning /
implementation
Subn
ation
al↔
loca
lsca
leLo
cal s
cale
Interactions COUPLING ADAPTATION
EXPOSURE
Temporal
Spatial
VULNERABILITY
Social
Physical
LACK OFRESILIENCECapacity to anticipate
Capacity to cope
Capacity to recover
SUSCEPTIBILITYand FRAGILITY
ENVIRONMENT
RISK
MANAGEMENT
SOCIETY
HAZARDSNatural events / socio-natural events
Ecological
Social
Institutional
CulturalEconomic
HTCI = HTC ÷ HTDEVENT
City Hospitalη = 3 Θ= 2
Country Hospitalη = 2 Θ= 3
Small City Hospitalη = 2 Θ= 2
HOSPITAL TREATMENT CAPACITY INDEX
HPI = [η x HTCI + θ x IS] / (η + θ)
HOSPITAL PERFORMANCE INDEX
Patient at Intensive Care Unit
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSHOSPITAL TREATMENT CAPACITY INDEX
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSHOSPITAL TREATMENT CAPACITY INDEX
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSHOSPITAL PERFORMANCE INDEX
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERS2. RISK MITIGATION OF HOSPITAL RESPONSE
Preliminary results.Florence case study.US case study
Complex System Analysis .Fault Tree Analysis
Definition of Hospital Response Indices.Hospital Treatment Capacity (HTC); .Intrinsic Security (IS);.Hospital Treatment Demand (HTD)..Hospital Treatment Capacity Index (HTCI); .Hospital Performance Index (HPI);
RISK ASSESSMENT
RISK MITIGATION
Validation.L’ Aquila case study application.Coefficient modifications.
Preliminary Results.Indirect interventions;.Direct interventions;.Italian and US comparison.
International Ph.D. Course onMitigation of risk due to natural hazard on structures and infrastructures
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSCOMPLEX SYSTEM ANALYSISFAULT TREE ANALISYS
Top Event ReliabilityR = 1 - Q
R = Reliability
Q = Unavailability
Top Event
B 1 B 2 B 3
Top Event
B 1 B 2 B 3
Parallel system Serial system
FTA is used to calculate the overall probability of failure of a system with both serial and redundant elements.
RISK ASSESSMENT
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSITALY CASE STUDY
RISK ASSESSMENT
1a
1b1c
OSMA HOSPITAL, FLORENCE
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSPRELIMINARY RESULTS
ICUTop Event Operability = 63.4%
I = 6
RISK ASSESSMENT
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSPRELIMINARY RESULTS
RISK ASSESSMENT
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSPRELIMINARY RESULTS
RISK ASSESSMENT
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSPRELIMINARY RESULTS
RISK ASSESSMENT
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSSCIENTIFIC VALIDATION
SAN SALVATORE L’AQUILA HOSPITAL
On 6 April 2009 a seismic event of magnitude 6.3 struck the province of L'Aquila.It caused damage to 100,000 buildings in 57 municipalities, left 67,500 local residents homeless, killed 308 people and injured 1,500, 202 of them seriously.
RISK ASSESSMENT
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSHAZARD IMPACT
Local casualties evaluation
I=6
RED TRIAGED 202
YELLOW TRIAGED
GREEN TRIAGED 1258
BLACK TRIAGED 308
Source: European Project MICRODIS
PRE EVENT Functional
H -beds Functional
Operating rooms Functional ICU-beds
464 10 8
POST EVENT (within 6 hours by the seismic shake) Functional
H -beds Functional
Operating rooms Functional ICU-beds
454 2 8 Source: San Salvatore Hospital Medical Direction.
RISK ASSESSMENT
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERS
POST VALIDATION IS
POST VALIDATION HTC
SCIENTIFIC VALIDATIONRISK ASSESSMENT
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSSCIENTIFIC VALIDATION
RISK ASSESSMENT
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSUS CASE STUDY
Santa Clara Valley Medical Center, US.US SCVMC Observership Program supervisor: Dr. Jeffrey Arnold
RISK ASSESSMENT
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSHAZARD IMPACT
• Hospital Treatment Demand per Hospital (HTDHospital) = Number of patients with surgical needs per hour arriving at the single hospital.
San Francisco, 1906M=8Source: U.S. Geological Survey
Real past event (seismic conditions)
Actual condictions (buildings and population)
International epidemiologic analysis
Civil Protection software for casualties estimation
SEISMIC IMPACT
1.28 patients per hour to each Santa Clara County hospital
M=8
HTDevent= [(HTD ÷ h) ÷ n° of hospitals]
[n°patients with surgically needs/h per hospital]
HOSPITAL TREATMENT DEMANDEVENT
RISK ASSESSMENT
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSHOSPITAL TREATMENT CAPACITY INDEXPRELIMINARY RESULTS
RISK ASSESSMENT
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSHOSPITAL PERFORMANCE INDEXPRELIMINARY RESULTS
RISK ASSESSMENT
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSRISK MITIGATION STRATEGIES
• DIRECT INTERVENTIONS
1. Emergency plan and organizational changes
2. Medical equipment and architectural elements fixing [$]
3. Basic installation fixing [$$]
4. Medical management and assumption [$$$]
5. Structural retrofitting [$$$$]
• INDIRECT INTERVENTIONS
1. Field hospital or medical mobile units’ installation
2. Casualty evacuation to other hospitals
RISK MITIGATION
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERS
RISK MITIGATIONPRELIMINARY RESULTS
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSPRELIMINARY RESULTS
RISK MITIGATION
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERS
RISK MITIGATIONPRELIMINARY RESULTS
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSITA-US COMPARISONDIRECT INTERVENTIONS
RISK MITIGATION
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSDIRECT INTERVENTIONSPRELIMINARY RESULTS
RISK MITIGATION
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERS
RISK MITIGATION
INDIRECT INTERVENTIONSPRELIMINARY RESULTS
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERS3. HOSPITAL SYSTEM RESPONSE DURING FLOODS
45 09/04/2023 www.move-fp7.eu
Province of Florence
• ASF- Florence Health System
• AOUC – main Florence Hospital
• Provincial Civil Protection Office of Florence
• National Civil Protection Department
www.move-fp7.eu
STAKEHOLDERS INVOLVED IN THE PROJECT
MULTIDISCIPLINARY APPROACH
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSGENERAL FRAMEWORK
ENVIRONMENT
Inte
rnati
onal
↔N
ation
al↔
Subn
ation
alsc
ale
RISKEconomic / social / environmental potential impact
RISK
REDUCTI
ON
PREPAREDNESS
DISASTER
MANAGE
MENT
PREVENTI
ON
MITIGATI
ON
TRANSFER
Hazard intervention
Vulnerability intervention
Susceptibilityreduction
Exposure reduction
Resilience improvement
RISK GOVERNANCEOrganization / planning /
implementation
Subn
ation
al↔
loca
lsca
leLo
cal s
cale
Interactions COUPLING ADAPTATION
EXPOSURE
Temporal
Spatial
VULNERABILITY
Social
Physical
LACK OFRESILIENCECapacity to anticipate
Capacity to cope
Capacity to recover
SUSCEPTIBILITYand FRAGILITY
ENVIRONMENT
RISK
MANAGEMENT
SOCIETY
HAZARDSNatural events / socio-natural events
Ecological
Social
Institutional
CulturalEconomic
SYSTEM VULNERABILIT
Y
RISK ASSESSMENT
HAZARD IMPACT
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSHAZARD IMPACT
47 09/04/2023 www.move-fp7.eu
1966 map with levels reached by floodwaters[0-2 m, 0-4 m, 4-5 m].
Florence flooding, 4th November 1966 34 deaths
CONSIDERED SCENARIO
3
2
1
01
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13121110
03020100
1
1000
0100
0010
0001
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c
aaaa
aaaa
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aaaa
I cAx
X= Output vectorI = Identity MatrixA = Dependencies matrixC = Input failures vector
Seismic effect on single systems with a
specific magnitude
How the systems are functionally connected to each others
BIDIRECTIONALLY
Modern Hospital inoperability level to a specific magnitude
HOSPITAL RESPONSE AND NATURAL DISASTERSCOMPLEX SYSTEM THEORYLEONTIEF MODEL
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSINPUT FAILURES VECTOR
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
Type Number of beds
Emergency dept. 20
Surgery 18
ICU 5
Sub ICU 3
EXPOSURE: HIGH
HOSPITAL: SANTA MARIA NUOVA
HEALTH FUNCTIONSUnderground Ground level First level and upper
ICU X EMERGENCY DEPT. XDIAGNOSTIC XSURGERY XUROLOGY XPHARMACY XSTERILIZATION XIN-PATIENT XLABORATORY XBLOOD BANK X
SYSTEMSUnderground Ground level First level and upper
MEDICAL GAS CENTRAL XPOWER CENTRAL XUPS AND BACK UP GENERATORS XDATA AND SERVERS X
HOSPITAL RESPONSE AND NATURAL DISASTERSRESULTS
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSRESULTS
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSRESULTS
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSRESULTS
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSRESULTS
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSRESULTS
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
HOSPITAL RESPONSE AND NATURAL DISASTERSCONCLUSIONS
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
• In case of Floods the huge loss of devices is responsible for big degradations in both Capacity to cope and Capacity to recover.
• Complete analysis of structural, non-structural and organizational aspects which are all indispensable for guaranteeing an efficient and safe hospital response.
• New index Intrinsic Security (IS) was developed. This allows to evaluate both the strategic (by the HTC index) and sheltering functions of health structures.
HOSPITAL RESPONSE AND NATURAL DISASTERSCONCLUSIONS
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
• Retrofitting interventions.
• Accurate planning, including appropriate earthquake hospitalizations at the right structures and proper FFH sizing;
• Organization of the local hospital design according to the medical needs and seismic vulnerability assessment.
HOSPITAL RESPONSE AND NATURAL DISASTERSCONCLUSIONS
NATO ATC 26TH- 29TH OCTOBER 2011 – FLORENCE Miniati R.
The institutions involved show a high level of interest in co-operating and manifest support for the idea.
Lack of communication and co-operation among institutions -- but....
Lack of a systematic approach to the culture of disaster management planning
HOSPITAL RESPONSE AND NATURAL DISASTERSRoberto Miniati
E-mail. [email protected]. +39.328.60.17.001Skype. robertominia
NATO ATCADVANCED TRAINING COURSE
Integrated Emergency Management For Mass Casualty Emergencies
26th – 29th October 2011, Florence - Italy