Design Strategies to Improve Emergency Departments’ Performance During Mass Casualty Incidents: A Survey of Caregivers

Author:

Valipoor Shabboo1ORCID,Hakimjavadi Hesamedin2,De Portu Giuliano3

Affiliation:

1. Department of Interior Design, College of Design, Construction and Planning, University of Florida, Gainesville, FL, USA

2. Department of Pharmacology and Systems Physiology, College of Medicine, University of Cincinnati, Cincinnati, OH, USA

3. Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville, FL, USA

Abstract

Objectives: To identify effective facility design strategies to improve the performance of healthcare providers and patient flow during mass casualty incidents (MCIs) in emergency departments. Background: Emergency departments (EDs) are the first line of medical care in MCIs. While operational surge management plans are well described in literature, physical design strategies to improve performance and patient flow during disasters are discussed scarcely. Method: An online questionnaire was sent to EDs’ caregivers nationwide asking them to rate the effectiveness of nine physical design strategies, discussed in the literature, to improve caregivers’ performance and patient flow during MCIs. Assessed strategies were about providing expandable departments and care areas, alternate care facilities for the least sick to maximize care areas for critical patients, care areas from nonemergency units, increased number of decontamination units, dedicated isolation units, within-hospital and close emergency operation centers, and within-hospital media areas. Results: All suggested strategies were rated as effective. The most effective and agreed-upon solution was identified as maximizing the care area for critical patients by establishing an alternate care facility with separate entrance and exit doors from the emergency department for the least critical patients. The least effective and agreed-upon strategy was identified as locating a media unit within the hospital outside of the ED. Conclusions: Caregivers who work in EDs consider design strategies to be effective in surge management during disasters. Designers can consider implementing identified strategies in designing new emergency departments or expansion and renovation projects.

Publisher

SAGE Publications

Subject

Critical Care and Intensive Care Medicine,Public Health, Environmental and Occupational Health

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