Disaster Management Plans Vital if Hospitals Are to Function

If hospitals are to maintain capacity and vital services during extreme events and disasters there needs to be more training for staff and greater consideration of their personal circumstances, say researchers.

In a new study, published in the International Journal of Disaster Risk Reduction, researchers from Anglia Ruskin University surveyed 197 staff, including clerical staff, management, doctors, nurses and allied health workers, using questionnaires returned by around 1 in 10 staff members from an unnamed NHS hospital from the beginning of the COVID-19 pandemic. The researchers found significant factors affected whether hospital workers felt able to do their job during and after an extreme event, including paucity of training for extreme events, and their own caring responsibilities, commuting distance and mental resilience.

Lead author Dr Nebil Achour said: “Healthcare services are among the most intricate and vital services in the world. The influx of COVID-19 patients has increased the requirement for capacity and resources in hospitals.”

Absent Staff Means Absent Services

The researchers found that 2 in 5 (39%) hospital workers were likely to be absent during an extreme event, leaving only those staff capable of attendance (61%) available to keep the hospital running.

Staff absence may cause a cessation of some hospital services, the researchers pointed out. For example, MRI scanners or ventilators might be unable to function if specialist staff were absent.

Least likely to be able to attend work in an extreme event were technicians, with the researchers explaining that “they also had the highest impact on services (62%) when they are absent”, since often they are the only staff members who can operate Certain machinery such as laboratory IT systems and blood machines.

Personal Responsibilities Need to be Taken into Account

The authors said that the need to consider dependents, travel issues, mental resilience, and training all influence the capability of hospital staff to attend during extreme events. These factors affect individuals differently based on their personal and professional circumstances.

Dr Achour said: “Many workplaces, including hospitals, tend to overlook the personal circumstances of staff and set expectations that are difficult for staff to achieve, particularly if they have caring responsibilities or live a significant distance from the. circumstances stress levels and mental resilience, which in turn reduces ability to attend work.”

Mental Health and Resilience

The ability to be resilient during times of intense stress, such as occurs during extreme events and disasters, and the impact of these events on mental health, is of increasing concern amongst healthcare professionals and organisations. In December 2020, the British Medical Association conducted a survey of over 7000 doctors, which revealed that nearly two-thirds of doctors had anxiety or depression. In fact, the Medscape UK Doctors’ Burnout and Lifestyle Survey 2020 found that levels of burnout amongst UK doctors had increased by 68% during the pandemic.

In the new report, researchers pointed out that among those surveyed mental resilience varied between 60% and 68% for all participants, indicating “staff are under mental pressure”. They emphasize the importance for hospitals to “revise their resilience strategies more than ever and ensure that staff are well trained for major emergencies”.

Other findings from the study were:

  • 91% of staff reported having no practical training for an extreme event, and 75% no theory training

  • Around 40% had dependents such as children, parents or partners, providing a risk to attendance during a time of extreme strain

  • 72% of staff were deemed to have a high chance of attendance due to living in close proximity to the hospital

  • 89% found their varied and meaningful

  • 66% had worked for the hospital for more than 11 years

“The likelihood of extreme events is increasing, such as storms, floods, and new pandemics. Healthcare managers need to be aware of the need to mitigate against some of these risks,” Dr Achour said. “Going forward, hospitals need to adopt a more comprehensive approach where disaster management is incorporated into a broader strategy of disaster mitigation.”