J.M. Magana
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2 records found
1
Patient flow logistics from disaster to care
A scoping review of actors, transport modes and decision problems
Sudden-onset disasters impact the health and well-being of millions of people each year. Typically, a sudden-onset disaster will lead to a surge of patients that require immediate acute care, even though health infrastructure and resources may be destroyed or not accessible. The challenge of patient flow logistics is transporting those in need of acute care rapidly to locations where they can be treated. The fields and disciplines tackling these challenges, therefore, span from disaster-related to health-related logistics, but it is not known whether and how research and approaches across these fields align. This study aims to scope this emergent field, identify research gaps and develop a conceptual framework that bridges the disaster-related and health-related logistics literature.
This paper follows a scoping review protocol. The authors screened an initial 8,491 papers, of which 127 were retained for a full-text review. Analyzing these papers, the authors map out the key concepts such as actors, locations, transportation modes and decision problems used in the literature. The study identifies research gaps and synthesize the findings into a conceptual framework to guide future research.
This review identified four gaps in the existing literature: (1) The literature focuses primarily on earthquakes and terrorist attacks, limited attention is given to other sudden-onset disaster types despite their frequency; (2) The literature focuses on formal actors such as health providers or civil protection bodies, while communities are largely portrayed as passive patients or victims; (3) Actors are largely assumed to follow standardized protocols, often ignoring emergent roles or behavioral changes typical for sudden-onset disasters; (4) Objectives predominantly relate to either efficiency or effectiveness, neglecting fairness and multiobjective problems.
To the best of the authors’ knowledge, this scoping review is the first to explore the different aspects of patient logistics in sudden-onset disasters by bridging the disaster-related and health-related literature.
Keeping healthcare afloat
A protocol for a 5-year multi-sited interdisciplinary research project into preparedness of healthcare for floods in the Netherlands
Introduction: The 2021 European floods in Germany, Belgium, and the Netherlands significantly impacted healthcare. With climate change increasing flood risks, healthcare preparedness is essential. Floods affect healthcare directly and indirectly by disrupting patient access, damaging infrastructure and impeding care continuity. Our interdisciplinary research in the Netherlands systematically assesses flood impacts on healthcare, optimises disaster preparedness, patient logistics, and continuity and explores crisis governance, incorporating lessons from coronavirus disease-2019 (COVID-19). Methods: Our multi-sited, interdisciplinary project titled “Pandemic lessons for flood disaster preparedness” includes literature reviews on: (i) the (in) direct impacts of floods on healthcare, (ii) disaster decision-making strategies and (iii) patient logistics during crises. Empirically, ethnographic methods (interviews, focus groups, document analyses, and observations) will: (a) assess hospital flood preparedness, (b) explore decision-making and crisis management strategies and (c) analyse the dynamics of health system governance during floods. Data from these sources and flood scenarios will inform models on healthcare impacts and decision-making, culminating in a simulation game for research and training. Discussion: This study offers a comprehensive, interdisciplinary approach to understanding and improving healthcare system preparedness for floods. By integrating diverse fields such as healthcare governance, disaster risk management, logistics and hydraulic engineering, we provide a unique lens on resilience. A key strength is the incorporation of lessons from the COVID-19 pandemic, allowing us to draw parallels between pandemic response and flood preparedness. In addition, our simulation game serves as a robust tool for translating knowledge into practice. However, the study’s reliance on collaboration with busy healthcare and disaster response professionals may limit engagement. Moreover, the absence of direct public and patient involvement in the research design, though partially mitigated by engaging representative organizations, presents a potential limitation. Lastly, the challenge of obtaining real-time data from flood events could introduce recall bias, but triangulation of various data sources aims to address this issue. Despite these challenges, the study’s integration of long-term data from recent floods and focus on healthcare-specific crisis governance provides valuable insights for improving disaster preparedness.