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A Hospital Emergency Support System for Real Time Surveillance Modeling and Effective Response
Abstract
Before 2001, public health departments, including hospitals, rarely played a role in disaster planning, though they functioned in critical roles for victim treatment and recovery. Their roles in disaster response usually initiated after a disaster event had occurred. But the potential for chemical or biological terrorism has pushed them to become frontline responders, as well as critical and central players in most state and local emergency planning teams. According to U.S. General Accounting Office [GAO] (2003), increasing expectations demand that public health agencies at all levels in the United States develop their capacities to respond to incidents of terrorism and other disasters (Bashir et al., 2003). For healthcare facilities, hospital emergency response plans rely on their emergency departments’ response. That is, the emergency department must determine the magnitude of the event and initiate the appropriate institutional response, including decisions to declare an institutional disaster or institutional lock-down and determinations of whether victim decontamination is needed. From this point of view, the extent of the response depends on the capability of each emergency department. At present, however, even without a terrorism incident, emergency departments are crowded, and patients might wait up to a full day to receive treatment (Brownstein, 2007; U.S. National Center for Injury Prevention and Control [NCIPC], 2007). According to a Harvard Medical School survey, the number of ER visits rose from 93.4 million in 1994 to 110.2 million in 2004. A patient has a one in four chance of waiting for more than 50 minutes because of overcrowding in the emergency department, and wait times appear likely to keep increasing (Reuters, 2008). This widespread problem logically will negatively influence their ability to respond to high-consequence chemical, biological, radiological, or nuclear (CBRN) attacks or natural disasters. Should a huge influx of patients arrive due to an unexpected disaster event, the current crowding situation of most emergency departments implies that real emergencies may be lost in the shuffle without an organized response (Conte, 2005 Morse, 2002).
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