From Planning to Execution: Delving into the Crucial Role and Challenges of HEPPUs in Hospital Emergency Management

Abstract

In 2018, the Emergency, Disasters and Ambulatory Transportation General Department at the Ministry of Health in Saudi Arabia established hospital emergency planning and preparation units (HEPPUs) to improve hospitals’ ability to respond to disasters. This study aimed to gain an in-depth understanding of the functioning of HEPPUs within hospitals in the western region of Saudi Arabia. Qualitative research methodology and semistructured interviews with emergency managers were employed. Four key themes emerged from the data: establishment and evolution, roles and responsibilities, communication and coordination, and challenges and limitations. The findings emphasize the importance of interdisciplinary collaboration, effective communication, and responses to challenges in enhancing healthcare resilience and disaster management. This study contributes insights and offers practical recommendations for improving the preparedness and performance of HEPPUs within Saudi Arabian hospitals.

Keywords

Disaster health / Disaster response / Hospital disaster planning / Hospital disaster preparedness / Incident command system / Saudi Arabia

References

[1] Abuadas MH, Albikawi ZF. Predictors of disaster preparedness among registered nurses in Saudi Arabia: A structural equation modelling analysis. Australasian Emergency Care, 2022, 25(2): 132-139

[2] Aitsi-Selmi A, Murray V. The Sendai framework: Disaster risk reduction through a health lens. Bulletin of the World Health Organization, 2015, 93(6): 362-362

[3] Al Harthi M, Al Thobaity A, Al Ahmari W, Almalki M. Challenges for nurses in disaster management: A scoping review. Risk Management and Healthcare Policy, 2020, 13: 2627-2634

[4] Al Harthi M, Al Thobaity A, Almalki M, Al Ahmari W. Improving disaster readiness and the response of nurses in Saudi Arabia. Risk Management and Healthcare Policy, 2021, 14: 4537-4544

[5] Al Thobaity A, Plummer V, Innes K, Copnell B. Perceptions of knowledge of disaster management among military and civilian nurses in Saudi Arabia. Australasian Emergency Nursing Journal, 2015, 18(3): 156-164

[6] Al Thobaity A, Williams B, Plummer V. A new scale for disaster nursing core competencies: Development and psychometric testing. Australasian Emergency Nursing Journal, 2016, 19(1): 11-19

[7] Al Thobaity, A., S. Alamri, V. Plummer, and B. Williams. 2019. Exploring the necessary disaster plan components in Saudi Arabian hospitals. International Journal of Disaster Risk Reduction 41: Article 101316.

[8] Ali, H.M., C. Desha, J. Ranse, and A. Roiko. 2021. Planning and assessment approaches towards disaster resilient hospitals: A systematic literature review. International Journal of Disaster Risk Reduction 61: Article 102319.

[9] Alruwaili A, Islam MS, Usher K. Hospitals disaster preparedness and management in the Eastern Province of the Kingdom of Saudi Arabia: A cross-sectional study. Disaster Medicine and Public Health Preparedness, 2022, 16(3): 1038-1045

[10] Al-Tawfiq JA, Memish ZA. Mass gathering medicine: 2014 Hajj and Umra preparation as a leading example. International Journal of Infectious Diseases, 2014, 27: 26-31

[11] Al-Wathinani, A., A.J. Hertelendy, S. Alhurishi, A. Mobrad, R. Alhazmi, M. Altuwaijri, M. Alanazi, R. Alotaibi, and K. Goniewicz. 2020. Increased emergency calls during the COVID-19 pandemic in Saudi Arabia: A national retrospective study. Healthcare 9(1): Article 14.

[12] Al-Wathinani, A., A.J. Hertelendy, A.M. Mobrad, R. Alhazmi, S. Althunayyan, M.S. Molloy, and K. Goniewicz. 2021. Emergency medical providers’ knowledge regarding disasters during mass gatherings in Saudi Arabia. Sustainability 13(6): Article 3342.

[13] Bahrami, P., A. Ardalan, A. Nejati, A. Ostadtaghizadeh, and A. Yari. 2020. Factors affecting the effectiveness of hospital incident command system; findings from a systematic review. Bulletin of Emergency & Trauma 8(2): Article 62.

[14] Bajow, N.A., and S.M. Alkhalil. 2014. Evaluation and analysis of hospital disaster preparedness in Jeddah. Health 6(19): Article 2668.

[15] Bayram JD, Zuabi S. Disaster metrics: Quantification of acute medical disasters in trauma-related multiple casualty events through modeling of the acute medical severity index. Prehospital and Disaster Medicine, 2012, 27(2): 130-135

[16] Bradley, D.T., M. McFarland, and M. Clarke. 2016. The effectiveness of disaster risk communication: A systematic review of intervention studies. PLoS Currents Disasters 81–120.

[17] Brinjee D, Al Thobaity A, Almalki M, Alahmari W. Identify the disaster nursing training and education needs for nurses in Taif City, Saudi Arabia. Risk Management and Healthcare Policy, 2021, 14: 2301-2310

[18] Brooks SK, Rubin GJ, Greenberg N. Traumatic stress within disaster-exposed occupations: Overview of the literature and suggestions for the management of traumatic stress in the workplace. British Medical Bulletin, 2019, 129(1): 25-34

[19] Chen J, Chen THY, Vertinsky I, Yumagulova L, Park C. Public–private partnerships for the development of disaster resilient communities. Journal of Contingencies and Crisis Management, 2013, 21(3): 130-143

[20] Chirico, F., G. Nucera, L. Szarpak, and S. Zaffina. 2023. The cooperation between occupational and public health stakeholders and its decisive role in the battle against the COVID-19 pandemic. Disaster Medicine and Public Health Preparedness 17: Article e100.

[21] Djalali, A., V. Hosseinijenab, M. Peyravi, M. Nekoei-Moghadam, B. Hosseini, L. Schoenthal, and K.L. Koenig. 2015. The hospital incident command system: Modified model for hospitals in Iran. PLoS Currents 7. https://doi.org/10.1371/currents.dis.45d66b5258f79c1678c6728dd920451a.

[22] El Sayed M, Chami AF, Hitti E. Developing a hospital disaster preparedness plan for mass casualty incidents: Lessons learned from the downtown Beirut bombing. Disaster Medicine and Public Health Preparedness, 2018, 12(3): 379-385

[23] Guha-Sapir, D., R. Below, and P. Hoyois. 2009. EM-DAT: The CRED/OFDA International Disaster Database. www.emdat.be. Brussels, Belgium: Université Catholique de Louvain.

[24] Hasan, M.K., S.M. Nasrullah, A. Quattrocchi, P. Arcos González, and R. Castro Delgado. 2022. Hospital surge capacity preparedness in disasters and emergencies: Protocol for a systematic review. International Journal of Environmental Research and Public Health 19(20): Article 13437.

[25] Hendrickx C, D’Hoker S, Michiels G, Sabbe M. Principles of hospital disaster management: An integrated and multidisciplinary approach. B-ENT Supplements, 2016, 26(2): 139-148.

[26] Hu H, Ma Y, Kong L, Guo J, Wang J, Liu M, Li Y, Wang J Application of hazard vulnerability analysis risk assessment for hospital acquired infection management. Chinese Journal of Hospital Administration, 2017, 12: 822-825.

[27] Kaji AH, Lewis RJ. Hospital disaster preparedness in Los Angeles County. Academic Emergency Medicine, 2006, 13(11): 1198-1203

[28] Khan, A., J. Alowais, A. Nofal, and T. Alama. 2021. Assessment of disaster preparedness at general hospitals in Al-Madinah Al-Munawarah Province, Western region of Saudi Arabia: A study of pre intervention and post intervention test scores from 2017 to 2019. Saudi Medical Journal 42(5): Article 537.

[29] Khorram-Manesh A, Lupesco O, Friedl T, Arnim G, Kaptan K, Djalali AR, Foletti M, Ingrasia PL Education in disaster management: What do we offer and what do we need? Proposing a new global program. Disaster Medicine and Public Health Preparedness, 2016, 10(6): 854-873

[30] Larson E, Raney LH. Emergency incident management systems: Fundamentals and applications, 2008, Hoboken, NJ: Wiley

[31] Marcozzi DE, Pietrobon R, Lawler JV, French MT, Mecher C, Peffer J, Baehr NE, Browne BJ. Development of a hospital medical surge preparedness index using a national hospital survey. Health Services and Outcomes Research Methodology, 2020, 20(1): 60-83

[32] MOH (Ministry of Health). 2019. Emergency, Disasters and Ambulatory Transportation General Department. https://www.moh.gov.sa/en/Ministry/Forms/EDATGD/Pages/default.aspx. Accessed 9 Jan 2023.

[33] Olivieri C, Ingrassia PL, Della Corte F, Carenzo L, Sapori J-M, Gabilly L, Segond F, Grieger F Hospital preparedness and response in CBRN emergencies: TIER assessment tool. European Journal of Emergency Medicine, 2017, 24(5): 366-370

[34] Patel, S.S., M.B. Rogers, R. Amlôt, and G.J. Rubin. 2017. What do we mean by “community resilience”? A systematic literature review of how it is defined in the literature. PLoS Currents Disasters 9. https://doi.org/10.1371/currents.dis.db775aff25efc5ac4f0660ad9c9f7db2.

[35] Phuspa SM, Kamal M, Rosanti E. Hospital fire risk analysis with hazard, vulnerability, capacity, risk assessment model. KEMAS Jurnal Kesehatan Masyarakat, 2019, 14(3): 353-358

[36] Prakash Narain J, Sodani P, Kant L. COVID-19 pandemic: Lessons for the health systems. Journal of Health Management, 2021, 23(1): 74-84

[37] Schultz, C.H., K.L. Koenig, M. Whiteside, R. Murray, and National Standardized All-Hazard Disaster Core Competencies Task. Force. 2012. Development of national standardized all-hazard disaster core competencies for acute care physicians, nurses, and EMS professionals. Annals of Emergency Medicine 59(3): 196–208.

[38] Shabanikiya H, Jafari M, Gorgi HA, Seyedin H, Rahimi A. Developing a practical toolkit for evaluating hospital preparedness for surge capacity in disasters. International Journal of Disaster Risk Reduction, 2019, 34: 423-428

[39] Sheikhbardsiri H, Raeisi AR, Nekoei-Moghadam M, Rezaei F. Surge capacity of hospitals in emergencies and disasters with a preparedness approach: A systematic review. Disaster Medicine and Public Health Preparedness, 2017, 11(5): 612-620

[40] Shooshtari, S., S. Tofighi, and S. Abbasi. 2017. Benefits, barriers, and limitations on the use of hospital incident command system. Journal of Research in Medical Sciences 22: Article 36.

[41] Søvold, L.E., J.A. Naslund, A.A. Kousoulis, S. Saxena, M.W. Qoronfleh, C. Grobler, and L. Münter. 2021. Prioritizing the mental health and well-being of healthcare workers: An urgent global public health priority. Frontiers in Public Health 9: Article 679397.

[42] Stoto MA, Nelson C, Piltch-Loeb R, Mayigane LN, Copper F, Chungong S. Getting the most from after action reviews to improve global health security. Globalization and Health, 2019, 15: 1-10

[43] Sultan MAS, Khorram-Manesh A, Sørensen JL, Berlin J, Carlström E. Disaster collaborative exercises for healthcare teamwork in a Saudi context. International Journal of Disaster Risk Science, 2023, 14(2): 183-193

[44] Timbie JW, Ringel JS, Fox DS, Pillemer F, Waxman DA, Moore M, Hansen CK, Knebel AR Systematic review of strategies to manage and allocate scarce resources during mass casualty events. Annals of Emergency Medicine, 2013, 61(6): 677-689

[45] Veenema TG. Disaster nursing and emergency preparedness, 2018, Berlin: Springer

[46] Veenema TG, Griffin A, Gable AR, MacIntyre L, Simons RN, Couig MP, Walsh JJ, Lavin RP Nurses as leaders in disaster preparedness and response—A call to action. Journal of Nursing Scholarship, 2016, 48(2): 187-200

[47] Wang, Y., H. Hao, and L.S. Platt. 2021. Examining risk and crisis communications of government agencies and stakeholders during early-stages of COVID-19 on Twitter. Computers in Human Behavior 114: Article 106568.

[48] Yadav DK, Barve A. Analysis of critical success factors of humanitarian supply chain: An application of interpretive structural modeling. International Journal of Disaster Risk Reduction, 2015, 12: 213-225

[49] Zhong S, Hou X-Y, Clark M, Zang Y-L, Wang L, Xu L-Z, FitzGerald G. Disaster resilience in tertiary hospitals: A cross-sectional survey in Shandong Province, China. BMC Health Services Research, 2014, 14(1): 1-10