Using discrete event simulation to evaluate the post-earthquake surge capacity in hospital emergency departments Blowes, K.; Palomino Romani, G.; Molina Hutt, Carlos
Damage to structural and nonstructural components of hospital buildings can limit emergency department functionality after a large seismic event. Integrating post-earthquake functionality assessments into emergency department simulations is therefore critical to understanding a hospital’s surge capacity. This paper presents a methodology to estimate the ratio of patient demand from casualties within a hospital catchment area to expected post-earthquake emergency department capacity, considering damage-induced loss of function. Discrete Event Simulation (DES) was used to simulate patient flow through a damaged emergency department and to quantify hospital performance by estimating patient wait time and length of stay. A case study hospital, constructed in the 1970s in Vancouver, Canada, was subjected to 30 Mw9.0 Cascadia Subduction Zone earthquake simulations. DES results show the patient wait time limit of 2 hours was exceeded in 7 of the 30 scenarios. The mean patient length of stay for all 30 scenarios nearly doubled from 6.5 hours to 12.5 hours. The methodology developed supports planning efforts by enabling the simulation of emergency department operability in hospitals after an earthquake with explicit consideration of the impact of building damage on functionality. The results can be used as a decision support tool to improve healthcare disaster planning.
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