Hospital evacuation: Exercise versus reality.

Area of Science:

• Disaster Medicine
• Emergency Preparedness
• Healthcare Management

Background:

• The Dutch Major Incident Hospital (MIH) is a specialized facility for large-scale emergency care during disasters.
• MIH has a history of managing patient transfers from evacuated hospitals, including a 1995 flooding incident and a 2014 exercise.

Purpose of the Study:

• To evaluate the MIH's performance during a 2014 evacuation exercise.
• To compare the exercise scenario with real-life patient transfer events in 1995 and 2015.
• To identify areas for optimizing future disaster response training.

Main Methods:

• Analysis of three patient transfer events (1995, 2014 exercise, 2015) using the Protocol for Reports from Major Accidents and Disasters.
• Evaluation of medical response, patient surge, IT system performance, and legal considerations.

Main Results:

• Patient surge varied across events, with 72 patients in the 2014 exercise and 143/70 in the 1995/2015 real events.
• Information technology (IT) systems were less reliable during the real 2015 event compared to the exercise.
• The acute phase of care was comparable across all events, with good performance, but exercises did not cover multi-day care implications.

Conclusions:

• Large-scale exercises effectively benchmark the acute phase of medical disaster response.
• The MIH demonstrated high preparedness for admitting entire evacuated hospitals or large patient groups.
• Real-world deployments highlighted challenges in multi-day care and IT system reliability not fully captured in exercises.