Factors causing emergency medical care overload during heatwaves: A Delphi study

Area of Science:

• Public Health
• Emergency Medicine
• Disaster Medicine
• Climatology

Background:

• Extreme heat events, or heatwaves, present a significant public health risk.
• Increased heatwave frequency and intensity correlate with higher demand for emergency medical services.
• Understanding factors contributing to emergency care overload during heatwaves is crucial for preparedness.

Purpose of the Study:

• To identify key factors contributing to emergency healthcare system overload during heatwaves.
• To establish consensus among experts on interventions for enhancing emergency care resilience.
• To inform strategies for mitigating health disaster risks associated with climate change.

Main Methods:

• An online Delphi study involving 15 experts in emergency medicine, disaster medicine, and public health.
• Three rounds of expert consensus-building, starting with an open-ended question and followed by rating statements on a 7-point scale.
• Consensus defined as a standard deviation of ≤ 1.0 for rated statements.

Main Results:

• Thirty-one initial statements were generated, with experts reaching consensus on 18 key factors.
• Agreed-upon factors primarily focused on patient processing inputs, stakeholder identification, and the role of primary care.
• Experts highlighted the need for dedicated resources and increased bed capacity to manage patient throughput and output.

Conclusions:

• Findings provide a foundation for developing and testing interventions to bolster emergency healthcare resilience during heatwaves.
• Addressing identified factors can help reduce the disaster risk posed by climate change-induced extreme weather events.
• Interventions should target patient intake processes, primary care coordination, and resource allocation within healthcare systems.