Quantitative Assessment of Surge Capacity in Rwandan Trauma Hospitals: A Survey Using the 4S Framework

Area of Science:

• Emergency Medicine
• Healthcare Management
• Global Health

Background:

• Mass casualty incidents (MCIs) pose significant challenges, especially in low-resource settings.
• Existing research on hospital surge capacity is predominantly from high-resource countries and may not be generalizable.
• Rwanda, a low-resource setting, frequently experiences MCIs, necessitating an understanding of its unique surge capacity.

Purpose of the Study:

• To assess the hospital surge capacity in Rwanda using the 4S Framework (staff, stuff, system, space).
• To evaluate the perceived ability of Rwandan hospitals to manage patient influxes during MCIs.
• To identify factors influencing surge capacity in Rwandan referral hospitals.

Main Methods:

• A cross-sectional survey was conducted in emergency and surgical departments of Rwandan referral hospitals.
• Data were analyzed using descriptive statistics, t-tests, Fisher's exact test, ANOVA, and linear mixed-model regression.
• Thirty-two participants (82% response rate) provided insights into hospital surge capacity.

Main Results:

• Hospitals perceived an average capacity to manage 13 MCI patients while maintaining routine care.
• Tertiary hospitals reported lower capacity (11 patients) compared to secondary hospitals (22 patients).
• Continuous access to imaging and availability of CT scans and ICU beds were key factors influencing perceived capacity.

Conclusions:

• Rwandan hospitals demonstrate capacity to manage small to moderate MCIs.
• For larger MCIs, a strategy involving patient distribution across facilities is advised.
• Prioritizing critical cases to tertiary hospitals is recommended for optimal patient outcomes during large-scale events.