September 24, 2019 | Health System Risk Management


Healthcare facility evacuations are becoming more common. Because internal or external situations may require either partial or total evacuation, healthcare organizations should assess their organization's risks, devise a comprehensive evacuation plan, and test the plan. The plan should incorporate strategies to conduct planned and unscheduled evacuations.

Many events could force a facility to evacuate some or all of its patients. Types of External Emergencies and Disasters explores the hazards associated with external disasters that could force an evacuation.

Unless directed by government mandate, healthcare facilities have the authority to determine whether and when it is in their patients' best interests to evacuate or shelter in place. Unfortunately, major disasters continue to occur, yet they provide lessons learned and offer opportunities for facilities to learn how to better prepare for an evacuation.

There are different types of evacuations. An isolated fire or loss of power in one part of the hospital would not necessarily require the entire facility to be evacuated. Risk managers should become familiar with the following definitions related to evacuations (MDPH):

When considering renovating an older facility or building a new one, remember that the traditional floor plan, placing administrative suites, gift shops, pharmacies, laboratory, and cafeteria services on the first floor while nonambulatory and high-acuity patients such as intensive care unit (ICU) patients are on higher floors, adds to the complexity when evacuating patients. Some authors contend that the floor plans should be reversed. The "flipped" version of the floor plan would locate the high-acuity patients, who need assistance with evacuating, on the ground floor. (Tzeng and Yin)

The time required to prepare for an event will have an effect on the evacuation decision and type. Some events, such as a fire, will require an immediate evacuation from the affected area; hospital fires are not as rare as one might think. A three-year study (2004–2006) of fires in medical facilities in the United States found that an average of 6,400 fires occurred each year, with 1.2 deaths and 25.6 injuries suffered per 1,000 fires (Tzeng and Yin; U.S. Fire Administration). A hurricane, however, usually provides time to prepare for a possible evacuation. Organizations should determine the language they will use to describe evacuation time frames. One set of recommended...

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