The Hospital SCOPE study
Matthias Traub
Outline
The Hospital SCOPE Study
Aim:
Apply epidemiologically-derived measures of hospital surge capacity to Australasian hospitals in order to quantify current clinical disaster preparedness
Design: cross-sectional survey
Partners: Trauma Research Group of ATS, The George Institute
Disaster Preparedness
Most data based on personal experience and perception
Fundamental KPI’s of emergency care for disaster victims are undefined and un-benchmarked
Surge Capacity
Ability to provide acute care to critical and non-critical mass casualties simultaneously
Casualty predictor
(US Centers for Disease Control and Prevention)
Surge Capacity
Staff stretch capacity
Holding capacity
Throughput capacity
Throughput capacity
How quickly can we process patients in ED and OT?
Throughput Capacity
Predicting hospital capacity to care for critical casualties (33%):
Number of available operating rooms
Throughput Capacity
Predicting hospital capacity to care for non-critical casualties (66%):
Non-critical casualties/h ~ Nr. of Xray machines x 6 pat/h
(US Centers for Disease Control and Prevention)
Throughput Capacity
Number of ICU/ventilation beds
Represent a resource ceiling on treatment capacity
Target Group
ED Directors of every ACEM accredited hospital in Australasia
Outcomes
Hospital technological resources
Dispersion
Comparison with international benchmarks
Response
88 of 94 ACEM accredited hospitals replied ( 94%)
7 of 7 non-ACEM hospital in metropolitan Sydney replied (100%)
Results
3.2 x-ray machines/100,000 population
2.9 operating theatres/100,000 population
4.9 ICU beds/100,000 population
Results Sydney
5.3 x-ray machines/100,000 population
4.8 operating theatres/100,000 population
4.9 ICU beds/100,000 population
International benchmarks
International best practice and casualty estimate models
Critical benchmarks
Health Resources and Services Administration:
500 patients/1 Million population
Resource requirements for Sydney:
Data Analysis Metro Sydney
Nr. ICU beds: 351
Nr. of operating theatres: 184
Nr. of x-ray: 202
What does it mean?
Accepted/acceptable level of care
Exponential drop of level of care with increasing patient load
Conclusions
Compared with international benchmarks, the Australian hospital system would fail to provide technical resources to many of its most critical injured patients
Lack of appropriate resources in Australian acute care hospitals (45-70%)
Population-based quantitative measures of hospital surge capacity coupled with consensus on preparedness benchmarks will enable informed monitoring of future disaster preparedness activities
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Ministry of Health
