Research - Vertical Evacuation
Evacuating patients from hospitals in a time of crisis - and particularly from the Intensive Care Units (ICU) - calls for extraordinary measures and care. Interested in assessing and reducing the risk involved in such circumstances, the ESI in collaboration with the Center for Innovative Learning and CRU investigators developed a research plan to evaluate the many processes involved in evacuating patients from hospital units and surging them to other area hospitals. WakeMed was one of just 11 hospitals across the nation to receive funding for this disaster-preparedness project.
A total of six CapRAC hospitals participated over three days of tornado disaster simulations. Three pairs of hospitals were organized such that one facility would be "hit" by the tornado, while the other would receive a surge of evacuated patients. Using human patient simulators we were able to evaluate the hospital system experience moving critically ill patients, sometimes down several flights of stairs, and to gather valuable data regarding important clinical parameters such as ventilation rates, equipment needs and other potential gaps in managing the ongoing critical care for these patients being evacuated and transported to other facilities.
The project allowed facility health care providers and administrators to see first hand that some critically ill patients may not survive evacuation. Using a failure mode evaluation and analysis (FMEA) process with a large group of key stakeholders at the WakeMed site, investigators were able to identify and overcome potential barriers in the evacuation plans for our ICUs. The theoretical risk reduction was 73 percent overall.
This project, called Project MoVES (Modeling via Evacuation Scenarios) was the first-ever proposal to develop, implement and evaluate a system-wide evacuation and surge scenario involving a range of patient acuities from multiple health care venues including primary, tertiary, and skilled care facilities, as well as special populations in both urban and rural communities.
Project MoVES not only produced a significant amount of data related to patient evacuation and surge, but also several other important outcomes:
- The project helped participating health care facilities become NIMS (National Incident Management System) compliant;
- The project team developed a “matrix” to assess the communication capability and needs of health care facility emergency operations centers;
- The team developed the Vertical Evacuation Simulation Training (VEST) course, a training program that teaches safe and effective evacuation processes to health care personnel.