Report on the Project on the Implementation of Continuity Operations in Disaster-Affected Healthcare Facilities Using Gensai Calendar HDMG and COOP Flow Diagram

Based on the lessons learned from past disasters, the Japanese Ministry of Health, Labour and Welfare has notified the establishment of disaster base hospitals and ensured medical care continuity based on business continuity plan (BCP). Following these, we created a disaster management training program with 45 items, the Disaster Mitigation (Gensai) Calendar for Healthcare Disaster Management Guide (HDMG)* (“Gensai Calendar”) in 2018. Thereafter, a three-year multicenter project was launched at the Tokyo Metropolitan Hospital Organization to introduce the “Gensai Calendar” and assess its merits as a self-learning material through tests based on it. The project also aimed at establishing a common operating procedure (COOP) for medical continuity at affected healthcare facilities using annual comprehensive disaster drills. The numbers of participants and hospitals recruited for the test over the three-year period were 4,281 in six hospitals, 6,179 in ten hospitals, and 6,216 in seven hospitals. The total of 55 questions were asked in the e-learning format in the first and second years, and 11 in the third year. Questions with less than 70% correct rate were same for three years. Through the drills, a COOP flow diagram was constructed based on the initial responses in the wards. Furthermore, the crisis management system of each hospital was unified, and each BCP was revised into a standard document along the “COOP Flow Diagram.” A COOP system combining the “Gensai Calendar” learnings, annual “COOP Flow Diagram” drill, and standard documentation can be a viable system for medical continuity. This system could also be versatile and introduced to many healthcare facilities. * This is also the abbreviation for the Hiroo Disaster Management Group, which has a double meaning. The group consists of disaster prevention staff from the Tokyo Metropolitan Hiroo Hospital, Komagome Hospital, and Bokutoh Hospital, and is responsible for planning and managing disaster mitigation measures.