Integral hospital response to emergencies and disasters in a private hospital in Mexico

In this manuscript, we show that the design and implementation of a hospital response protocol for emergencies and disasters is essential to offer an effective health response attached to international programs aimed at risk reduction, which allow the identification of personnel and the actions to be taken during a critical event. Our purpose was to evaluate their previous knowledge and actions in similar situations, as well as to detect the strengths and areas of opportunity of each organization. This brief article describes the perceptions of the staff of a private hospital in Mexico City about their individual and institutional actions in emergencies and disasters, collected through questionnaires and semi-structured interviews. *Correspondence to: Luz Angélica de la Sierra de la Vega, Professor and researcher, Center for Population Health Research. National Institute of Public Health Cuernavaca, Mexico, Tel: (52) 7773293000 Ext. 3301; E-mail: luz. delasierra@insp.mx Received: September 24, 2019; Accepted: November 12, 2019; Published: November 21, 2019 Introduction Mexico has been the subject of many social and natural events that have tested its capacity for health response, especially in matters of infrastructure and Resources [1]. The second and third level hospital units are an axis of central response and reference in this type of events, so guaranteeing their integral response, organized and with a decisive vision, promotes a strategy of prevention and mitigation of risk in emergencies and disasters [2]. The frequency of climate-related disasters is increasing, since in the last twenty years an annual average of 30,000 lives has been claimed and caused more than 4,000 million injured. According to the UN, 90% of natural disasters are related to the climate, while the remaining 10% are of geophysical origin (earthquakes, volcanic eruptions and landslides). In the first group, the deadliest and most serious effects are floods and droughts, causing 80% of the victims and which are predominantly poor countries [3]. Mexico and in particular Mexico City present special challenges, such as overpopulation and poor access to sanitation services. The most destructive event with greater repercussions, has been the earthquake that occurred in 1985, with approximately 6000 deaths, generating an approximate cost of $ 4.1 billion, which showed the inability of the system to face events of similar magnitude [4]. This situation was faced based on the national and international solidarity social response. There were no trained personnel in the areas of critical response for the reception of the injured, rescue, much less with organizational principles to provide an effective health response. Recovering the evidence and statistics of the repercussions of these events, the Pan American Health Organization (PAHO) promoted a resolution (CD 45.R8) demanding that member states adopt a policy on risk reduction the initiative of “Safe Hospital against disasters ”in such a way as to ensure their capacity to respond and function in critical situations. This was adopted by 168 countries, including Mexico, in 2005 in the framework of the "World Conference on Disaster Reduction" in Kobe Hyogo, Japan [5]. This highlights the need for priority attention to multiple victims and the support and organization of medical services. With central axes the protection of life, infrastructure and function [6]. The proper functioning of health services depends on several important aspects, including functionality and integrity in the provision of vital services and the adequate supply of supplies [5,7]. In these situations, some of the scenarios to be analyzed are the massive flow of patients with injuries that may or may not be of traumatic origin, patients with chronic conditions that derive from this type of sudden situation require in-hospital management and finally the increase in intracommunicable diseases and outpatient [8,9]. This increase in the demand for services requires an organized reaction of administrative, technical and operational processes, before, during and after the response to the event. Therefore, regardless of the origin of the Emergency or Disaster, it is essential to have a unique plan of action, which guides and guides the areas that lead the response to promote an effective limitation of damage, not only to the health structure, but also in social costs. It is extremely important to have a plan that allows consecutive steps to be taken and that ensures timely and safe patient care [9]. This requires that all people involved in the design, direction, performance and control of the plans are motivated to develop a high level of awareness and commitment, resulting in a more active participation in the search for integral solutions [10,11]. Saleme-Cruz EN (2019) Integral hospital response to emergencies and disasters in a private hospital in Mexico Volume 3: 2-4 Health Prim Car, 2019 doi: 10.15761/HPC.1000175 they predominantly point to earthquakes and fires / explosions as the main ones. It was interesting to analyze their knowledge regarding the training received, 90% reported having it being an access requirement to work especially in hospital areas. Regarding 83.3% reported having been trained in person (course) or at the time of a drill.The options that the hospital offers for such training vary: 60% report having been trained through an in-person course, an online course, scheduled drills and instructional responsibility by the immediate bosses. Only 10% of them report having been instructed by all possible methods, while 60% indicate that they received instruction by at least 2 methods (classroom course and simulation). Regarding the knowledge about the Crisis Plan of the ABC Medical Center (document that sets out some chains of action in case of internal emergency, the organizational chart of the Crisis Committee, the meeting points), 80% of the participants know the same and in almost similar figures, (85%) know where they can locate it for consultation. Stage During an Emergency or Disaster Situation When questioning participants about their knowledge about warning / alert and activation systems in an Emergency or Disaster situation at ABC Medical Center, only 3.3% said they did not know it.Regarding the services that pay attention during this type of situation, 93.3% stated that they identified those services that should do it and that their service was part of the necessary response. Only 13% of the participants did not identify their service as a response provider, although within the actions all the services of the participants are required in it. It was questioned whether at the time of answering an algorithm in their service that was used as an action guide, 40% of the participants did not identify any type of action algorithm in their service. Finally, the question we asked about who should be in charge of directing and organizing the response in their service of origin, having as an answer that the Head of the Service or they themselves would have that function. Emergency Service. Questioned about the knowledge of codes for activation of the warning or assistance of other hospital areas in a critical situation, everyone answered positively. However, at the time of questioning during this type of event, who should carry out the activation, 56.6% indicated to the Chief of the Emergency Department as the person in charge of the activation, the rest stated that it was a partner or themselves who should activate it. 100% of participants indicated knowing the activation process and the expected response (assistance and mobilization) by other services and their role in this response to Emergencies or Disasters.