Evacuation from Healthcare Facilities in Poland: Legal Preparedness and Preparation
2. Material and Methods
3. Evacuation of Hospital Facilities in Poland
4. Hospital Safety–Legal Liability
- Designation of personnel responsible for the evacuation of staff (and patients) and combating fires.
- Providing the necessary resources for emergency first-aid, firefighting, and evacuation of workers. The number of employees required to perform firefighting and evacuation activities is not specified in the regulations. The manager decides on their number and the training and equipment they should have, taking into account the type and level of risk involved. The manager is also obliged to inform other employees about who has been appointed to perform these tasks . The information should include:
- The name and surname of the designated employee(s);
- The place where the designated employee performs their work, e.g., the department;
- The employee’s company telephone number or other means of electronic communication.Employees required to perform firefighting and evacuation activities must have completed occupational health and safety training under the provisions of the Regulation of the Minister of Economy on Training in Occupational Health and Safety .
- ensuring communication with external services specialized in particular in emergency first-aid, rescue and fire protection .
5. Hospital Evacuation Process
- In the event of an emergency or when hospital personnel receives information about potential danger and the need to evacuate, the personnel shall trigger a warning alarm (sirens, lights, voice announcements by the personnel of the facility, other methods, according to the capabilities/equipment of the facility).
- The fire brigade, the police, the director of the hospital, the head of the affected ward, as well as the other ward managers and the porters (and potentially other persons included in the evacuation plan), should be immediately notified of the event.
- Staff should begin the process of evacuation of patients as soon as possible, following the plan adopted by the medical facility.
- When the first unit of the State Fire Service arrives at the scene of the event, they take command of the evacuation procedure. Facility personnel should cooperate with the fire service at all times and carry out the orders of the fire officer in command. It should be remembered that the State Fire Service units arriving at the site do not know the facility, therefore, the logistical support of hospital staff is essential .
- It is assumed that about 50% of patients on the hospital premises can move around without the help of third parties. They should, therefore, be encouraged to self-evacuate. (Patients awaiting scheduled services should be discharged from the hospital and their scheduled treatment should be postponed to another date. Also, people who are in good health may be discharged home if they need to be evacuated) .
- The remaining patients, depending on their condition, should be transported to the hospital(s) and other places indicated in the evacuation plan. The most severely ill patients should be transported in ambulances under the care of medical personnel to the receiving hospital(s) with whom the respective medical facility has a cooperation agreement in case of evacuation. Patients who do not require medical transport may be transported to a safe place such as a hotel or school boarding house through city buses, taxis or other means of transport with which the evacuated medical entity has an agreement for emergency support.
- If, after the evacuation of all patients, it is possible for the medical personnel or technical/administrative staff to return safely, they should consider the feasibility of evacuating high-value medical equipment. Medical equipment can be extremely expensive and often fragile, it is important to take action to recover and protect it where feasible. Of course, this is only possible if it does not endanger the life and health of the staff. The most expensive equipment should be recovered first. Priority should be given to items that are lightweight and easy to carry .
6. Triage Management
7. Strengths, Limitations and Requirements for Future Research
8. Conclusions and Recommendations
Conflicts of Interest
- Wegrzyn, J.; Gluszak, M.; Telega, A. Infrastructure endowment, financial constraints and willingness to engage in PPPs: The case of Poland. Public Money Manag. 2019, 39, 132–138. [Google Scholar] [CrossRef]
- Wyte-Lake, T.; Griffin, A.R.; Dobalian, A. Supporting staff through a complete hospital evacuation and extended displacement period. J. Healthc. Manag. 2018, 63, 195–209. [Google Scholar] [CrossRef] [PubMed]
- Kautsch, M.; Dela, R. Changes in hospital CEO profiles in Poland—Professionalisation of management? Int. J. Health Plan. Manag. 2019, 34, 1238–1250. [Google Scholar] [CrossRef] [PubMed]
- Siedlecki, R.; Bem, A.; Ucieklak-Jeż, P.; Prędkiewicz, P. Rural Versus Urban Hospitals in Poland. Hospital’s Financial Health Assessment. Procedia Soc. Behav. Sci. 2016, 220, 444–451. [Google Scholar] [CrossRef][Green Version]
- Porębski, D. Integrated management system based on the BSC method: Application in polish hospitals. Inf. Syst. Manag. 2016, 5, 99–108. [Google Scholar]
- Mróz, K.; Hager, I.; Korniejenko, K. Material solutions for passive fire protection of buildings and structures and their performance testing. Procedia Eng. 2016, 151, 284–291. [Google Scholar] [CrossRef][Green Version]
- Pecio, M. Selected fire protection problems in designed and modernized high-rise buildings. Bezpieczeństwo Technika Pożarnicza 2016, 42. [Google Scholar] [CrossRef]
- Binio, J.; Kieliszek, S. Analysis of the use of Fire Protection Water Supply Systems in public utility buildings and residential buildings. In Proceedings of the MATEC Web of Conferences, Lviv, Ukraine, 7–8 November 2018; EDP Sciences: Les Ulis, France, 2018; Volume 247, p. 00010. [Google Scholar] [CrossRef]
- Kunikowski, G.; Kosieradzka, A.; Kąkol, U. Methodology for the preparation of rescue plans—A Polish case study. Disaster Prev. Manag. Int. J. 2019. [Google Scholar] [CrossRef]
- Gawlowski, P.; Biskup, A. Victim evacuation techniques in emergency conditions. Disaster Emerg. Med. J. 2019, 4, 116–123. [Google Scholar] [CrossRef]
- Bish, D.R.; Tarhini, H.; Amara, R.; Zoraster, R.; Bosson, N.; Gausche-Hill, M. Modeling to optimize hospital evacuation planning in EMS Systems. Prehosp. Emerg. Care 2017, 21, 503–510. [Google Scholar] [CrossRef]
- Kunikowski, G.; Rostek, K. Good practices in civil planning and crisis management in the world and their implementation in Poland. Jagiellonian J. Manag. 2019, 3, 135–150. [Google Scholar] [CrossRef][Green Version]
- Nieszporska, S. Priorities in the Polish health care system. European J. Health Econ. 2017, 18, 1–5. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Rosiek, A.; Rosiek-Kryszewska, A.; Leksowski, Ł.; Leksowski, K. A comparison of direct and two-stage transportation of patients to the hospital in Poland. Int. J. Environ. Res. Public Health 2015, 12, 4572–4586. [Google Scholar] [CrossRef][Green Version]
- Bem, A.; Siedlecki, R.; Prędkiewicz, P.; Gazzola, P.; Ryszawska, B.; Ucieklak-Jeż, P. Hospitals’ Financial Health in Rural and Urban Areas in Poland: Does It Ensure Sustainability? Sustainability 2019, 11, 1932. [Google Scholar] [CrossRef][Green Version]
- Kożuch, B.; Sienkiewicz-Małyjurek, K. Inter-organizational coordination for sustainable local governance: Public safety management in Poland. Sustainability 2016, 8, 123. [Google Scholar] [CrossRef][Green Version]
- Goniewicz, K.; Goniewicz, M.; Burkle, F.M. The Territorial Defence Force in Disaster Response in Poland: Civil-Military Collaboration during the State of Emergency. Sustainability 2019, 11, 487. [Google Scholar] [CrossRef][Green Version]
- Wukich, C.; Khemka, A. Social media adoption, message content, and reach: An examination of the Red Cross and Red Crescent national societies. Int. J. Emerg. Manag. 2017, 13, 89–116. [Google Scholar] [CrossRef]
- Lechowska, E. What determines flood risk perception? A review of factors of flood risk perception and relations between its basic elements. Nat. Hazards 2018, 94, 1341–1366. [Google Scholar] [CrossRef][Green Version]
- Goniewicz, K.; Burkle, F.M. Disaster early warning systems: The potential role and limitations of emerging text and data messaging mitigation capabilities. Disaster Med. Public Health Preparedness 2019, 13, 709–712. [Google Scholar] [CrossRef]
- Janowicz, R. Interdisciplinary Design Teams in Poland—Architecture as a Tool for Preventing Hospital-Acquired Infections. In Human Systems Engineering and Design, Proceedings of the IHSED 2018, Reims, France, 25–27 October 2018; Ahram, T., Karwowski, W., Taiar, R., Eds.; Advances in Intelligent Systems and Computing; Springer: Cham, Switzerland, 2018; Volume 876. [Google Scholar] [CrossRef]
- Bielawska-Drózd, A.; Cieślik, P.; Wlizło-Skowronek, B.; Winnicka, I.; Kubiak, L.; Jaroszuk-Ściseł, J.; Depczyńska, D.; Bohacz, J.; Korniłowicz-Kowalska, T.; Skopinska-Rozewska, E.; et al. Identification and characteristics of biological agents in the work environment of medical emergency services in selected ambulances. Int. J. Occup. Med. Environ. Health 2017, 30, 617–627. [Google Scholar] [CrossRef]
- Kelen, G.D.; Troncoso, R.; Trebach, J.; Levin, S.; Cole, G.; Delaney, C.M.; Jenkins, J.L.; Fackler, J.; Sauer, L. Effect of reverse triage on the creation of surge capacity in a pediatric hospital. JAMA Pediatr. 2017, 171, e164829. [Google Scholar] [CrossRef]
- Kelen, G.D.; Sauer, L.; Clattenburg, E.; Lewis-Newby, M.; Fackler, J. Pediatric disposition classification (reverse triage) system to create surge capacity. Disaster Med. Public Health Preparedness 2015, 9, 283–290. [Google Scholar] [CrossRef] [PubMed]
- Burkle, F.M. Pediatric Reverse Triage—Uncomfortable but Real Decision Making for Community Preparedness. JAMA Pediatr. 2017, 171, e164839. [Google Scholar] [CrossRef] [PubMed]
- Ueda, S.; Hanzawa, K.; Shibata, M.; Suzuki, S. High prevalence of deep vein thrombosis in tsunami-flooded shelters established after the great East-Japan earthquake. Tohoku J. Exp. Med. 2012, 227, 199–202. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Sun, X.C.; Zhou, X.F.; Chen, S.; Liu, Y.X.; Wang, Y.J.; Zhang, W.; Gao, Y.C. Clinical characteristics of hypertension among victims in temporary shield district after Wenchuan earthquake in China. Eur. Rev. Med. Pharmacol. Sci. 2013, 17, 912–916. [Google Scholar]
- Suzuki, H.; Ohira, T.; Takeishi, Y.; Hosoya, M.; Yasumura, S.; Satoh, H.; Kawasaki, Y.; Takahashi, A.; Sakai, A.; Ohtsuru, A.; et al. Increased prevalence of atrial fibrillation after the Great East Japan Earthquake: Results from the Fukushima Health Management Survey. Int. J. Cardiol. 2015, 198, 102–105. [Google Scholar] [CrossRef]
- Takuya, T. Post-traumatic stress due to structural violence after Fukushima Disaster. Japan Forum 2020. [Google Scholar] [CrossRef]
- Yasumura, S. Evacuation effect on excess mortality among institutionalized elderly after the Fukushima Daiichi nuclear power plant accident. Fukushima J. Med. Sci. 2014, 60, 192–195. [Google Scholar] [CrossRef][Green Version]
- Nomura, S.; Blangiardo, M.; Tsubokura, M.; Nishikawa, Y.; Gilmour, S.; Kami, M.; Hodgson, S. Post-nuclear disaster evacuation and survival amongst elderly people in Fukushima: A comparative analysis between evacuees and non-evacuees. Prev. Med. 2016, 82, 77–82. [Google Scholar] [CrossRef]
- Tanigawa, K.; Hosoi, Y.; Hirohashi, N.; Iwasaki, Y.; Kamiya, K. Loss of life after evacuation: Lessons learned from the Fukushima accident. Lancet 2012, 379, 889–891. [Google Scholar] [CrossRef]
- Hasegawa, A.; Ohira, T.; Maeda, M.; Yasumura, S.; Tanigawa, K. Emergency responses and health consequences after the Fukushima accident; evacuation and relocation. Clin. Oncol. 2016, 28, 237–244. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Murakami, M.; Ono, K.; Tsubokura, M.; Nomura, S.; Oikawa, T.; Oka, T.; Kami, M.; Oki, T. Was the risk from nursing-home evacuation after the Fukushima accident higher than the radiation risk? PLoS ONE 2015, 10, e0137906. [Google Scholar] [CrossRef] [PubMed]
- Koyama, A.; Fuse, A.; Hagiwara, J.; Matsumoto, G.; Shiraishi, S.; Masuno, T.; Miyauchi, M.; Kawai, M.; Yokota, H. Medical relief activities, medical resourcing, and inpatient evacuation conducted by Nippon Medical School due to the Fukushima Daiichi Nuclear Power Plant accident following the Great East Japan Earthquake 2011. J. Nippon Med. Sch. 2011, 78, 393–396. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Trzos, A. The Use of the Mobile Information and Communication Technologies in Mass-Casualty Incident and Disaster Management-A Medical Triage System. Prehosp. Disaster Med. 2017, 32, S239–S240. [Google Scholar] [CrossRef][Green Version]
- Goniewicz, K.; Burkle, F.M. Challenges in implementing the Sendai framework for disaster risk reduction in Poland. Int. J. Environ. Res. Public Health 2019, 16, 2574. [Google Scholar] [CrossRef][Green Version]
- Holecki, T.; Romaniuk, P.; Woźniak-Holecka, J.; Szromek, A.R.; Syrkiewicz-Świtała, M. Mapping health needs to support health system Management in Poland. Front. Public Health 2018, 6, 82. [Google Scholar] [CrossRef][Green Version]
- Dubas-Jakóbczyk, K.; Kowalska-Bobko, I.; Sowada, C. The 2017 reform of the hospital sector in Poland–The challenge of consistent design. Health Policy 2019, 123, 538–543. [Google Scholar] [CrossRef]
- Sowada, C.; Sagan, A.; Kowalska-Bobko, I. Poland: A Health System Review; World Health Organization, Regional Office for Europe: Copenhagen, Denmark, 2019; Available online: https://apps.who.int/iris/handle/10665/325143 (accessed on 18 December 2019).
- Nomura, S.; Blangiardo, M.; Tsubokura, M.; Ozaki, A.; Morita, T.; Hodgson, S. Postnuclear disaster evacuation and chronic health in adults in Fukushima, Japan: A long-term retrospective analysis. BMJ Open 2016, 6, e010080. [Google Scholar] [CrossRef][Green Version]
- McGinty, M.D.; Burke, T.A.; Resnick, B.; Barnett, D.J.; Smith, K.C.; RutkowL. Decision processes and determinants of hospital evacuation and shelter-in-place during Hurricane Sandy. J. Public Health Manag. Pract. 2017, 23, 29–36. [Google Scholar] [CrossRef]
|Date, Location||HH II Facility||Cause||Additional Information|
|Hospital for the mentally and neurotically ill||Fire||Around 5.30 a.m., the roof caught fire.|
|Public institutions throughout the country, including hospitals||Report that explosives had been planted||Several dozen public institutions across the country received e-mails with the message:|
“at 12:00 the building will be blown up.”
|31/07–01/08/2013, Kwidzyń||Hospital||Report that explosives had been planted||Phone call message: “there is a bomb in the hospital. This is not a joke. I want a million zloty (Polish currency) or everything will blow up.”|
|Psychiatric hospital||Fire||Fire broke out mid-day causing a mattress fire, probably started by a patient.|
|20/10/2014, Dąbrowa Górnicza||Hospital||Fire||After midnight, a fire resulted from a patient lighting a cigarette. A 70-year-old man took off his oxygen mask to smoke resulting in the explosion of the oxygen cylinder.|
|10/09/2015, Oświęcim||Hospital||Fire||The perpetrator, a 50-year-old patient brought to the emergency ward in a state of alcohol intoxication. Setting the cubicle curtains on fire with a lighter.|
|Hospital||Fire||At 10:30 p.m., fire occurred probably set by a 50-year-old patient.|
|Hospital||Fire||Crane engine room fire from a short circuit of the electrical system. At the time of the event, all fire protection devices, resistance doors separating zones, had passed inspection. Thanks to the applied technical solutions and the efficiency of technical and administrative services, the danger was noticed and reported quickly, making it possible to reduce the range and losses to a minimum.|
|28/12/2017, Pruszków||Hospital||Report that explosives had been planted||The police report about a bomb being planted in a local hospital.|
|Pediatric hospital||Fire||The fire occurred in the anesthesiology and intensive care unit. 60 people evacuated, no casualties.|
|Hospital||Report that explosives had been planted||Midday anonymous call to the nurse’s duty room claiming an explosive device was placed in the surgical ward. Patients evacuated immediately. Pyrotechnicians search of the whole building failed to find any; no explosive device.|
|05/07/2018, Warszawa||Hospital||Report that explosives had been planted||A male phoned the hospital twice during the time that a well-known politician was a patient, stating that a bomb had been planted. No explosive device was found.|
|Social Welfare Home||Fire||10 p.m., roof fire.|
|Social Welfare Home||Fire||2 a.m., roof fire.|
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Goniewicz, K.; Misztal-Okońska, P.; Pawłowski, W.; Burkle, F.M., Jr.; Czerski, R.; Hertelendy, A.J.; Goniewicz, M. Evacuation from Healthcare Facilities in Poland: Legal Preparedness and Preparation. Int. J. Environ. Res. Public Health 2020, 17, 1779. https://doi.org/10.3390/ijerph17051779
Goniewicz K, Misztal-Okońska P, Pawłowski W, Burkle FM Jr., Czerski R, Hertelendy AJ, Goniewicz M. Evacuation from Healthcare Facilities in Poland: Legal Preparedness and Preparation. International Journal of Environmental Research and Public Health. 2020; 17(5):1779. https://doi.org/10.3390/ijerph17051779Chicago/Turabian Style
Goniewicz, Krzysztof, Patrycja Misztal-Okońska, Witold Pawłowski, Frederick M. Burkle, Jr., Robert Czerski, Attila J. Hertelendy, and Mariusz Goniewicz. 2020. "Evacuation from Healthcare Facilities in Poland: Legal Preparedness and Preparation" International Journal of Environmental Research and Public Health 17, no. 5: 1779. https://doi.org/10.3390/ijerph17051779