As the COVID-19 pandemic subsides in the United States, a new study by the University of Maryland School of Medicine (UMSOM) and the University of Maryland Medical Center (UMMC) believes that hospitals across the country can not being properly prepared for the next pandemic. A 10-year analysis of hospitals ’preparedness for pandemics and other mass-victim events found only marginal improvements in a measure to assess preparedness during the years leading up to the COVID-19 pandemic. The study was published last month in Journal of Healthcare Management.
“Our work links objective health data to hospital score that assesses the ability to save lives in a disaster, “said study author David Marcozzi, MD, professor of emergency medicine at UMSOM and senior clinical director / senior vice president at UMMC.” It tries to fill a glaring gap nationwide conversation about the need to improve assessments and the opportunity for better hospital planning to ensure readiness. “
To conduct the investigation, Dr. Marcozzi, who is also the incident commander of COVID-19 in the University of Maryland medical system, and colleagues first developed and published an overvoltage index tool. which related standard informed hospital information to health preparation items. The tool, called the Hospital Medical Surge Preparedness Index (HMSPI), used data from 2005 to 2014 to produce a score designed to predict the extent to which a hospital can manage a sudden influx of patients due to ‘a massive shot or an outbreak of infectious diseases. These data include the size of the medical staff, the number of hospital beds, and the amount of equipment and supplies.
Medical overload capacity is an important measure to assess a hospital’s ability to expand rapidly beyond normal services to meet increased demand for health care. The mass shooting in Las Vegas in 2017, for example, sent more than 500 attendees to local hospitals. During the first weeks of the COVID-19 pandemic, New York City hospitals were harassed with 4,000 hospitalized patients. To calculate the HMSPI, the researchers enter data from four important metrics.
- Staff: doctors, nurses, pharmacists, respiratory technicians and others
- Supplies: personal protective equipment, heart monitors, sterile bandages and fans
- Space: Total beds and number of beds that can be managed by current staff
- Systems: framework to allow the electronic exchange of files and information between departments and various hospitals
In the new study, Dr. Marcozzi and colleagues used data from the American Hospital Association’s annual surveys of more than 6,200 hospitals nationwide that were collected from 2005 to 2014. They also used data from the U.S. Census Bureau. United to determine population estimates in cities and the Dartmouth Atlas Project to establish the geographic service area of each hospital. They combined hospital metrics obtained from annual AHA surveys with geographic data to calculate HMSPI composite scores from hospitals in each state.
His assessment found varying levels of increase in HMSPI scores from 2005 to 2014 in all states, which could indicate that states are increasingly prepared to cope with a medical increase. Scores also indicated that ideal preparedness had not yet been achieved in any state prior to the COVID-19 pandemic.
“This is just the starting point. We need to better understand the capacity of our nation’s hospitals to save lives in times of crisis,” Drs. Marcozzi. This information and the follow-up studies that are based on this work will be key to better adapting the health resources of states to their population to ensure optimal care. Dr. Marcozzi described a follow-up study that would be shocking when using data from the COVID-19 pandemic to see if the index was predictive to indicate which hospitals were best prepared for the pandemic increase based on patient outcomes.
“This pioneering work is a necessary breakthrough that could allow for a transparent assessment of a hospital’s ability to save lives in a large-scale emergency,” said Drs. Marcozzi. “The COVID-19 pandemic showed that there is still much room to improve the capacity of our nation’s health care system to select and manage multiple patients in a crisis and this translates into unnecessarily lost lives. Our research is dedicated to those who lost their lives in this tragedy and in other mass casualty events. We can do better. “
National health leadership organizations, such as the U.S. Medicare and Medicaid Service Centers, the Deputy Secretary for Preparedness and Response, the Joint Commission, and the American Medical Association, as well as state and local emergency planners, could potentially benefit from the use of HMSPI scores, according to Dr. Marcozzi. The tool could be used to support the development of data-based policies and the allocation of resources to reduce gaps and ensure that people receive the care they need, when they need it, during a crisis.
Ricardo Pietrobon, MD, Ph.D., MBA, Associate Professor of Emergency Medicine at UMSOM, Nicole Baehr, Operations Manager at UMMC, and Brian J. Browne, MD, Professor and Chair of the Department of Medicine of Emergencies, were co-authors of this study. Researchers from the University of Nebraska Medical Center, the University of Miami and the U.S. Department of Veterans Affairs also participated in this research. The study was funded by the Bipartisan Biodefense Commission.
“The COVID-19 pandemic taught us that we need to be better prepared for the unexpected crisis,” said E. Albert Reece, MD, Ph.D., MBA, executive vice president for medical affairs, UM Baltimore, and John Z and Akiko K. Bowers Distinguished Professor and Dean of the University of Maryland School of Medicine. “Having an important metric like HMSPI could change the game that ultimately saves lives during a wave by helping hospitals identify and address their vulnerabilities.”
David E. Marcozzi et al, Applying a readiness index to hospital medical surges to assess the readiness of national pandemic victims and others, Journal of Healthcare Management (2021). DOI: 10.1097 / JHM-D-20-00294
University of Maryland School of Medicine
Citation: Hospitals are not properly prepared for the next pandemic, according to the study (2021, July 7), recovered on July 8, 2021 at https://medicalxpress.com/news/2021-07-hospitals-adequately -pandemic.html
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