CRISIS PLANNING
the physical infrastructure (e.g. critical systems and space) of healthcare facilities, and management considerations, (e.g. emergency response plans), the COVID-19 outbreak has demonstrated that despite this significant effort, much more work is needed. In this article I have looked to capture some of the key issues, but many other issues (such as those related to supplies, equipment, and staff) are not covered. The major conclusions that can be drawn are: n NHS hospitals are not prepared for an event as far-reaching as the coronavirus outbreak, yet frontline staff are doing a great job addressing the pandemic with the resources they have.
n The maintenance backlog is a major threat to hospitals’ effective operation.
n UK hospitals currently do not have adequate space capacity to deal with mass casualty events.
n Despite their importance, EPRR, HBNs, and other official guidance, have not resulted in a truly resilient healthcare service and hospitals.
To address and improve hospital resilience: n NHS hospitals need to be evaluated thoroughly, with a view to ‘rebuilding’ their resilience based on national and international experience.
n NHS estates personnel UK-wide, and the central Estates & Facilities teams within the Department of Health & Social Care and the health departments within the devolved administrations, are highly encouraged to work with
Nebil Achour
After gaining a BSc in Civil Engineering from the Tunis Advanced School of Science and Technology in Tunisia, Dr Nebil Achour worked in private engineering and design firms on designing structures and training engineers in several countries. Granted a Japanese Government Scholarship to further his education, he gained his MSc with a focus on the response of hospital lifeline systems following seismic activities, and his PhD on hospital fragility assessment, in 2004 and 2007 respectively, from Kanazawa University, and developed an assessment approach.
Dr Achour is the director for the MSc Healthcare Management programme at Anglia Ruskin University. He worked as a research associate at Loughborough University between 2007 and 2013, where he coordinated the research activities of the £11 million HaCIRIC research centre. He also worked as a post-doctoral researcher at his graduate University. His research outputs include more than 50 scientific publications, including book chapters, editorials, and journal and conference articles. He was awarded the Best Paper Award during the CIB World Congress 2010, and the Highly Commended Paper in the 2016 and 2015 Emerald Literati Network Awards for Excellence.
He is actively involved in national and international research and consultancy activities. He has contributed to several international events, including as a keynote speaker, a Member of the Global Panel for the Revision of the WHO Hospital Safety Index, and as the organiser of international seminars and workshops. Dr Achour is keen to exchange knowledge with academics and practitioners, and specifically those working on similar topics. He is also a Member of the Editorial Board of the International Journal of Disaster Resilience in the Built Environment (IJDRBE), and associate editor of the international journal, Disaster Medicine and Public Health Preparedness (DMPHP).
22 Health Estate Journal July 2020 Injury/Patient
Building (Structure/ Architecture)
Lifeline utilities Equipment Treatment Suppliers Yes
Transfer to other hospital
Back home Admission No Hospital Supply
Personal/Professional circumstances
Accessibility Staff
Figure 5: A simplified model of hospital dependencies.
researchers to enhance the resilience of hospitals.
n The relevant HBNs need to be updated to integrate resilience more effectively, reflecting the complexity of hospitals. hej
References 1 Gibbs T. Interview with Tony Gibbs: The most expensive hospital is the one that fails. United Nations Office for Disaster Risk Reduction, 2007 (
https://tinyurl.com/y9o9vyd9).
2 Achour N, Munokaran S, Barker F, Soetanto R. Staff stress: The sleeping cell of healthcare failure. Procedia Engineering 2018; 212: 459-66.
DOI:
https://doi.org/10.1016/ j.proeng.2018.01.059.
3 Achour N, Miyajima M. Post-earthquake hospital functionality evaluation: The case of Kumamoto earthquake 2016. Earthquake Spectra. SAGE. [In press] DOI:
https://tinyurl.com/y9f7ut24
4 Pascale F, Achour N, Price ADF, Polverino F. Evaluation of factors and approaches affecting emergency department space planning. Facilities 2014; 32 (13/14): 761-85. DOI:
http://dx.doi.org/10.1108/F-09-2012-0073.
5 Anandaciva S. The deteriorating state of the NHS estate. King’s Fund, 2019 (
https://tinyurl.com/y7wbccca).
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