Hospital Evacuation in Disasters: Uncovering the Systemic Leverage Using System Dynamics

Our aim is to understand systemic processes that apply to hospital evacuation and patient relocation during and after a disaster. We use system dynamics to simulate hospital evacuation in such an event. System dynamics is a well-established simulation method for analysing complex social systems that include feedback. We found that the key to efficient hospital evacuation lies less in management of patient transportation and more in the ability of the receiving hospital to manage the influx of patients. The decision makers at the hospital receiving patients are most subject to feedback effects and therefore hold the most leverage in determining the rate of the evacuation. On the basis of simulation results, we develop recommendations for hospital evacuation and patient relocation. Planners, policy makers and practitioners can use the recommendations to facilitate efficient hospital evacuations