An Exploratory, Qualitative, Enterprise-Level Management Model for a World Health Organization Defined Type III Field Hospital: Preliminary System Description, Concept of Operations and Alignment Strategies for Deployment during the Uncertainties of an International Earthquake Response
Open AccessThis research uses an exploratory methodology structured by strategic organizational design theory and the systems engineering methodology of “deconstruction” to develop a qualitative, enterprise-level management model for a World Health Organization (WHO) compliant, Type III field hospital for the response to international earthquake disasters. This research fills a gap in the international peer-reviewed literature on field hospital earthquake response, which offers case studies with varying levels of relevant management information but no complete field hospital management models. The model created here captures management functions from the US health care administration and hospital disaster response literatures to address management gaps in the technical guidance presented in WHO Type III field hospital requirements. To evaluate the model, two validation tests were developed from the international peer-reviewed literature on field hospital response (1994 to 2018) to evaluate the effectiveness of model elements to solve problems encountered by deployed field hospital teams. A third set of validation tests was developed following an assessment of the hazard and response uncertainties reported in the international peer reviewed literature during the response to the Nepal earthquake in 2015. The final field hospital model represents a preliminary system description for a deployed team that reflects WHO requirements with additional management elements that promote patient quality and safety, response coordination and the goal of maintaining continuity of operations during response. The preliminary concept of operations combines routine hospital management practices with modified incident action planning and a proactive management process from the US public health and health care disaster response literature to facilitate field hospital management. Preliminary alignment strategies developed using the Balanced Scorecard method are included. The model parameters set by this exploratory model provide a framework for future modeling at the level of process design. Model validation tests are presented as independent research outcomes for other researchers working in the area of field hospital management modeling.
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