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The Feasibility of Implementing the Flexible Surge Capacity Concept in Bangkok: Willing Participants and Educational Gaps.

ABSTRACT: The management of emergencies consists of a chain of actions with the support of staff, stuff, structure, and system, i.e., surge capacity. However, whenever the needs exceed the present resources, there should be flexibility in the system to employ other resources within communities, i.e., flexible surge capacity (FSC). This study aimed to investigate the possibility of creating alternative care facilities (ACFs) to relieve hospitals in Bangkok, Thailand. Using a Swedish questionnaire, quantitative data were compiled from facilities of interest and were completed with qualitative data obtained from interviews with key informants. Increasing interest to take part in a FSC system was identified among those interviewed. All medical facilities indicated an interest in offering minor treatments, while a select few expressed interest in offering psychosocial support or patient stabilization before transport to major hospitals and minor operations. The non-medical facilities interviewed proposed to serve food and provide spaces for the housing of victims. The lack of knowledge and scarcity of medical instruments and materials were some of the barriers to implementing the FSC response system. Despite some shortcomings, FSC seems to be applicable in Thailand. There is a need for educational initiatives, as well as a financial contingency to grant the sustainability of FSC.

SUBMITTER: Phattharapornjaroen P

PROVIDER: S-EPMC8345441 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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The Feasibility of Implementing the Flexible Surge Capacity Concept in Bangkok: Willing Participants and Educational Gaps.

Phattharapornjaroen Phatthranit P Glantz Viktor V Carlström Eric E Dahlén Holmqvist Lina L Sittichanbuncha Yuwares Y Khorram-Manesh Amir A

International journal of environmental research and public health 20210722 15

The management of emergencies consists of a chain of actions with the support of staff, stuff, structure, and system, i.e., surge capacity. However, whenever the needs exceed the present resources, there should be flexibility in the system to employ other resources within communities, i.e., flexible surge capacity (FSC). This study aimed to investigate the possibility of creating alternative care facilities (ACFs) to relieve hospitals in Bangkok, Thailand. Using a Swedish questionnaire, quantita ...[more]

PMID: 34360083

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Project description:ObjectivesCoronavirus disease 2019 (COVID-19) has consumed many available resources within contingency plans, necessitating new capacity surges and novel approaches. This study aimed to explore the possibility of implementing the concept of flexible surge capacity to reduce the burden on hospitals by focussing on community resources to develop home isolation centres in Bangkok, Thailand.Study designA qualitative study consisted of observational and semi-structured interview data.MethodsThe development and activities of home isolation centres were observed, and interviews were conducted with leaders and operational workforces. Data were deductively analysed and categorised based on the practical elements necessary in disaster and emergency management.ResultsData were categorised into the seven collaborative elements of the major incident medical management and support model. The command-and-control category demonstrated four subcategories: (1) coordination and collaboration; (2) staff engagement; (3) responsibility clarification; and (4) sustainability. Safety presented two subcategories: (1) patients' information privacy and treatment; and (2) personnel safety and privacy. Communication showed internal and external communications subcategories. Assessment, triage, treatment and transport followed the processes of the COVID-19 treatment protocols according to the World Health Organisation (WHO) guidelines and hospital operations. Several supply- and patient-related challenges were identified and managed during centre development.ConclusionsThe use of community resources, based on the flexible surge capacity concept, is feasible under restricted circumstances and reduced the burden on hospitals during the COVID-19 pandemic. Continuous education among multidisciplinary volunteer teams facilitated their full participation and engagement. The concept of flexible surge capacity may promote an alternative community-based care opportunity, irrespective of emergencies' aetiology.

Project description:This study deals with haze characteristics under the influence of the cold surge and sea breeze for Greater Bangkok (GBK) in 2017-2022, including haze intensity and duration, meteorological classification for haze, and the potential effects of secondary aerosols and biomass burning. A total of 38 haze episodes and 159 haze days were identified. The episode duration varies from a single day to up to 14 days, suggesting different pathways of its formation and evolution. Short-duration episodes of 1-2 days are the most frequent with 18 episodes, and the frequency of haze episodes decreases as the haze duration increases. The increase in complexity in the formation of relatively longer episodes is suggested by a relatively higher coefficient of variation for PM2.5. Four meteorology-based types of haze episodes were classified. Type I is caused by the arrival of the cold surge in GBK, which leads to the development of stagnant conditions favorable for haze formation. Type II is induced by sea breeze, which leads to the accumulation of air pollutants due to its local recirculation and development of the thermal internal boundary layer. Type III consists of the haze episodes caused by the synergetic effect of the cold surge and sea breeze while Type IV consists of short haze episodes that are not affected by either the cold surge or sea breeze. Type II is the most frequent (15 episodes), while Type III is the most persistent and most polluted haze type. The spread of haze or region of relatively higher aerosol optical depth outside GBK in Type III is potentially due to advection and dispersion, while that in Type IV is due to short 1-day episodes potentially affected by biomass burning. Due to cold surge, the coolest and driest weather condition is found under Type I, while Type II has the most humid condition and highest recirculation factor due to the highest average sea breeze duration and penetration. The precursor ratio method suggests the potential effect of secondary aerosols on 34% of the total haze episodes. Additionally, biomass burning is found to potentially affect half of the total episodes as suggested by the examination of back trajectories and fire hotspots. Based on these results, some policy implications and future work are also suggested.

Dataset Information

The Feasibility of Implementing the Flexible Surge Capacity Concept in Bangkok: Willing Participants and Educational Gaps.

Publications

The Feasibility of Implementing the Flexible Surge Capacity Concept in Bangkok: Willing Participants and Educational Gaps.

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