ASOURCE Times

Few BCP formulation hospitals

In the earthquake with a maximum seismic intensity of 7 that struck Hokkaido in September last year, power outages occurred in nearly 400 hospitals, fuel for emergency power supply was insufficient, and artificial dialysis could not be performed, making it difficult to continue using the ventilator. There were a lot of hospitals that became sick. During the heavy rains in western Japan, at a general hospital, emergency power equipment was submerged and power was lost, and there were several hospitals that could not continue medical treatment due to water outage. The Ministry of Health, Labor and Welfare points out that "if the BCP had been formulated, it would have been possible."

BCP is an acronym for Business Continuity Plan, which refers to a preliminary plan for companies and local governments to continue or interrupt their business in the event of an emergency such as a disaster, and should be prioritized for damage estimation. Determine the work and staffing plan. The Ministry of Health, Labor and Welfare urged medical institutions nationwide to formulate a BCP in March 2012 after the Great East Japan Earthquake. In addition, in March 2017 after the Kumamoto earthquake, disaster base hospitals (736 hospitals nationwide) that accept patients 24 hours a day in the event of a disaster were obliged to formulate a BCP during FY2018.

Medical institutions are required to perform their functions more in an emergency than in normal times. In addition to hardware such as earthquake resistance, securing power sources and water, and building a system to preferentially supply fuel, medicines, medical equipment, etc. are the keys. However, in a sample survey released by the Cabinet Office in 2013, the number of medical institutions that formulate BCPs was as low as 7.1% of all medical facilities. Opinions such as "there is no skill and know-how necessary for formulation", "cannot secure the personnel to formulate", and "insufficient information on the contents of BCP" were received as the reasons.

Hospital operations that are highly dependent on electricity

According to the "Guidelines for BCP Formulation of Disaster Base Hospitals in the Event of a Large-Scale Earthquake" prepared by the Bureau of Social Welfare of Tokyo, the operations expected for BCP of disaster base hospitals are: ➀ Surgery for symptomatic patients and treatment for trauma patients. High-priority normal work that cannot be interrupted even in the event of a disaster, such as medication for ICU patients. Emergency restoration work (operation of emergency generator, start of use for sewage of well water) ➃ High-priority restoration work (cut off electricity) to restore medical service functions such as restoration of damaged lifeline Replacement of trunk lines, replacement of damaged water supply pipes) ⑤ Work related to daily preparations to prepare for disasters (BCP operation / inspection, formulation of manuals) can be mentioned. Of these, the important matters are securing power supplies, water, medicines, and medical equipment.

In recent hospital operations, the dependence on electric power is increasing. Medical records, management work, procurement of supplies, etc., which were previously done on paper, are all compatible with personal computers. In addition, sterilization equipment, MRI, CT, etc. also consume a large amount of electricity, so securing a power source is of utmost importance. It is generally said that it takes about 3 days to stockpile supplies and secure fuel for emergency power sources.

Secure shipping routes even in the event of a disaster

In logistics, roads are cut off by disasters, and trucks that carry supplies cannot reach hospitals. In addition to emergency stockpiling, it is necessary to discuss alternative delivery routes with wholesalers.

Based on the lessons learned from the Great East Japan Earthquake, the MEDIUS Group is working to strengthen distribution centers from the perspective of BCP, and the Tokyo Metropolitan Area, Shizuoka, and Gunma distribution centers are working together to build a system that can maintain the supply of medical equipment even in the event of a disaster. ing. In the Tokyo metropolitan area, which handles a large amount of goods, a seismic isolated distribution center (Sagamihara City, Kanagawa Prefecture) is in operation. The inside of the warehouse is designed to minimize the fall and damage of goods, and since the seismic isolation structure is adopted not only in the building but also in the ramp way, a shipping route can be secured even in the event of a large-scale disaster, and a power source is used. Even if the supply of power is stopped, it is possible to supply power for 72 hours or more by the private power generation device. The center has an inventory of about 11,500 items and supplies medical equipment to about 650 facilities in the metropolitan area, but has two weeks' worth in stock in case of a disaster.

Expected catastrophe

However, no matter what facilities and stockpiles are in place, medical activities cannot be carried out without doctors and nurses. In addition, hospital functions will stop without hospital staff. Therefore, it can be said that how to secure people in the event of a disaster is an important point.

The worst damage estimated by the Nankai Trough earthquake is 323,000 dead and 623,000 injured, and the estimated damage caused by the Tokyo metropolitan earthquake is 23,000 dead and 113,000 injured. It is said that there is an urgent need to formulate a BCP for hospitals.