Table 3.
Mitigation measures for Intensive Care Units (ICUs) and Internal Medicine Units (IMUs) during hospital relocations or evacuations
| Groups | Mitigation measures | No of failure modes affected |
| Departure medical examination protocol | Triage algorithm (checkpoints, mode of transport) | 3 |
| Checklist (treatment modification, departure decision traceability) | 15 | |
| Tracking and transmission tools | Transmission protocol (doctor, nurse and transport team; same team at the departure and the day before; in addition, departure staff should gradually arrive with patients at the new site) | 9 |
| Tracking (patient’s identification and localisation) | 4 | |
| Checklist (equipment, transmission process, medication tracking, annotation, specific to a patient, follow patient, checkpoints) | 19 | |
| Medication handling protocol | Specific medications transported with the patient, tracked and sealed | 6 |
| Vital medication available at all times | 14 | |
| IMU patients moved without their regular medication | 4 | |
| Checklist (medication administration monitoring, specific medication tracking, print patient’s medication list) | 21 | |
| Technical and human support | Resuscitation team available at departure and arrival sites | 4 |
| Pharmacy hotline available 24 hours/day | 4 | |
| Medication checked by pharmacy technician at departure hospital and on arrival at new hospital site | 3 | |
| Medical dispensing specialist available at the new hospital | 2 | |
| Specific transport team given initial triage algorithm (patient(s), patient(s)/nurse, patient(s)/nurse/doctor) | 6 | |
| Additional evacuation preparedness | Emergency evacuation kit (eg, evacuation plan, checklist) | 14 |
| Advanced Medical Post available and staff aware of it | 10 | |
| Vital medication, antidotes and emergency drugs bags | 16 | |
| Emergency call-back mode | 4 | |
| Fail-safe mode available and tested (eg, electronic patient records) | 5 | |
| Training | Inform staff about risks and mitigation measures and describe the 'Move' day (e-learning, newsletters) | Overarching mitigation measures |
| Training on the tools developed (checklists, automated medication dispensing, new equipment, tracking systems) | ||
| Simulations |