Introduction: Despite mitigation safety measures, disasters will occasionally impact medical facilities. This report examines the 2023 Wexford General Hospital (WGH) fire’s impact on emergency doctor redistribution and patient safety. Little has been written to date on staff redistribution after a healthcare facility’s temporary closure/reorganization. A change in the standard ED profile was necessary because of extremely limited inpatient & ICU beds for 4 months, with Ambulance diversion, and the Standard Emergency Department (ED) model of care was amended to an injury unit & assessment units for medical, surgical, and pediatric patients. Skeleton staffing remained on site, and nursing/medical/admin staff were redirected to regional receiving facilities. Methods: Data was obtained from the roster coordinator, WGH’s managerial planning committee, and standardized anonymized reports from the electronic patient record system, iPMS. Results: WGH ED distributed 45% of the medical staff to a neighboring hospital, which geographically would have addressed the majority of patient diversion. The study found that despite WGH ED injury unit functioning with fewer staff, average waiting times across all patient categories decreased by 77%, down from 3 hours and 12 minutes to 44 minutes. This occurred despite the patient load only being down 56% on average. Conclusion: The redistribution of staff to neighboring facilities helped alleviate the additional workload in those facilities and did not result in a significant increase in waiting time for walk-in and GP-referred patients to the injury and assessment units. Encouragingly, it decreased patient waiting times, highlighting the importance of process flow adaptation during and in the recovery phase of a disaster. Adjusting the ED services to identify and continue to safely manage appropriate patients unlikely to need admission locally was also found to have a positive impact on patient turnover and limited the effect on other regional receiving units for that extended 4-month duration.
Rensburg et al. (Sun,) studied this question.