Impact of Heatwaves on Emergency Departments in Singapore: A Qualitative Study on Perceptions of Healthcare Workers

Introduction: Climate change is a significant threat to human health. It is affecting emergency medicine practice through the increase in climate-related disease patterns and shifts in epidemiology for conditions diagnosed and treated in emergency departments (EDs), especially for vulnerable populations. Singapore is ranked 187/192 on the World. Risk Index based on the 2022 World Risk Report. Singapore has thus far been fortunate to be spared from natural disasters such as earthquakes, typhoons, and volcanic eruptions. There has been occasional flooding during heavy rain, but it is not sustained and does not significantly impact transport systems. The objective is to assess the current state of knowledge and perceptions towards heatwaves of emergency department (ED) healthcare workers in Singapore and investigate potential strategies and solutions to improve the knowledge and readiness. Methods: A qualitative study was conducted in Khoo Teck Puat Hospital in Singapore, using semi structured face-to-face interviews with an open-ended interview guide, on emergency physicians and registered nurses of various lengths of work experience actively working in the ED. The thematic analysis approach was employed, which involves memo-writing, coding, and theme development with constant comparison. Results: Six themes— (1) Knowledge and understanding of Extreme Weather Events, (2) Knowledge and understanding of Heatwaves, (3) Impressions of vulnerability to heatwaves, (4) Measures or factors to help prevent heat related illness, (5) Perceived impact of heatwave on emergency departments, and (6) Potential strategies and solutions— emerged and were presented in an interactive framework. Conclusion: There is basic foundational knowledge, with more education and training required, especially targeting the knowledge gaps identified. There is also a need to increase awareness of heatwaves, their impact on health, and to develop comprehensive extreme heat response plans. The findings provide a framework for emergency departments to guide their preparations for inevitable heat waves and their associated health impacts.