Evaluating strategies for coping with patient surge in hospitals due to mass casualties along a highway in Western Kenya

Abstract

Background: During mass casualty incidents, nearby hospitals receive `many patients who tend to stretch hospital resources resulting in poor outcomes. Objective: To evaluate strategies for coping with patient surge in Hospitals during mass casualties along a highway in Western Kenya. Design: Adescriptive cross-sectional study. Setting: The study was carried out conveniently selected hospitals along the main highway A-104 from Nakuru to Malaba, Kenya Subjects: Healthcare workers, Hospital administrators, Patients, Civil society organizations and the Police. Results: Majority 35% (n=286) of the hospital staff had worked in their stations for more than 10years. Overall, Seventy-four per cent (74%) of the respondents indicated that their facility was able to cope with increased numbers of patients during mass casualty incidences withchallenges. Insufficient critical resources, poor staffing levels and poorly organized incident command system were cited as the main systemic factors. Some of the strategies reported by key informants included recall of staff on leave, transfer to neighboring hospital at patient’s expense and utilization corridors and auditoriums. Conclusion: There were strategies in place during mass casualty incidents however, challenges such as low staff numbers, lack of motivation to responders, low administrative culture in emergency management and poor critical resource placement and service. A lot should be done in hospital setup too enable them cope with patient surge during mass casualty incidents.