Field Hospitals

Background The need for field hospitals arise when existing health services fall behind in case of a disaster or an emergency. This study is intended to generate a standard level for the capacity of field hospitals with different levels. Methods In the descriptive study, standard levels (SS) were generated for field hospitals upon assessment of specifications of the field hospital models designed or applied onsite in the literature through content analysis. Results The field hospitals were standardized in four categories in the research: SS I, SS II, SS III and SS IV. SS is divided into two parts as health units and support services, and their use among the SS's depends on the need. Health units consist of Triage+Reception, Operating Room, 4 Bed ICU, Surgical Preparation, Laboratory/ Blood Bank, Radiology, CT, Resuscitation Room, Emergency Service, Ambulatory Care, Pharmacy, Dentistry, Dermatology, Psychiatry, Birth Consultation, Pediatric Department, Patient Admission, Doctors' Room, Sterilization, Morgue, Contagious Diseases, and Ophthalmology, while support services consist of Management, Office, Workshop (Medical Gas), Staff Dorm, Storage / Transportation, WC / Bathroom, Generator, Fresh / Waste Water, Dining Hall, Kitchen, Cold Storage Room, Laundry Room, Solid Waste, Staff Rest Room, and Reception. SS I provides emergency services and transfer to an upper level, and contains specific health units only. SS II allows for short term ambulatory treatment for the patients and contains specific health and support units. Since SS III has fundamental ambulatory care services and SS IV has wide range of ambulatory care services, they contain various health and support units. Conclusions Specifications of the field hospital SS's were defined in line with the need for health service that might arise during the disaster preparation planning. Key messages Health and support units forming the field hospital SS’s were determined. SS’s enables sustainability of the public health services following a disaster.

Effective change management in a regional Sub-acute Ambulatory Care Services setting

Government policies and community expectations in Australia continually lead to calls for healthcare change. These changes are often met with resistance from clinicians and managers. Making change happen requires consideration of the way policies, culture, context, shared vision and leadership can drive or impede change. This reflective case study critically investigates one change process; the evolution of a Sub-acute Ambulatory Care Services (SACS) program in an Australian regional hospital over a 3-year period. The new Community Rehabilitation Services (CRS) program evolved from a merger of Centre and Home Based Rehabilitation (CBR and HBR). Hospital amalgamations, closures and privatisation, and the Department of Health policy relating to SACS, ambulatory care and rehabilitation were some of the key elements explored in this paper. What is known about the topic? Healthcare is an industry constantly focussed on improving services and care to patients. There has been a lot written about change management in healthcare. Change can be difficult to implement and is a dynamic phenomenon. There are many factors which can assist or hinder change. What does this paper add? This reflective case study outlines the change process in this particular regional healthcare setting context within a multidisciplinary team. This paper adds to the body of knowledge by considering the influences of the unique history and culture of the setting, and the complex interrelated nature of factors which can affect change. What are the implications for practitioners? Healthcare service managers need to understand that the change process is complex and can be confusing. Government policy constantly drives change in this industry to improve patient care, but how an organisation works through this is unique to the setting. One size does not fit all, and understanding the organisation, staff, culture and having a vision at that point in time is an essential prerequisite. Any change requires working with people who need time to adapt, up skill and learn new processes and procedures. Reanalysing the change process and being flexible during the journey can assist in reaching the desired change outcome.