How can private hospitals be used as a solution to provide outflow surge capacity to public hospitals during mass casualty incidents

INTRODUCTION: Private hospitals are not utilised as a part of a solution in Ireland in the event of Mass Casualty Incidents (MCI) in Ireland. While disaster planning is evident in each hospital and there is also a national plan in place, no plan details the difficulties public hospitals are facing on a daily basis with overcrowding in both Emergency Departments (ED) and throughout the hospital. The aim of this study is to look at how private hospitals may be used as part of the greater solution in providing Outflow Surge Capacity (OSC) to the public hospitals, and: are private hospitals able to deliver outflow surge capacity in times of great need. MATERIAL AND METHODS: This study was conducted from October 2018 – May 2019 in a selection of public and private hospitals in the greater Dublin (Ireland) region. Ethics approval was obtained and purposive sampling was employed. Semi-structured interviews following a Straussian Grounded Theory (SGT) design were conducted following the recruitment of 16 high-level key stakeholders in 4 hospitals of interest representing both public and private sectors. No demographic data was collected, ensuring anonymity. Data was analysed manually using grounded theory principles, which involved open, axial and selective coding. RESULTS: All participants were found to be open to utilising private hospitals as OSC. Private hospitals were recognised by public hospitals as having the ability, skills and expertise to assist public hospitals with OSC. High awareness of the need for additional space in acute hospitals was evident. All participants showed concern for current overcrowding hospital wide nationally. CONCLUSIONS: Public hospitals identified a number of approaches to utilise private hospitals as OSC. Private hospitals showed readiness and agreement to provide OSC, however, willingness was not assessed due to the number of private hospitals included in the study Further research is required to ascertain Government willingness to participate and establish financial accountability should this finding be introduced