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MANAGEMENT: TSUNAMI EVALUATION
that it activated immediately, but because of the
uniqueness of the situation, it had to adapt and adjust
accordingly. (See the Figure 1 for the JCI standard
addressing having a disaster plan.)
➜ Assign one medical and one administrative decision
maker to take the lead and make quick decisions.
Organizations should have one commander – BI chose
the medical director or his designee as the commander.
However, it is important to have the COO or his or her
designee be part of the disaster management committee
➜ BI found there were many nonmedical-related decisions
for which the medical and nursing teams need not be
responsible. As this was the holiday season, most of
BI’s senior management was not in Bangkok. However,
its disaster planning prepared BI for this situation, and
the one senior manager on duty handled all
administrative decisions.
➜ Be able to take a quick inventory of resources and
capacity. As a result of the year-end holidays, many of
BI’s employees were away on vacation. Even with the
lag time before the first patient reached BI, there were
still small gaps with some shortage of porters and
drivers for a few hours early on 27 December. This
demonstrated that BI needed to review all resources
during its planning activities.
➜ Conduct a postevent review of the emergency response
to identify any weak links in the system. Bumrungrad
International held two postevent reviews with the
operations team, including the porter supervisor and
ER nurses, and held another review with the senior
management team that coordinated the crisis. Based on
these reviews, BI quickly readjusted its disaster plan.
One lesson BI learned was to have a checklist for the
commander to begin using immediately when learning
of a potential crisis.
➜ Assign a coordinator to manage volunteers during a
disaster.
Bumrungrad International also took the initiative to send
a medical team consisting of five surgeons and six nurses –
with an ambulance loaded with medications and medical
supplies – on the morning of 27 December, when flights
resumed and airlines were offering free flights to physicians
and nurses who were flying to Phuket. By having the team
on the ground, BI was able to remain aware of the patient
situation and provide critical medical assistance where it was
most needed in Phuket the day after the tsunami. Because of
the feedback from this onsite medical team, BI knew the
extent of the disaster and injuries and staff were able to
anticipate and prepare for the high volume of patients. ❑
Note to readers: Bumrungrad International Hospital would
like to pay a special tribute to the physicians, nurses, and staff of
the many hospitals in southern Thailand who worked day and
night coping with the massive number of patients in the tsunami’s
aftermath. Many Thai doctors and nurses flew in from various
parts of the country to assist in the South. Some volunteer medical
and nursing teams from neighbouring countries also flew in to
help. In Bangkok, Bumrungrad International recognized that it
saw only a fraction of the patients that the Southern hospitals had
to cope with, and they did their work under very difficult
circumstances and with limited resources. The Thai government
authorities were very responsive in restoring communications and
providing other infrastructure support to the South in the week
following the tsunami disaster.
Acknowledgements
© Joint Commission Resources: “Bumrungrad International Hospital in Thailand
helped treat tsunami patients” Joint Commission International Newsletter 3(2):1-4,
2005. Reprinted with permission.
26 | World Hospitals and Health Services | Vol. 41 No. 3