Most hospitals have a contingency plan,based on all-risks and all-hazards assessment principles.How-ever,emerging threats and risks often necessitate a flexible approach to emergency management at several levels of a disaster response system,for example,in hospitals.Swe-den,and possibly other countries,has limited possibilities of surge capacity in the management of large-scale disas-ters and emergencies,which necessitates a local/national partnership and a flexible local disaster and contingency plan.This study evaluates the opinions of a selected mana-gerial group,both at operative and strategic levels,regard-ing possible changes in a major hospital's contingency plan during the ongoing COVID-19 pandemic.Semistructured interviews were conducted to explore the elements of surge capacity and an operational tool,consisting of command and control,safety,communication,assessment,triage,treatment,and transport.The results show a need to cre-ate feasible management methods that can be evaluated,establish clear leadership,put preparedness as a constant point on the highest managerial agenda,improve external monitoring,and create a regional coordinating center.Fur-thermore,the results emphasize the significant role played by the incident command system and qualified leadership to facilitate competent and crucial medical decision making,as well as to provide reliable communication,collaboration,and coordination in a multi-agency response system during dynamic and unexpected emergencies.These steps enable a constant connection between reactive contingency plans and the proactivity in continuous risk assessment and enhance the flexibility of the contingency plans.

Ingela Wennman;Catharina Jacobson;Eric Carlstr?m;Anders Hyltander;Amir Khorram-Manesh

Institute of Health and Care Sciences,Sahlgrenska Academy,Gothenburg University,413 46,Gothenburg,Sweden;Preparedness Unit,Sahlgrenska University Hospital,413 05 Gothenburg,Sweden;Institute of Clinical Sciences,Department of Surgery,Sahlgrenska Academy,Gothenburg University,413 45,Gothenburg,Sweden

国际灾害风险科学学报（英文版）

[1]Ingela Wennman;Catharina Jacobson;Eric Carlstr?m;Anders Hyltander;Amir Khorram-Manesh-.Organizational Changes Needed in Disasters and Public Health Emergencies:A Qualitative Study among Managers at a Major Hospital)[J].国际灾害风险科学学报（英文版）,2022(04):481-494

Emergencies,Swe,disas,mana,gerial,Semistructured,preparedness,proactivity

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