-simulation to devise evacuation strategies · introduction-hospital management are responsible for...
TRANSCRIPT
Usin
g M
icro
-Sim
ula
tio
n t
o
Devis
e E
vacu
atio
n S
trate
gie
s
Ao
ife H
un
t, P
h.D
.
Octo
ber
5, 2
01
6
Intr
od
ucti
on
-1800 f
ire
s in
UK
ho
sp
itals
each
year.
-Larg
e,
vu
lnera
ble
po
pu
latio
ns r
eq
uir
ing
co
nti
nu
ing
care
.
-M
ob
ilit
y im
pair
me
nts
an
d a
sso
cia
ted
mo
bili
ty e
qu
ipm
en
t.
Octo
ber
5,
2016
Pag
e 2
Ped
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
Intr
od
ucti
on
-H
igh
ly c
om
ple
x s
pace
s.
-D
ep
en
den
cy o
n s
taff
pro
ce
du
res
for
evacu
atio
n.
-H
igh
sta
ff t
urn
over
an
d
ch
alle
ng
es w
ith
tra
inin
g.
-L
ive
dri
lls a
re im
pra
cti
cal,
co
stly,
an
d a
rgu
ab
ly
un
eth
ical.
-U
pco
min
g d
em
og
rap
hic
sh
ift
will
mean
mo
re e
lderl
y
patien
ts a
nd
mo
re p
eo
ple
with
red
uced
mo
bili
ty (
PR
M).
Octo
ber
5,
2016
Pag
e 3
Ped
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
Intr
od
ucti
on
-H
osp
ital m
an
ag
em
en
t are
re
sp
on
sib
le f
or
evacu
atio
n
pla
nn
ing
.
-P
rog
ressiv
e h
ori
zo
nta
l e
vacu
ati
on
is t
yp
ically
pre
scri
bed
.
-P
ost-
incid
en
t an
aly
ses h
ave h
igh
ligh
ted
th
e n
ee
d t
o r
evis
e
cu
rren
t p
roced
ure
s.
-M
ove
me
nt
assis
tan
ce
is v
ital
in a
n e
merg
en
cy.
-A
vaila
bili
ty a
nd
tra
inin
g in
mo
ve
me
nt
de
vic
es h
as n
ot
been
co
nsis
ten
t, o
r su
ffic
ien
t.
Octo
ber
5,
2016
Pag
e 4
Ped
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
Au
gu
st
9,
20
16
Wh
at’
s m
issin
g?
•T
he
tim
e r
eq
uir
ed
fo
r p
roce
du
res a
nd
th
e p
hysic
al
imp
act
of re
pe
ate
d p
atie
nt co
llectio
n is n
ot
we
ll
un
de
rsto
od
.
•S
imu
latio
n m
od
els
can
pro
vid
e in
sig
ht,
bu
t cu
rre
ntly
do
no
t e
ffe
cti
ve
ly r
ep
rese
nt
the
assis
ted
evacu
atio
n
of P
RM
.
•A
naly
sis
is n
ee
de
d t
o s
ub
sta
nti
ate
th
e c
urr
en
t
ide
as t
hat
the
evacu
atio
n s
eq
ue
nce
sh
ou
ld e
ith
er
be
gin
or
en
d w
ith
th
e m
ost
cri
tical p
atie
nts
.
•T
he
re is a
ne
ed
to
mo
de
l assis
ted
evacu
atio
n, n
ot
on
ly fo
r h
osp
itals
, b
ut fo
r all b
uild
ing
s w
ith
PR
M.
Octo
ber
5,
2016
Pag
e 6
Ped
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
Ou
r o
bje
cti
ve
s
•W
hat in
flu
en
ce
s t
he
ou
tco
me
of h
osp
ital evacu
atio
n?
•W
hat d
ata
an
d m
od
ellin
g d
eve
lop
me
nts
are
req
uir
ed
?
•H
ow
do
mo
vem
en
t assis
t d
evic
es p
erf
orm
in
th
e
ho
rizo
nta
l an
d v
ert
ical e
vacu
ati
on
of
PR
M?
•H
ow
can
th
ese d
ata
be u
sed
to
co
mp
are
th
e
pe
rfo
rman
ce
of m
ovem
en
t d
evic
es in
evacu
atio
n?
•H
ow
can
mo
vem
en
t d
evic
es b
e e
xp
licit
ly m
od
elle
d?
Tri
al D
ata
An
aly
sis
Perf
orm
an
ce
Evalu
atio
n
Th
eo
retical
Mo
delli
ng
Testin
g a
nd
Veri
ficatio
n
Octo
ber
5,
2016
Pag
e 7
Ped
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
Data
co
lle
cti
on
or
or
or
or
Opera
tors
on s
tairs
Opera
tors
on s
tairs
Opera
tors
on s
tairs
Opera
tors
on s
tairs
Octo
ber
5,
2016
Pag
e 8
Ped
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
Data
co
lle
cti
on
•In
vestig
ate
d t
he t
ime
re
qu
ire
d f
or
ho
sp
ital evacu
atio
n
pro
ced
ure
s a
nd
im
pact
of re
peate
d p
atien
t co
llectio
n.
•3
2 t
rials
testin
g f
ou
r d
evic
es o
ver
two
days, th
rou
gh
an
11 s
tore
y h
osp
ital.
•D
evic
e o
pera
tors
were
exp
ert
man
ual
han
dle
rs.
•Tw
o a
cto
r “P
RM
s”.
•F
ou
r te
am
s o
f U
niv
ers
ity G
hen
t p
art
icip
an
ts:
two
team
s
with
male
op
era
tors
an
d t
wo
team
s w
ith
fe
male
op
era
tors
.
Octo
ber
5,
2016
Pag
e 9
Ped
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
VerticalHorizontalPreparation
Data
co
lle
cti
on O
cto
ber
5,
2016
Pag
e 1
0P
ed
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
Data
co
lle
cti
on O
cto
ber
5,
2016
Pag
e 1
1P
ed
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
Sta
ir D
escent S
peed
Pre
para
tion T
ime
Horizonta
l Speed
68 s
ecs
(63
-74
)
29 s
ecs
(24
-32
)
35 s
ecs
(32
-40
)
53 s
ecs
(46
-60
)
88 s
ecs
(61
-12
0)
36 s
ecs
(30
-42
)
48 s
ecs
(41
-52
)
78 s
ecs
(67
-86
)
1.0
9 m
/s(0
.99
-1.2
3)
1.5
5 m
/s(1
.51
-1.6
5)
1.5
4 m
/s(1
.44
-1.7
5)
1.1
6 m
/s(1
.08
-1.2
3)
0.9
9 m
/s(0
.91
-1.0
9)
1.3
9 m
/s(1
.34
-1.4
4)
1.4
6 m
/s(1
.41
-1.5
1)
0.7
2 m
/s(0
.52
-0.9
7)
0.6
3 m
/s(0
.59-0
.66)
0.8
3 m
/s(0
.78-0
.88)
0.5
0 m
/s(0
.40
-0.6
1)
0.8
2 m
/s(0
.78
-0.8
5)
0.4
4 m
/s(0
.40-0
.48)
0.8
2 m
/s(0
.79-0
.85)
0.6
6 m
/s(0
.58
-0.7
4)
0.5
2 m
/s(0
.50
-0.5
5)
1.0
9 m
/s(0
.99
-1.2
3)
(ave
rag
e
) (ran
ge
)
min
imu
m n
um
ber
ph
ysic
ally r
eq
uir
ed
Data
co
lle
cti
on O
cto
ber
5,
2016
Pag
e 1
2P
ed
estr
ian
Mo
delli
ng
in H
ealth
care
Facili
ties
Stretcher Carry Chair
Evacuation Chair Rescue Sheet
(0.6
7 m
/s)
(0.8
4 m
/s)
(0.6
0 m
/s)
(0.5
4 m
/s)
Data
co
lle
cti
on O
cto
ber
5,
2016
Pag
e 1
3P
ed
estr
ian
Mo
delli
ng
in H
ealth
care
Facili
ties
Ave
rag
e
Co
rrid
or
Sp
ee
d (
m/s
)
Str
etc
he
rE
va
cC
ha
irC
arr
y C
ha
irR
escu
e S
he
et
MF
MF
MF
MF
Str
aig
ht-
Lin
e
Po
rtio
n1
.24
1.1
91
.54
1.4
21
.44
1.3
31
.38
0.8
7
Ove
rta
kin
g
Po
ten
tia
l
Str
etc
he
rE
va
cC
ha
irC
arr
y C
ha
irR
escu
e S
he
et
MF
MF
MF
MF
No
. S
tair
La
ne
sO
ccu
pie
d2
21
11
21
.51
.5
Ave
rag
e
Co
rrid
or
Sp
ee
d (
m/s
)
Str
etc
he
rE
va
cC
ha
irC
arr
y C
ha
irR
escu
e S
he
et
MF
MF
MF
MF
90
De
gre
e
Co
rne
r T
urn
1.1
21
.09
1.4
01
.14
1.4
31
.35
1.0
70
.86
Data
co
lle
cti
on O
cto
ber
5,
2016
Pag
e 1
4P
ed
estr
ian
Mo
delli
ng
in H
ealth
care
Facili
ties
•M
ovem
en
t d
evic
e p
erf
orm
an
ce c
om
pari
so
n m
atr
ix,
see:
Hu
nt,
A., G
ale
a,
E.
R., &
Law
ren
ce
, P.
J.
(20
15
). A
n a
naly
sis
an
d n
um
eri
cal sim
ula
tio
n o
f th
e
pe
rfo
rman
ce
of tr
ain
ed
ho
sp
ital sta
ff u
sin
g m
ove
me
nt
assis
t d
evic
es t
o e
vacu
ate
pe
op
le w
ith
red
uce
d m
ob
ility
.Fir
e a
nd
Mate
rials
,39
(4),
40
7-4
29
.
•Im
plic
it m
od
elli
ng
in
bu
ildin
gE
XO
DU
S:
Pe
rfo
rman
ce
Co
mp
ari
so
n
Octo
ber
5,
2016
Pag
e 1
5P
ed
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
Th
eo
reti
cal m
od
el d
eve
lop
me
nt
•E
xis
tin
g e
vacu
atio
n m
od
els
were
exam
ined
to
dete
rmin
e t
heir
su
itab
ilit
y f
or
use
in
sim
ula
tin
g h
osp
ital evacu
atio
ns.
•M
ost
mo
dels
were
un
su
itab
le g
iven
in
nate
lim
itati
on
s in
th
e
ap
pro
ach
ad
op
ted
(e.g
. u
nab
le t
o r
ep
resen
t in
div
idu
al
beh
avio
urs
).
•O
thers
were
ab
le t
o s
imu
late
re
du
cti
on
s in
ag
en
t sp
ee
d,
bu
t
were
in
cap
ab
le o
f effectively
rep
resen
tin
g t
he p
hysic
al
pre
sen
ce o
f th
e d
evic
e o
r th
e a
sso
cia
ted
sta
ffin
g p
roced
ure
s.
•In
co
rpo
rati
ng
larg
e o
bje
cts
in
to e
vacu
ati
on
mo
de
ls
(i.e
. b
igg
er
than
on
e a
gen
t) is v
ital an
d c
halle
ng
ing
.
Octo
ber
5,
2016
Pag
e 1
6P
ed
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
Ap
plicati
on
of
Data
-D
evelo
ped
mic
rosim
ula
tio
n t
oo
ls t
o m
od
el h
osp
ital
evacu
atio
n.
Octo
ber
5,
2016
Pag
e 1
7P
ed
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
Imp
act
•D
em
on
str
atio
n c
ases r
eveale
d n
ew
fo
recasti
ng
ab
ilit
y.
•T
his
en
han
cem
en
t n
ow
allo
ws p
ractitio
ners
to
test
the u
se o
f
evacu
atio
n d
evic
es a
s p
art
of h
osp
ital evacu
atio
n
pro
ced
ure
s a
nd
qu
an
tify
th
eir
im
pact
(po
sitiv
e o
r n
eg
ative)
on
overa
ll p
erf
orm
an
ce.
•In
fo
recastin
g,
this
cap
acity e
nab
les in
sig
ht
to b
e g
ain
ed
pri
or
to t
he im
ple
men
tatio
n o
f a n
ew
pro
ced
ure
, a n
ew
bu
ildin
g d
esig
n o
r th
e u
se o
f n
ew
devic
es.
•T
he m
od
el en
han
ces p
lan
nin
g a
nd
dia
gn
ostic c
ap
ab
ilities,
so
th
at
new
desig
ns a
re b
ett
er
info
rmed
an
d t
hat ri
sk
asse
ssm
en
ts a
nd
evid
en
ce
-base
d a
naly
se
s a
re b
ett
er
su
pp
ort
ed
in
th
e fu
ture
.
Octo
ber
5,
2016
Pag
e 1
8P
ed
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
Ou
r cap
ab
ilit
y
-W
e c
an
cre
ate
be
sp
oke
mo
de
ls b
ased
on
in
div
idu
al
ho
sp
ital p
lan
s.
-W
e c
an
rep
resen
t n
orm
al
op
era
tio
n a
nd
em
erg
en
cy
sit
uati
on
sto
test
pro
ced
ure
s a
nd
in
vestig
ate
safe
ty facto
rs.
-W
e c
an
fo
recast
the t
ime
take
n t
o f
ulf
il p
roce
du
res;
e.g
.
patien
t tr
iag
e a
nd
reg
istr
atio
n,
pre
pari
ng
patien
ts fo
r
evacu
atio
n,
an
d m
ovem
en
t tim
es f
or
evacu
atio
n.
-W
e c
an
co
mp
are
pro
gre
ssiv
e h
ori
zo
nta
l evacu
atio
n
pro
ced
ure
s w
ith
th
e fu
ll-b
uild
ing
(i.e.
vert
ical)
evacu
atio
n
pro
ced
ure
s.
Octo
ber
5,
2016
Pag
e 1
9P
ed
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
Ou
r cap
ab
ilit
y
-W
e c
an
mo
del th
e r
ole
of
sta
ff m
em
be
rs in
ord
er
to t
est
pro
ced
ure
s,
an
d t
o a
id in
tra
inin
g b
y p
rovid
ing
a r
eal-tim
e
sim
ula
tio
n o
f sta
ff m
em
bers
’ vari
ou
s r
ole
s d
uri
ng
an
em
erg
en
cy e
ven
t.
-W
e c
an
aid
with
th
e d
esig
n o
f p
ers
on
al
em
erg
en
cy
evacu
ati
on
pla
ns a
nd
re
fug
e a
reas f
or
patien
ts a
nd
investig
ate
th
e u
se o
f evacu
atio
n d
evic
es.
-W
e c
an
cre
ate
be
sp
oke
asse
ssm
en
ts in
resp
on
se t
o c
lien
t
need
s,
su
ch
as a
naly
sis
of p
ed
estr
ian
mo
vem
en
t in
no
rmal
op
era
tio
ns:
qu
eu
ing
man
ag
em
en
t fo
r o
utp
atien
ts a
nd
A&
E, p
ati
en
t tr
an
sfe
r syste
ms,
an
d p
ed
estr
ian
are
as f
or
vis
ito
rs a
nd
reta
il o
utlets
, etc
.
Octo
ber
5,
2016
Pag
e 2
0P
ed
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
Ke
y a
dvan
tag
es
-E
nh
an
cin
g p
lan
nin
g a
nd
dia
gn
osti
c c
ap
ab
ilities w
ith
in
ho
sp
ital an
d o
ther
health
care
facili
ties.
-F
ore
castin
g c
ap
acity e
nab
les in
sig
ht
to b
e g
ain
ed
pri
or
to
the im
ple
men
tatio
n o
f n
ew
pro
ced
ure
s,
new
bu
ildin
g
desig
ns o
r th
e u
se o
f n
ew
devic
es.
-R
isk a
ssessm
en
ts a
nd
evid
en
ce-b
ased
an
aly
se
s a
re
be
tte
r su
pp
ort
ed
in h
ealth
care
en
vir
on
men
ts.
Octo
ber
5,
2016
Pag
e 2
1P
ed
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
•M
ore
data
are
req
uir
ed
, fo
r exam
ple
to
in
vestig
ate
:
•H
an
dle
r fa
tig
ue
•D
iffe
ren
t m
ed
ical an
d p
rep
ara
tio
n r
eq
uir
em
en
ts.
•P
hysic
al p
erf
orm
an
ce (
i.e.
mix
ed
-gen
der
team
s)
•Im
pact
of tr
ain
ing
•T
he m
od
el d
eve
lop
me
nt
is c
on
tin
uin
g t
o m
ake t
he
rep
resen
tatio
n o
f d
evic
es g
en
eri
c a
nd
user-
frie
nd
ly.
•T
he c
ap
ab
ility
will
be e
xte
nd
ed
to
oth
er
ob
jects
:
•P
ram
s,
tro
lleys a
nd
lu
gg
ag
e
•V
eh
icle
s
Th
e F
utu
re
Octo
ber
5,
2016
Pag
e 2
2P
ed
estr
ian
Mo
delli
ng
in
Health
care
Facili
ties
Th
an
k Y
ou
ao
ife.h
un
t@aeco
m.c
om
Octo
ber
5, 2
01
6