Addressing a climate emergency amidst the COVID-19 pandemic: A mixed-methods study on a hospital evacuation during the 2021 European floods

IntroductionIn July 2021, several European countries were affected by severe floods with water levels of the river Meuse reaching a record high. VieCuri Medical Center (Venlo, the Netherlands) is a hospital located directly adjacent to this river, and in response to the flood threat it was decided to completely evacuate the hospital. The aim of this study was to explore the decision-making process of this emergent evacuation. MethodsA mixed-method approach was used. Qualitative data were collected through semi-structured interviews with 11 key participants closely involved in the evacuation. Quantitative data on the patients that were admitted at the time of the evacuation decision were collected, and included 30-day mortality, 7-day readmission rates and Charlson Comorbidity Index. ResultsThree themes were constructed from the interviews: risk-assessment, COVID-19 experience and collaboration. Participants highlighted the role of previous experiences from the COVID-19 pandemic. The use of a national patient coordination center enabled to rapidly assess capacity of potential destination hospitals. Furthermore, the hospitals preparedness for evacuation could be improved by a thorough analysis of locoregional hazards and preparing for loss of regional healthcare capacity. Findings unrelated to decision-making included the inefficiency of large-scale ambulance dispatches and the expansion of business continuity plans. No patients died unanticipated during this hospital evacuation or within 30 days. ConclusionExperiences of the COVID-19 pandemic and the availability of a national patient coordination center were found to be decisive in performing this evacuation. This allowed for the swift identification of available capacity in appropriate destination hospitals.