This study conducted action research to design an effective business continuity plan (BCP) addressing potential flood situations for hospitals. The research consisted of two main Steps. In Step 1 (Clarifying actions), we performed a scenario-based analysis of a near-term flood situation. Then, we conducted a cross-sectional survey across all 48 departments of a selected hospital based on the calculated flood risk (Step 0). In Step 2 (Challenges toward an appropriate BCP), we organized a workshop to identify the potential challenges that hospitals could face during a disaster. This innovative approach is encapsulated in our action research model, “Step 3Cs.” We found that, in case of a life-threatening crisis, 17.6% of hospital inpatients may be at risk, while 28.0% of staff members may need to leave and return home. The qualitative analysis revealed that a significant challenge to establishing an effective BCP is the lack of concrete organizational policies and supplementary measures to address anticipated damage caused by floods. By integrating data from each department, Step 1 effectively emphasized the worst-case scenarios that hospitals might encounter during an emergency. Furthermore, Step 2 identified organizational challenges associated with developing a BCP for floods, enabling participants to view the situation from multiple perspectives. Overall, the Step 3Cs action research model is a potentially highly effective framework for creating an effective BCP for hospitals threatened by flood risks.

【Background/Objective】 Activities conducted by Disaster Medical Assistance Teams (DMATs) during the COVID-19 pandemic included those that involved collaboration with the infection control department “inside the facility” that each team belonged to and those that were conducted “outside the facility” where each team was dispatched to. In this article, we reveal the actual status of these activities. 【Method】 Responses to a questionnaire administered to 14 medical institutions that had their own DMAT in the prefecture were used for the analysis, along with the data provided by the prefecture government about facilities that received the support of DMATs. 【Results】 In regard to activities conducted “inside the facility,” 33.3% of the institutions answered that the DMAT was “involved” when a patient was found to be positive for COVID-19 within each institution; the most frequently conducted activity, accounting for 33.3% of all activities, was “personnel adjustment”. In regard to the activities conducted “outside the facility,” nursing homes were the locations that the teams were most frequently dispatched to, accounting for 58.9% of the times. 【Discussion】 Activities conducted “inside the facility” primarily consisted of supporting the functions of the disaster control headquarters, such as personnel adjustment and command system establishment. In the case of pandemic disasters, it would appear that establishment of a disaster control headquarters may enhance collaboration between the infection control department and the DMAT. As an activity conducted “outside the facility,” providing support to nursing homes is a highly needed activity and should be prepared for in advance.

【Purpose】 This study aimed to investigate the awareness of disaster risks and the preparedness status of locals living near a university designated as an evacuation shelter. 【Method】 A web-based survey was conducted among residents aged ≥20 years in District A of Sapporo City to assess their awareness of disaster risks and their current preparedness measures. 【Results】This study included 205 participants, many had received disaster education primarily during elementary and junior high school. Respondents without prior disaster experience tended to perceive the risk of disasters near their homes as low. The number of participants who had prepared medications as part of their disaster preparedness was relatively low. Universities were widely regarded as the safest evacuation shelters. 【Discussion】 Opportunities for disaster education appear to be limited after high school, particularly among adults. Individuals without disaster experience tended to inadequately recognize the potential risks in their residential areas. In addition, preparedness for medications during emergencies was insufficient, indicating the need to enhance awareness of the importance of keeping essential medicines on hand. Beyond serving as a safe evacuation site, universities are expected to contribute to the community through disaster education and the development of emergency response manuals.

【Objective】 There are few opportunities for medical professionals to intervene in architectural design to provide input about accommodating the acceptance of casualties during a disaster, and, as a result, there are facilities that have various problems such as ensuring stable and effective flow lines. This study aimed to clarify what rooms are used for accepting casualties for disaster relief in base hospitals as well as the ability of medical personnel to intervene and make requests during the architectural design stage. 【Methods and Subjects】 A questionnaire survey was mailed to multiple disaster base hospitals, and 67 facilities provided valid responses. Statistical analysis was used to examine the data, and the results are discussed here. 【Results】 We found that the space in front of the outpatient entrance is likely to be used as a triage area and the emergency treatment room as a red area. The results also showed that the need for medical intervention was high in all areas, but especially in the triage and red areas when compared to the black area. 【Conclusion】 The high need for medical intervention in the triage and red areas indicates that the spaces at the outside of the outpatient entrance, the main entrance hall, and the emergency room, which were frequently cited as the areas designated for use as triage and red areas, believes that the views of medical professionals need to be given special priority in the architectural planning stage.

In the event of the Nankai Trough Earthquake in western Japan, Wakayama Prefecture is predicted to experience the highest number of human casualties in western Japan. Therefore, disaster medical drills have been repeatedly conducted based on the assumption that the Nankai Trough Earthquake will occur. These drills have revealed the characteristics and challenges of such a disaster in Wakayama Prefecture. The transportation network in Wakayama Prefecture is concentrated in coastal areas, and the southern part of the Kii Peninsula will be isolated immediately after the disaster. Therefore, an air transport system is essential during the acute phase of disasters. Wakayama Prefecture has planned and established five air transport bases in the prefecture gradually for this reason. Hospitals in the northern part of the prefecture must also provide care for sick and injured patients from the southern part. However, it was found that many hospitals have not been reinforced against earthquakes and have less than 24 hours of operation time for private power generation. While it is desirable to improve the functions of all hospitals, it is first necessary for disaster-based hospitals to take the initiative to expand their functions and support the community. As a result, Wakayama Prefecture as a whole needs to be prepared to endure on its own until support from outside the prefecture arrives.

During the 2024 Noto Peninsula Earthquake, the Ishikawa Prefectural Health, Medical, and Welfare Coordination Headquarters coordinated the evacuation of patients on dialysis. The responsibilities were shared with the Ishikawa Dialysis Liaison Council: the council selected evacuation destinations, whereas the Disaster Medical Assistance Team secured transportation. This joint effort involving the Self-Defense Forces and private emergency services ensured the safe evacuation of 167 patients. However, challenges have emerged, including confusion in the command system, inadequate information-sharing, and insufficient evacuee identification. To facilitate swift and safe evacuations during disasters, it is essential to strengthen multidisciplinary collaboration set up in the initial response phase, establish robust information-sharing systems, and clearly define roles and responsibilities. Additionally, developing a dialysis patient information-sharing system and establishing evacuation protocols are crucial. These measures aim to ensure the safety of patients undergoing dialysis and optimize the use of limited medical resources in future disasters.