The Israel Medical Association journal : IMAJ · 2026
Multidisciplinary Operational Leadership and Proactive Risk Management for Safe Hospital Relocation During Operation Roaring Lion.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Etzioni Tamar, Kibari Adi, Yurin Vitali, Modiano Eliad, Bergman-Raskin Liat, Tal Ahuva, Goldberg Avi
Аннотация
BACKGROUND: During Operation Roaring Lion, Carmel Medical Center, a 500-bed tertiary hospital, relocated nearly half of its inpatient activity to the fortified underground facility of Rambam Health Care Campus while maintaining independent clinical and managerial responsibility. Returning patients after hostilities subsided represented a complex organizational transition requiring preservation of patient safety and continuity of care.
OBJECTIVES: To describe a multidisciplinary operational leadership model and evaluate the use of failure mode and effects analysis (FMEA) to support safe wartime hospital relocation.
METHODS: A prospective quality improvement study used multidisciplinary FMEA before patient relocation. The relocation pathway was divided into four phases, and potential failure modes were scored by severity, occurrence, and detectability to prioritize mitigation strategies. Interventions included centralized command, real-time patient tracking, structured clinical handoffs, standardized transfer checklists, medication reconciliation, risk stratification, and enhanced post-transfer monitoring. Outcomes included patient safety events, falls, resuscitation events, unplanned intensive care unit (ICU) admissions within 24 hours, multidrug-resistant organism (MDRO) cross-transmission, and departmental feedback.
RESULTS: During 55 days of wartime activity, 843 patients were hospitalized in the underground facility. In total, 84 medically complex patients were relocated in three operational waves. The highest-risk domains involved communication, documentation, operational coordination, staffing, and clinical monitoring. No predefined patient safety events, falls, resuscitation events, unplanned ICU admissions within 24 hours, or documented MDRO cross-transmission were identified. Department leaders reported high organizational preparedness and improved operational control.
CONCLUSIONS: A multidisciplinary operational leadership model integrating proactive FMEA enabled coordinated management of clinical, informational, operational, and infection-related risks during complex wartime hospital relocation.
OBJECTIVES: To describe a multidisciplinary operational leadership model and evaluate the use of failure mode and effects analysis (FMEA) to support safe wartime hospital relocation.
METHODS: A prospective quality improvement study used multidisciplinary FMEA before patient relocation. The relocation pathway was divided into four phases, and potential failure modes were scored by severity, occurrence, and detectability to prioritize mitigation strategies. Interventions included centralized command, real-time patient tracking, structured clinical handoffs, standardized transfer checklists, medication reconciliation, risk stratification, and enhanced post-transfer monitoring. Outcomes included patient safety events, falls, resuscitation events, unplanned intensive care unit (ICU) admissions within 24 hours, multidrug-resistant organism (MDRO) cross-transmission, and departmental feedback.
RESULTS: During 55 days of wartime activity, 843 patients were hospitalized in the underground facility. In total, 84 medically complex patients were relocated in three operational waves. The highest-risk domains involved communication, documentation, operational coordination, staffing, and clinical monitoring. No predefined patient safety events, falls, resuscitation events, unplanned ICU admissions within 24 hours, or documented MDRO cross-transmission were identified. Department leaders reported high organizational preparedness and improved operational control.
CONCLUSIONS: A multidisciplinary operational leadership model integrating proactive FMEA enabled coordinated management of clinical, informational, operational, and infection-related risks during complex wartime hospital relocation.