Introduction: Recently, the risk of flood disasters due to concentrated heavy rains has been increasing in Japan. While some cases of hospital evacuation have been reported, standards for hospital evacuation have not been established. Moreover, regional administrative evacuation plans do not include medical facilities. Aim: To clarify the timeline for in-hospital vertical evacuation during a flood disaster. Method: We set a timeline for vertical evacuation as a criteria of our hospital’s emergency response based on the Arakawa River Downstream Timeline, which is a timeline of the large Arakawa River located near our facility. We also considered the time required to make the decision to evacuate by calculating backwards from 0 hours when the river floods. A drill was held to verify the timeline. Results: Our timeline was based on the water level of the Arakawa River as objective evidence of risky transfer of critical patients; therefore, the decision to evacuate was made when the water level reached a dangerous level (-3 hours). However, this was not enough time to evacuate and caused a shortage of human resources to evacuate both patients and medical resources. We also planned to shutdown the electronic clinical record system at 0 hours to avoid water damage and to evacuate its server, but 3 hours was not enough time to prepare clinical or nursing summaries of all evacuated patients. Discussion: We need greater and earlier preparation for evacuation to reduce or discharge patients who can leave the hospital when a flood disaster is predicted. We considered only in-hospital vertical evacuation because it is very risky to transfer critical patients without governmental or municipalities’ enforcement. In fact, over 10,000 patients would need to be evacuated in our region if the Arakawa River floods. Therefore, a regional plan is indispensable for such large scale and simultaneous hospital evacuations.
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