JDR Vol.18 No.2 pp. 114-123
doi: 10.20965/jdr.2023.p0114

Survey Report:

Report on the Project on the Implementation of Continuity Operations in Disaster-Affected Healthcare Facilities Using Gensai Calendar HDMG and COOP Flow Diagram

Yasushi Nakajima*,†, Akane Yoshida**, and Tsuyoshi Kato***

*Tokyo Metropolitan Hiroo Hospital
2-34-10 Ebisu, Shibuya-ku, Tokyo 150-0013, Japan

Corresponding author

**Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan

***Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

August 10, 2022
November 14, 2022
February 1, 2023
business continuity plan (BCP), continuity operation, disaster education, disaster drill, crisis management

Based on the lessons learned from past disasters, the Japanese Ministry of Health, Labour and Welfare has notified the establishment of disaster base hospitals and ensured medical care continuity based on business continuity plan (BCP). Following these, we created a disaster management training program with 45 items, the Disaster Mitigation (Gensai) Calendar for Healthcare Disaster Management Guide (HDMG)* (“Gensai Calendar”) in 2018. Thereafter, a three-year multicenter project was launched at the Tokyo Metropolitan Hospital Organization to introduce the “Gensai Calendar” and assess its merits as a self-learning material through tests based on it. The project also aimed at establishing a common operating procedure (COOP) for medical continuity at affected healthcare facilities using annual comprehensive disaster drills. The numbers of participants and hospitals recruited for the test over the three-year period were 4,281 in six hospitals, 6,179 in ten hospitals, and 6,216 in seven hospitals. The total of 55 questions were asked in the e-learning format in the first and second years, and 11 in the third year. Questions with less than 70% correct rate were same for three years. Through the drills, a COOP flow diagram was constructed based on the initial responses in the wards. Furthermore, the crisis management system of each hospital was unified, and each BCP was revised into a standard document along the “COOP Flow Diagram.” A COOP system combining the “Gensai Calendar” learnings, annual “COOP Flow Diagram” drill, and standard documentation can be a viable system for medical continuity. This system could also be versatile and introduced to many healthcare facilities.

* This is also the abbreviation for the Hiroo Disaster Management Group, which has a double meaning. The group consists of disaster prevention staff from the Tokyo Metropolitan Hiroo Hospital, Komagome Hospital, and Bokutoh Hospital, and is responsible for planning and managing disaster mitigation measures.

Cite this article as:
Y. Nakajima, A. Yoshida, and T. Kato, “Report on the Project on the Implementation of Continuity Operations in Disaster-Affected Healthcare Facilities Using Gensai Calendar HDMG and COOP Flow Diagram,” J. Disaster Res., Vol.18 No.2, pp. 114-123, 2023.
Data files:
  1. [1] Ministry of Health, “On the enhancement and strengthening of the initial emergency medical system in the event of a disaster,” Notification of the Director-General of the Health Policy Bureau, No.451, 1996 (in Japanese).
  2. [2] Ojiya General Hospital Nursing Department, “Niigata Prefecture Chuetsu Earthquake Ojiya General Hospital Nursing Department Activity Record – At that time, nursing is…,” 2007 (in Japanese).
  3. [3] S. Kushimoto and K. Ishimaru, “Lives saved by Ishinomaki Red Cross Hospital, Kesennuma City Hospital and Tohoku University Hospital,” Aspect Inc., 2011 (in Japanese).
  4. [4] Japan Institute of Healthcare Architecture, “Report on survey research on actual damage to elderly facilities in the Great East Japan Earthquake,” 2012 (in Japanese).
  5. [5] Saiseikai Kumamoto Hospital, “Saiseikai Kumamoto Hospital Kumamoto Earthquake Record – What I thought and what I did at that time,” 2016 (in Japanese).
  6. [6] Ministry of Health, Labour and Welfare, “Partial revision of requirements for designation of base hospitals for disaster medical services,” Notification of the Director-General of the Health Policy Bureau, No.0331-33, 2017 (in Japanese).
  7. [7] Y. Nakajima et al., “A trial to refine the hospital emergency incident command system by revising manual and introducing action cards,” Japanese J. of Disaster Medicine, Vol.16, No.2, pp. 198-204, 2011 (in Japanese).
  8. [8] Y. Nakajima, M. Kikuchi, and M. Sasaki, “Preparation of informational triage method in the disaster countermeasure headquarters using the two-dimensional expansion method,” J. of Japanese Society for Emergency Medicine, Vol.16, No.2, pp. 108-113, 2013 (in Japanese).
  9. [9] K. Takemoto, Y. Motoya, and R. Kimura, “A Proposal for Effective Emergency Training and Exercise Program to Improve Competence for Disaster Response of Disaster Responders,” J. Disaster Res., Vol.5, No.2, pp. 197-207, 2010.
  10. [10] J. Dians, T. Ogawa, and N. Sejima, “Adult learning, adult teaching,” All Japan Federation of Social Education, Tokyo, 1996 (in Japanese).
  11. [11] Advanced Life Support Group, “Pocket guide to teaching for medical instructors (Second Edition),” BMJ Books, 2008.
  12. [12] Japan Academy of Midwifery, “Disaster preparedness drill for midwives,” (in Japanese). [Accessed August 2, 2022]
  13. [13] A. C. Edmondson and J. F. Harvey, “Extreme teaming: Lessons in complex, cross-sector leadership,” Emerald Publishing Limited, 2017.
  14. [14] Y. Shibata, “Instructional design for interprofessional education,” Medical Education, Vol.45, No.3, pp. 183-192, 2014 (in Japanese).
  15. [15] S. Ohta et al., “Sustainable training-model development based on analysis of disaster medicine training,” J. Disaster Res., Vol.10, No.5, pp. 900-918, 2015.
  16. [16] A. Umeno and Y. Asada, “Reviewing the wide-scale disaster simulation training to improve using an instructional design,” Japanese J. of Occupational Medicine and Traumatology, Vol.63, No.6, pp. 378-384, 2015 (in Japanese).
  17. [17] Health Statistics Office, Counselor to the Director for Policy Coordination, “2020 survey of medical facilities (static and dynamic) and summary of hospital reports,” (in Japanese). [Accessed August 2, 2022]
  18. [18] Japan Association of Healthcare Builders and Architects, “Report of research study on damage and business continuity of hospitals due to natural disasters in 2008,” 2019 (in Japanese).
  19. [19] M. J. W. Thomas, “Training and assessing non-technical skills: A practical guide,” CRC Press, 2017.
  20. [20] R. M. Gagne, W. W. Wager, K. C. Golas, and J. M. Keller, “Prin- ciples of Instructional Design (5th Edition),” Wadsworth Pub. Co., 2004, Translation Supervised by M. Iwasaki and K. Suzuki, “Principles of Instructional Design,” Kitaooji Shobo Publishing, 2007 (in Japanese).
  21. [21] M. Ikeda et al., “Development of Disaster Management Education Program to Enhance Disaster Response Capabilities of Schoolchildren During Heavy Rainfall – Implementation at Elementary School in Nagaoka City, Niigata Prefecture, a Disaster-Stricken Area,” J. Disaster Res., Vol.16, No.7, pp. 1121-1136, 2021.
  22. [22] Juhadi, N. Hamid, E. Trihatmoko, M. Herlina, and E. N. Aroyandini, “Developing a Model for Disaster Education to Improve Students’ Disaster Mitigation Literacy,” J. Disaster Res., Vol.16, No.8, pp. 1243-1256, 2021.
  23. [23] T. Nagata, M. Ikeda, R. Kimura, and T. Oda, “Development of Tsunami Disaster Risk Reduction Education Program for Children with No Experience of Earthquake Disaster – Practice and Verification at Shichigahama Town, Miyagi Prefecture,” J. Disaster Res., Vol.17, No.6, pp. 1000-1014, 2022.
  24. [24] J. D. Kirkpatrick and W. K. Kirkpatrick, “Kirkpatrick’s four levels of training evaluation,” ATD Press, 2016.

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