Quantitative Assessment of Surge Capacity in Rwandan Trauma Hospitals

A Survey Using the 4S Framework

Datos Bibliográficos

ID15499669
AutoresLotta Velin (0000-0002-1929-6011, Linköping University, autor de correspondencia), Menelas Nkeshimana (0000-0003-3573-8075, Centre Hospitalier Universitaire de Kigali), Eric Twizeyimana (0009-0000-8672-3901, University of Global Health Equity), Didier Nsanzimfura (0009-0004-7192-8145, Centre Hospitalier Universitaire de Kigali), Andreas Wladis (0000-0003-4377-0892, Linköping University), Laura Pompermaier (0000-0001-6304-9686, Linköping University)
Año2025
Volumen22
Número10
Páginas1559-1559
Fecha de publicación2025-10-13
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaInternational Journal of Environmental Research and Public Health (JOURNAL)
Identificadores de la revistaISSN: 1661-7827 • E-ISSN: 1660-4601
EditorialMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/ijerph22101559
PMID41154963
OpenAlexW4415172672
IdiomaEN
Referencias citadas28

Surge capacity is the ability to manage sudden patient influxes beyond routine levels and can be evaluated using the 4S Framework: staff, stuff, system, and space. While low-resource settings like Rwanda face frequent mass casualty incidents (MCIs), most surge capacity research comes from high-resource settings and lacks generalisability. This study assessed Rwanda's hospital surge capacity using a cross-sectional survey of emergency and surgical departments in all referral hospitals. Descriptive statistics, t -tests, Fisher's exact test, ANOVA, and linear mixed-model regression were used to analyze responses. Of the 39 invited participants, 32 (82%) responded. On average, respondents believed that they could manage 13 MCI patients (95% CI: 10-16) while maintaining routine care, with significant differences between tertiary and secondary hospitals (11 vs. 22; p = 0.016). The intra-class correlation was poor for most variables except for CT availability and ICU beds. Surge capacity perception did not vary significantly by professional category, though less senior staff reported higher capacity. Significantly higher capacity was reported by those with continuous access to imaging ( p < 0.01). Despite limited resources, Rwandan hospitals appear able to manage small to moderate MCIs. For larger incidents, patient distribution across facilities is recommended, with critical cases prioritized for tertiary hospitals

Capacity building · Cross-sectional study · Descriptive statistics · Mass-casualty incident · Needs assessment · Referral · Surge · Surge Capacity · Tertiary referral hospital · Disaster Response and Management · Global Maternal and Child Health · Trauma and Emergency Care Studies