This diploma thesis deals with security in the hospital enviroment. The work creates a new evacuation plan for large-monoblock Hospital for adults in FN Motol. Evacuation plan covers all activities of the announcement of evacuation after the removal of the last patient from the hospital. For developed evacuation plan at workcompiled four simulation models in SIMUL8. With these models, theevacuation plan and tested models provide a quantitative value, according to which it can better prepare for possible evacuation. This thesis has fulfilled its purpose -- was created functional evacuation plan, and simulation models provide additional information as to which should be ensured smoother running of the evacuation.

This dissertation addresses the development and analysis of optimization models for evacuation planning. Specifically we consider the cases of large-scale regional evacuation using household vehicles and hospital evacuation. Since it is difficult to estimate the exact number of people evacuating, we first consider the case where the population size is uncertain. We review the methods studied in the literature, mainly the strategy of using a deterministic counterpart, i.e., a single deterministic parameter to represent the uncertain population, and we show that these methods are not very effective in generating a good traffic management strategy. We provide alternatives, where we describe some networks where an optimal policy exist independent of the demand realization and we propose some simple heuristics for more complex ones. Next we consider the traffic management tools that can be generated from an evacuation plan. We start by introducing the cell transmission model with flow reduction. This model captures the flow reduction after the onset of congestion. We then discuss the management tools that can be extracted from this model. We also propose some simplification to the model formulation to enhance its tractability. A heuristic for generating a solution is also proposed, and its solution quality is analyzed. Finally, we discuss the hospital evacuation problem where we develop an integer programming model that integrates the building evacuation with the transportation of patients. The impact of building evacuation capabilities on the transportation plan is investigated through the case of a large regional hospital case study. We also propose a decomposition scheme to improve the tractability of the integer program. / Ph. D.

This dissertation addresses the development of optimization models for hospital evacuation logistics, as well as the analyses of various resource management strategies in terms of the equity of evacuation plans generated. We first formulate the evacuation transportation problem of a hospital as an integer programming model that minimizes the total evacuation risk consisting of the threat risk necessitating evacuation and the transportation risk experienced en route. Patients, categorized based on medical conditions and care requirements, are allocated to a limited fleet of vehicles with various medical capabilities and capacities to be transported to receiving beds, categorized much like patients, at the alternative facilities. We demonstrate structural properties of the underlying transportation network that enables the model to be used for both strategic planning and operational decision making. Next, we examine the resource management and equity issues that arise when multiple hospitals in a region are evacuated. The efficiency and equity of the allocation of resources, including a fleet of vehicles, receiving beds, and each hospital\'s loading capacity, determine the performance of the optimal evacuation plan. We develop an equity modeling framework, where we consider equity among evacuating hospitals and among patients. The range of equity of optimal solutions is investigated and properties of optimal and equitable solutions based on risk-based utility functions are analyzed. Finally, we study the integration of the transportation problem with the preceding hospital building evacuation. Since, in practice, the transportation plan depends on the pace of building evacuation, we develop a model that would generate the transportation plan subject to the output of hospital building evacuation. The optimal evacuation plans are analyzed with respect to resource utilization and patient prioritization schemes. Parametric analysis of the resource constraints is provided along with managerial insights into the assessment of evacuation requirements and resource allocation. In order to demonstrate the performance of the proposed models, computational results are provided using case studies with real data obtained from the second largest hospital in Virginia. / Ph. D.

Population evacuation plan is one of the plans of specific operations, which are covered within the region's emergency plan according to Decree No. 328/2001 Coll.Evacuation belongs among the basic methods of population protection, being a summary of principles and organisation measures to ensure moving the persons, animals and material assets from the area endangered by an extraordinary event to other area. In the case of an extraordinary event endangering larger territorial unit, not only the populated agglomerations and industrial facilities may be included in the area evacuation, but also the inpatient healthcare facilities, where the situation difficulty is amplified by the patients depending on care by medical personnel and provision of healthcare services. Presently, there is no clear legal standard imposing an obligation on organisations to elaborate a complete evacuation plan. This issue is covered only partially in the sphere of legislation concerning fire protection. Nevertheless within the region's emergency plan elaborated for solution of extraordinary events requiring declaration of the third level (in the case of endangering more than 100 and less than 1,000 persons) and special level of alarm (when more than 1,000, a part of a municipality or enterprise grounds are endangered), all organisations with more than 100 persons should have the evacuation plans prepared. In the case of inpatient healthcare facilities, elaboration of evacuation plans is absolutely inevitable. The theoretical part of the dissertation describes the general principles and methods of performing the population evacuation. Attention was paid also to professional coverage, evacuation authorities and organisations and their structure according to the scope of the taken measures. In the chapter called "Application of the evacuation plan to inpatient healthcare facilities", the general principles and procedures concerning evacuation were applied to the inpatient healthcare facilities. In the practical part of the dissertation, an analysis of preparedness of the inpatient healthcare facilities for possible area evacuation to all-nation extent was made and the hitherto experience of the personnel of the inpatient healthcare facilities with any type of evacuation and their preparedness for possible complete evacuation were examined. Such examinations were made by questionnaire surveys. The collected data have been processed by statistical methods. The evaluation of results is presented in the "Results" chapter. On the basis of the acquired knowledge, a proposal of evacuation plan was drafted for the inpatient healthcare facilities. At the end of the dissertation, the procedures are suggested that may help manage perfectly the potential complete evacuation. Expected utilisation of the dissertation results was directed to definition of the optimum procedures and measures leading to successful management of evacuation of an inpatient health care facility. The dissertation conclusions may be used not only as the document for creating evacuation plans for other health care facilities, but they may contribute to considerable extent to elaboration of uniform evacuation preparation methodology within the emergency preparedness of the healthcare services.