Phatthranit Phattharapornjaroen: Flexible surge capacity in disasters

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PHATTHRANIT PHATTHARAPORNJAROEN
Dissertation defense: 7 June 2024 (click for details)
Doctoral thesis: Flexible Surge Capacity in Disasters and Major Incidents
Research area: Surgery
Sahlgrenska Academy, The Institute of Clinical Sciences

What is the background of your dissertation?
“Major incidents’ incidence rates and severity have shown an upward trend in recent decades. These crises arise from various sources, including natural phenomena such as flooding and earthquakes, human-induced conflicts like wars and terrorism, and public health emergencies like the Ebola outbreak or the COVID-19 pandemic,” says Phatthranit Phattharapornjaroen, an emergency physician at Faculty of Medicine Ramathibodi Hospital, Bangkok, currently pursuing her doctorate at the Institute of Clinical Sciences in Gothenburg.

She continues, “These events impose significant economic tolls and strain healthcare resources, resulting in a disparity of healthcare supply and demand and additional loss of life. Community resources have emerged as a promising strategy in response to these challenges, particularly in scenarios where damaged infrastructure impedes resource distribution. However, the practical application of such an approach has encountered obstacles due to the intricate nature of contextual factors and healthcare system dynamics.”

Studies conducted in Bangkok

What is your research about?
“The thesis delved into utilizing a community resource called the ‘Flexible Surge Capacity’ (FSC) concept. The studies began with developing a conceptual framework to illustrate a strategy for community resource engagement. This framework laid the groundwork for later studies on feasibility and applicability, which involved implementing complex interventions in healthcare science.”

How was the implementation of the FSC concept done?
“The concept was implemented in feasibility studies examined through a cross-sectional survey conducted in communities in Bangkok and applicability studies conducted during a pandemic-induced hospital overload, where it was used to supply patient care, easing the burden on hospitals. The data were collected through observation and survey. Additionally, the concept was applied in a scenario where the hospital faced imminent threats and required evacuation with the assistance of local and external resources. The application of the concept to hospital evacuation was successfully conducted through the three-level collaboration exercise. This exercise measured the levels of collaboration, learning, and usefulness of the concept.”

“Concept proven effective”

What are the key research findings and what practical applications can they have?
“The FSC concept was feasible and applicable in a community where there is a noticeable daily disparity between healthcare supply and demand, which worsens during crises. Additionally, the concept has proven effective across various incidents, especially when hospitals are at risk and require relief or evacuation measures. The thesis serves as a comprehensive link between research on complex interventions and their implementation within the intricate health system”.

“A pleasant surprise”

What aspects of your doctoral project have been enjoyable and challenging?
“The most fulfilling and enjoyable aspects were the full collaboration proven by the community facilities testing the concept. These facilities showed remarkably high engagement and capacities, which was a pleasant surprise. However, a subsequent challenge in the future arises in setting up a systematic and digital process for registering and mobilizing these community resources when their assistance is needed,” says Phatthranit Phattharapornjaroen, adding:

“Furthermore, the research methods for disasters and public health emergencies predominantly utilized mixed methods, integrating qualitative and quantitative methodologies. Ensuring that these methodologies complemented each other posed a challenge from the outset.”

Text: Jakob Lundberg