Functionality assessment and improvement of medical buildings during the emergency: Incorporating resource restructuring and patient priority scheduling

This study proposes a comprehensive framework for post-earthquake functionality assessment of medical buildings. This framework incorporates the cascading damages of structural and non-structural components, medical equipment, and the functional interdependencies of subsystems by combining Bayesian networks and fault tree methods. Considering the emergency characteristics of medical buildings, the maximum treatable nominal number of earthquake casualties is proposed as the functionality indicator. The indicator is quantified by applying a Genetic Algorithm to a discrete event simulation model based on the Markov process. In this study, resource restructuring, medical room redistribution, and dynamic priority scheduling of casualties are introduced into the framework for the first time, which addresses the gaps in the dynamic changes and self-adaptation adjustments of emergency treatment scenarios. The operability and effectiveness of this framework are verified through numerical research on a hospital. This study analyzes the effects of cascading damages of components on hospital functionalities, revealing that hospital functionality is overestimated when the interdependence of components is ignored. Additionally, the study also validated the effectiveness of organizational management methods such as resource restructuring and redistribution, as well as dynamic priority scheduling of casualties, in improving hospital functionalities through parameter analysis methods.