Introduction: Traditional evacuation drills are costly, disrupt hospital routines, and require significant downtime, making it essential that hospital personnel fully understand evacuation concepts, challenges, and routes prior to full-scale drills. This study presents a novel token-based methodology for conducting hospital evacuation tabletop simulations, which serve as a vital preparatory step before large-scale drills. Methods: The methodology was tested in eight tabletop sessions at Fundación Cardioinfantil, a leading hospital in Colombia ranked third in Latin America. Participants included area leaders and key decision-makers responsible for crisis response, ensuring that the exercise closely mirrored the risk of structural collapse during an earthquake. The simulation begins with a detailed list of patients in the simulated area, including health status information, enabling participants to prioritize evacuations based on medical needs and vulnerabilities. A flow chart guides decision-making, helping participants sequence evacuations to prioritize critical patients while minimizing risks. Architectural plans are also used to identify main and alternative evacuation routes, providing a clear spatial understanding of the hospital’s layout. Participants used tokens representing patients and available hospital personnel (e.g., doctors, nurses, administrative staff) according to actual staffing levels during specific shifts to perform the feasible evacuations. This token-based approach allows participants to identify constraints and visualize challenges such as resource allocation and staff distribution during an emergency. Results: Feedback from participants highlighted several benefits, including improved insights into patient prioritization, identification of previously unclear evacuation routes, enhanced occupant distribution through different exits, and a heightened awareness of the availability of neighboring resources, such as additional space or staff. Challenges related to resource allocation were also identified, allowing the hospital to address potential gaps before a live evacuation. Conclusion: This tabletop methodology provides a robust, scalable approach, ensuring critical decision-makers are well prepared before executing full-scale exercises and improving the safety of evacuations in real emergencies.
Betancourt et al. (Sun,) studied this question.