A Novel Operational Protocol for the Establishment of a Medical Facility for Receiving Returning Hostages: Structure, Process, and Outcomes

Introduction: On October 7, 2023, Hamas carried out an unprecedented attack on the State of Israel and kidnapped 251 people into captivity in the Gaza Strip. Several months later, as part of a humanitarian exchange deal, 105 hostages were released in five phases and admitted to one of six hospitals throughout the country for treatment. Shamir Medical Center (SMC) was one of these facilities. This study aims to describe the structure, process, and outcomes of establishing a comprehensive, multi-step operational protocol for receiving hostages returning from captivity. Methods: Description of the process of preparing SMC as a receiving center, the establishment of procedures for implementation of the medical protocol, and the assessment of multi-disciplinary team preparedness and implementation, and outcomes in an institutional protocol. Results: Twenty-four returning hostages were received at SMC. Social workers, dietitians, and translators were used by 100% of the majority group of returning hostages from the same country of origin, and the sole individual from the other country of origin utilized a dietitian, social worker, ENT consultations, and a hearing test. Among the majority group, orthopedic and dermatological consultations were utilized by 17.4%, and 13% received an ENT consultation. Of the administered imaging, 13% received a chest X-ray, 8.7% received a limb X-ray, 17.4% received a head CT scan, and 4.3% received an abdominal CT. In addition, 21.7% were provided with antibiotic therapy. Protocol efficacy was measured by assessing the time to various operational aspects of protocol implementation and medical procedures, such as the mean hours to room assignment, primary physician evaluation, and social worker session. No correlation between age and operational variables was found. Conclusion: This novel operational protocol was successfully implemented and may serve as a framework for managing similar unpredictable sensitive events in the case of future need.