{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:24:43Z","timestamp":1790691883267,"version":"4.1.0"},"reference-count":29,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T00:00:00Z","timestamp":1566518400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disaster med. public health prep."],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec id=\"S1935789319000697_as1\"><jats:title>Objective:<\/jats:title><jats:p>The study provides a comprehensive insight into how an initial receiving hospital without adequate capacity adapted to coping with a mass casualty incident after the Formosa Fun Coast Dust Explosion (FFCDE).<\/jats:p><\/jats:sec><jats:sec id=\"S1935789319000697_as2\"><jats:title>Methods:<\/jats:title><jats:p>Data collection was via in-depth interviews with 11 key participants. This was combined with information from medical records of FFCDE patients and admission logs from the emergency department (ED) to build a detailed timeline of patients flow and ED workload changes. Process tracing analysis focused on how the ED and other units adapted to coping with the difficulties created by the patient surge.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789319000697_as3\"><jats:title>Results:<\/jats:title><jats:p>The hospital treated 30 victims with 36.3% average total body surface area burn for over 5 hours alongside 35 non-FFCDE patients. Overwhelming demand resulted in the saturation of ED space and intensive care unit beds, exhaustion of critical materials, and near-saturation of clinicians. The hospital reconfigured human and physical resources differently from conventional drills. Graphical timelines illustrate anticipatory or reactive adaptations. The hospital\u2019s ability to adapt was based on anticipation during uncertainty and coordination across roles and units to keep pace with varying demands.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789319000697_as4\"><jats:title>Conclusion:<\/jats:title><jats:p>Adapting to beyond-surge capacity incident is essential to effective disaster response. Building organizational support for effective adaptation is critical for disaster planning.<\/jats:p><\/jats:sec>","DOI":"10.1017\/dmp.2019.69","type":"journal-article","created":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T07:38:39Z","timestamp":1566545919000},"page":"467-476","source":"Crossref","is-referenced-by-count":20,"title":["Coping With a Mass Casualty: Insights into a Hospital\u2019s Emergency Response and Adaptations After the Formosa Fun Coast Dust Explosion"],"prefix":"10.1017","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3099-3624","authenticated-orcid":false,"given":"Sheuwen","family":"Chuang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D.","family":"Woods","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsien-Wei","family":"Ting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard I.","family":"Cook","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiin-Chyr","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2019,8,23]]},"reference":[{"key":"S1935789319000697_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2011.06.012"},{"key":"S1935789319000697_ref15","first-page":"228","volume-title":"Decision Making in Action: Models and Methods","author":"Woods","year":"1993"},{"key":"S1935789319000697_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2009.12.003"},{"key":"S1935789319000697_ref22","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X00021294"},{"key":"S1935789319000697_ref1","doi-asserted-by":"publisher","DOI":"10.4172\/2167-0374.S3-001"},{"key":"S1935789319000697_ref26","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002148"},{"key":"S1935789319000697_ref9","first-page":"14","article-title":"Mass burn injury triage experience in Formosa Fun Coast Dust Explosion disaster of National Taiwan University hospital","volume":"26","author":"Chuang","year":"2017","journal-title":"J Taiwan Soc Plast Surg"},{"key":"S1935789319000697_ref28","volume-title":"Resilience Engineering in Practice","author":"Woods","year":"2011"},{"key":"S1935789319000697_ref23","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3181f3ed9c"},{"key":"S1935789319000697_ref3","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303261"},{"key":"S1935789319000697_ref14","doi-asserted-by":"publisher","DOI":"10.1109\/21.31053"},{"key":"S1935789319000697_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2017.04.032"},{"key":"S1935789319000697_ref12","doi-asserted-by":"publisher","DOI":"10.1037\/h0061470"},{"key":"S1935789319000697_ref27","doi-asserted-by":"publisher","DOI":"10.1001\/dmphp.D-09-00059R1"},{"key":"S1935789319000697_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2016.10.008"},{"key":"S1935789319000697_ref21","volume-title":"Guidance for Establishing Standards of Care for Use in Disaster Situations","author":"Altevogt","year":"2009"},{"key":"S1935789319000697_ref13","doi-asserted-by":"publisher","DOI":"10.1002\/j.0022-0337.2008.72.3.tb04496.x"},{"key":"S1935789319000697_ref8","first-page":"1","article-title":"Five critical clinical periods for managing mass burn casualties in Formosa Fun Coast Dust Explosion disaster \u2013 experience of tri-service general hospital","volume":"26","author":"Dai","year":"2017","journal-title":"J Taiwan Soc Plast Surg"},{"key":"S1935789319000697_ref7","first-page":"1372","article-title":"Progress in disaster planning and preparedness since 2001","volume":"306","author":"Inglesby","journal-title":"JAMA. 2011"},{"key":"S1935789319000697_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2017.06.011"},{"key":"S1935789319000697_ref19","doi-asserted-by":"publisher","DOI":"10.1002\/0471739448.ch6"},{"key":"S1935789319000697_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/S0733-8627(05)70262-5"},{"key":"S1935789319000697_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2010.08.002"},{"key":"S1935789319000697_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2016.10.016"},{"key":"S1935789319000697_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2005.11.023"},{"key":"S1935789319000697_ref5","unstructured":"5. 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