The hospital is nearby. But can it provide the care needed?

A hospital may be nearby, with a surgical department, operating theatres and an intensive care unit. But is that enough to include it in a medical plan for a particular type of injury?

Distance and a list of departments provide initial information. They do not yet explain who will receive the casualty, which intervention the team can perform, when it will become available, or what further treatment will require. Medical planning needs to move from the name of a facility to specific care available under specific conditions.

Recently, I collected information about hospital capabilities with precisely this purpose in mind. I prepared a list of questions beforehand, also using ChatGPT as a supporting tool. It helped me structure the conversations and avoid overlooking questions relevant to planning.

I asked about specialists and duty coverage, the types and frequency of operations, emergency procedures the facility did not perform, specialist arrival times, equipment, blood and medications. I also asked about operating tables, intensive care, support for burns and neurosurgical injuries, available investigations and whether they were accessible around the clock.

The most useful part was open discussion with medical leaders and surgeons. In my experience of these conversations, nobody concealed information or tried to claim capabilities beyond what they had. It led to a practical conclusion: direct contacts with medical leadership and the clinicians who actually deliver care help build a more complete picture.

Distance to the building and time to care

A plan can easily contain a line such as: “nearest hospital — surgery, ICU, CT.” Yet several uncertainties remain. Are the necessary people available at night? Can the team begin the required intervention after the casualty arrives? Can the facility support the patient after surgery? Will another transfer be needed?

I suggest considering distance alongside time to the required care. That depends on transport, reception, access to investigations, team preparation and the organisation of treatment. This approach helps identify which parts of the process still need clarification.

The updated JTS operational guideline on interfacility transport emphasises time to the required intervention, actual en route care capability and communication between those involved in patient transfer [3]. Its scope is the US military system. The relevant contribution here is the general logic of coordination; that system's organisational requirements do not automatically become requirements for a Ukrainian hospital.

A nearer facility may be useful for a particular stage of care even if it cannot provide the entire subsequent course of treatment. However, geographic proximity alone does not determine where a particular casualty should go. That is a clinical and organisational decision involving the patient's condition, available care and transport circumstances.

Three different questions about capability

For a working description of a hospital, I suggest separating three matters.

Reported capability describes the services the hospital says it can provide and the resources intended to support them. This is where understanding the facility begins, but it does not complete the check of availability.

Actual availability at a specified time concerns whether the necessary team, equipment, supplies and treatment space are available now or at the expected arrival time. Even a statement of nighttime availability needs clarification: is the specialist on site, on call, or available only for remote consultation?

Capacity under increased demand concerns what the hospital can add, how quickly and under which conditions. Receiving one severely injured patient and supporting several at the same time require different resources. Current workload and the ability to continue caring for existing inpatients also need clarification.

WHO's Hospital emergency response checklist recommends assessing expanded capacity in relation to staff, essential resources and suitable space, rather than bed numbers alone. It also addresses cooperation with other hospitals and interfacility transfer [2]. This is a general hospital emergency response tool.

An answer such as “we can activate several operating tables” therefore deserves a follow-up question: how many fully supported teams can work simultaneously? This includes surgical, anaesthetic and nursing staff, equipment, instruments, supplies and postoperative care. The same approach applies to ICU beds: a physical space and the ability to deliver treatment should be described separately.

Ask about the care the team actually delivers

WHO's official overview of Guidelines for essential trauma care connects services for injured patients with human and physical resources: staffing, training, infrastructure, equipment and supplies [1]. This offers a useful starting point for a conversation. What follows is my proposal for making that discussion more specific.

Personnel and duty coverage

“Do you have a surgeon?” should lead to more specific questions: who is actually on duty, which specialists are in the hospital, who must be called in, and who can make decisions about receiving and treating a patient? The discussion needs to include anaesthetists, operating theatre and intensive care nurses, diagnostic services and the personnel responsible for transfusion support.

For an on-call specialist, it is useful to distinguish the time needed to establish contact, the expected arrival time and the time until they are ready to work. If the estimate is approximate, record it as approximate. The expected time may change when calls overlap or circumstances change.

Night and weekend coverage deserves a separate question. An answer about daytime operations should not automatically be applied to every hour. This clarifies the service arrangement rather than questioning colleagues' competence.

Surgery and anaesthetic support

Rather than asking generally whether the hospital provides surgery, it is more useful to ask the team to describe the emergency procedures it performs and those requiring another facility. Where relevant, the conversation can cover experience with severe trauma, haemorrhage control and abdominal, thoracic or limb injuries, without becoming an examination of the clinicians' knowledge.

Operation frequency helps describe the team's practice, but is not sufficient evidence of competence on its own. A total number of procedures is difficult to interpret without their type, complexity, team composition and available conditions.

Anaesthetic support should be discussed alongside surgery. Who provides emergency anaesthesia? Are the necessary monitoring, ventilation, medications and postoperative observation available? What happens when the team is already caring for another patient? An equipment list should be supplemented by questions about availability and the people who use it.

Intensive care, burns and neurotrauma

The name “intensive care unit” still leaves the actual scope of treatment open. For planning, I would clarify the availability of staffed and equipped beds, personnel, respiratory support and monitoring, as well as the ability to continue caring for a critically ill patient until onward handover.

For burns and neurosurgical injuries, it is useful to describe initial care, stabilisation, specialist treatment and transfer arrangements separately. Access to a neurosurgical consultation does not establish access to a neurosurgical operation; the ability to receive a patient with a burn does not define the full extent of subsequent treatment.

These questions help identify the boundaries of care and the facility's place in subsequent treatment.

Diagnostics, blood and medications

For investigations, it is useful to record not only whether a service exists, but also its operating hours, how staff are brought in, and access to both the examination and its interpretation. A CT scanner in the building, access to the required scan at night and an available report are related but separate questions.

For transfusion support, I suggest asking which blood components are actually available, how they are obtained for emergency care, who coordinates compatibility procedures and replenishment, and what limitations apply when demand increases. A discussion of capability must not replace the established procedures for transfusion safety.

For medications, distinguish a drug included in procurement lists from one available for the required care at a particular time. Working records should retain the date and source of stock information: supplies change and are not a permanent characteristic of a hospital.

Leadership and clinical teams complement each other

My experience demonstrated the value of both levels of contact. Medical leadership helps explain how the hospital organises its work and cooperation. Clinicians directly involved in care can make its practical scope and conditions more specific. Combining these conversations gave me a fuller picture.

If answers differ, I suggest first clarifying the time, team and scope of care each person is describing. One may be talking about daytime work and another about duty coverage; one may mean the possibility of calling a specialist and another their presence now. Until the discrepancy is resolved, retain both answers and mark the uncertainty.

Communication also needs an agreement: who can confirm current availability, how to make contact outside working hours, and which backup channel has been agreed. Possessing a telephone number does not, by itself, establish an agreed process for receiving casualties.

For onward referral, clarify how clinical agreement, information handover and transport coordination are organised. JTS emphasises communication about actual capability between the transferring facility, transport team, medical coordination and receiving facility [3].

Record the basis of the answer as well as the answer

“Available around the clock” has a different evidential basis if it was reported during a conversation, stated in a document or separately confirmed by the responsible service. I suggest recording how each important piece of information was obtained.

A record might say “reported by medical leadership,” “reported by the duty clinician,” “confirmed by a document — title and date,” or “requires clarification.” If no other confirmation occurred, it should not be assumed. Confirmation of one item does not automatically confirm the entire record.

Unknown information is best left explicitly unknown. An unanswered question about nighttime diagnostics establishes neither availability nor unavailability. For planning, it remains an open issue with an identified way of clarifying it.

I propose no universal interval for repeat checks. Updating information depends on how changeable it is, changes in hospital operations and the consequences of an error for the plan. Changes in duty arrangements, notification of a temporary limitation or a new mission may justify revisiting the relevant entries. In an actual situation, current availability is clarified through the agreed communication process.

How this information supports a medical plan

A completed card helps describe the hospital's possible role in the care system: which treatment is available, what needs prior coordination and where another facility is required. It also shows which planning assumptions remain unconfirmed.

I would use this information to discuss primary and alternative options, communication requirements, patient escort and onward transfer. However, the card does not automatically determine a route. A specific evacuation requires an up-to-date clinical assessment, current receiving information, actual transport capabilities and decisions by responsible professionals within the established arrangements.

A hospital should not be assigned a military Role based on its departments, nor should a civilian trauma centre level from another country be transferred to it. These are different systems for describing and organising care. A working record is more precise when it names the specific service, conditions of availability and limitations rather than creating an unsupported category.

What does it mean to understand a hospital's capabilities?

For medical planning, understanding a hospital means having more than its address and department list. It means knowing which team can provide the required care, when, with what support, and what happens when its capabilities are insufficient.

My experience of collecting information demonstrated the value of open conversations with medical leadership and clinical teams. The next step I suggest is retaining those answers together with dates, availability conditions, sources and unresolved questions.

A useful planning description answers these questions: what care can be provided, who supports it, when it is available and what requires further coordination?

This clarification supports cooperation between colleagues and makes the assumptions in a medical plan visible. The hospital remains a partner with a defined scope of care, and its honestly described limitations become part of realistic planning.

Practical supplement: questions and a recording card

The following questions and card are author-proposed working tools for collecting information. They are not a validated scale, accreditation process or official trauma readiness standard. They provide no scores or “ready / not ready” rating.

A compact question list for the conversation

1. What emergency trauma care can you provide, and which interventions require another facility?
2. Who is actually available during the day, at night and on weekends: on site, on call or only for consultation?
3. If a specialist must be called in, what is the expected time to arrival and readiness to work? What affects that estimate?
4. Which emergency operations does the team perform? What are the type and frequency of that practice, and which procedures are not performed?
5. How many operating teams can work simultaneously with anaesthetic, nursing and material support? What is required to bring in another team?
6. What intensive care support is available, and what limits the admission of another critically ill patient?
7. What care for burns and neurotrauma can be provided before specialist treatment, and how is onward referral organised?
8. Which necessary investigations are available around the clock, who performs and interprets them, and what delays may occur?
9. How are emergency transfusion support, access to necessary medications and replenishment organised?
10. Who confirms current receiving capacity, how should clinical information be shared, and how is contact arranged outside working hours?
11. What changes with several simultaneous arrivals, and which additional resources can actually be brought in?
12. Which details still need clarification, how can they be confirmed, and how will changes be communicated?

Example of a blank recording card

The card is completed for operational use. Contacts and facility-specific limitations are not intended for the public article.

Complete a separate block for each capability. The vertical layout keeps the fields readable on a narrow screen.

Additional fields, where needed:

Sources

1. WHO / International Association for the Surgery of Trauma and Surgical Intensive Care. Guidelines for essential trauma care. Mock C, Lormand JD, Goosen J, Joshipura M, Peden M. Geneva: WHO, 2004. ISBN 92 4 154640 9. Official WHO overview. Scope: organisation of trauma care in health facilities, including clinics and hospitals, and the human and physical resources needed. The official overview was checked for this article; the full PDF was unavailable during preparation. The webpage date of 16 June 2012 is not the document's publication year. Detailed tables and sections have not been used as verified requirements.
2. WHO Regional Office for Europe. Hospital emergency response checklist: an all-hazards tool for hospital administrators and emergency managers. 2011. Full document. Text checked, including components 2, 5, 7 and 8 on communication, surge capacity, personnel and resources. Scope: general hospital emergency response, rather than dedicated trauma centre accreditation.
3. Joint Trauma System / Committee on En Route Combat Casualty Care. Interfacility Transport of Patients Between Medical Treatment Facilities. Operational Guideline, 12 December 2025, superseding the version of 24 April 2018. Full document on the JTS website. The cover date and the Introduction, Expected ERC Capabilities and Patient Movement/Evacuation Coordination Elements sections were checked. Scope: the US military system and intra-theater interfacility transport. It is not used here as a regulatory readiness standard for a Ukrainian hospital.

Sources checked during preparation on 3 October 2026.

Revision date: 03.10.2026