Development of Sub-National Policies for Making Hospitals Safe from Disasters: Study in Yogyakarta Province, Indonesia

Abstract

Introduction:Disaster and emergency management planning has an essential role to ensure that hospitals can continue to function in disaster response situations. However, there are several gaps for safe hospital policies and implementations between national and provincial/district level. The Special Region of Yogyakarta, as one of the provinces with high disaster risk in Indonesia, initiated a study to identify local policies needed for safe hospitals.Method:Focus Group Discussion (FGD) series were conducted with several hospitals representing private, public, academic, and military hospitals located in the first ring of Mount Merapi, an active volcano located on the border between Yogyakarta and Central Java Province. The FGD participants consisted of the Hospital Disaster Plan team, hospital task force of COVID-19, emergency department and hospital management team. Three FGD were carried out with different topics of discussion in each session. The topics were hospital experiences in implementing Hospital Disaster Plans during COVID-19, hospital incident command, coordination and networking. In addition, they also conducted advocacy and public consultationResults:The study that involved 12 hospitals and 40 persons, resulting in 11 specific additional policies for Yogyakarta safe hospital which include; six additional Standard Operating Procedure (SOP) in terms of donation management, volunteers’ recruitment and cost claim; one initiated Memorandum of Understanding (MoU) for surge capacity; conducting functional exercise rather than full scale ritual simulation with management scenario, as well as develop two plans for cyber-attack and business continuity plan.Conclusion:The pocketbook of Yogyakarta’s safe hospital will be useful for more than 70 hospitals in implementing and developing their hospital disaster plan, improving coordination among hospitals in the disaster phase, as well as a lesson-learned process for other regions to develop their local-based safe hospital policies.