The Quality of Hospital Disaster Plans in Belgium: Evaluation Research. Development and Content Validity of a Questionnaire to Define the Quality Key Performance Indicators Influencing Hospital Disaster Preparedness: A Modified Delphi Study

Abstract

Introduction:Emergency and disaster situations have a major impact on hospitals, some of which are already overloaded daily. The recent COVID-19 outbreak, attacks in Brussels, floods in Wallonia and influx of Ukrainian refugees show that the risk of facing a disaster and involvement of local hospitals (and stakeholders) is real. However, how hospitals implement their own hospital disaster plan (HDP), the position of the hospital disaster coordinator (HDC) and the real efficacy of these measures remain unclear. Therefore, an evaluation tool with an expert-consensus set of Key Performance Indicators (KPIs) and an evaluation of the HDC position is neededMethod:A semi-quantitative survey, as part of evaluation research, was designed by a research group. This questionnaire was based on the document analysis of the main topics of the national template and accompanying legislation. To establish consensus on the importance of the KPIs concerning the HDP, a three-round email-based modified Delphi study (Policy Delphi) was undertaken.Results:For a task group, 15 qualified multidisciplinary professionals (in-hospital) agreed to participate, 11 completed all rounds. As a pilot group, a total of 25 ‘experts on the field’, were purposively selected from Belgian hospitals, nine of them completed the questionnaire. The modified Delphi reached the agreed consensus threshold (i.e.75%), resulting in five main themes: demographic characteristics/profile HDC, hospital incident management system (HIMS), pre-incident phase, incident phase, post-incident phase. Collectively including a core set of 289 KPIs (29 indicators to assess progress concerning the HDC position).Conclusion:This study employed a modified Delphi approach to establish consensus, resulting in the development of an evaluation tool to measure hospital disaster preparedness and to evaluate progress of the HDC position within Belgian hospitals. All indicators were considered relevant and immediately implementable. When the implementation of KPIs is completed, the statement is that a HIMS exists within the hospitals.