Comprehensive Set Of Indicators Research Articles

Identifying the most significant indicators of the total road safety performance index

The review of the national and international literature dealing with the assessment of the road safety level has shown great efforts of the authors who tried to define the methodology for calculating the composite road safety index on a territory (region, state, etc.). The procedure for obtaining a road safety composite index of an area has been largely harmonized. The question that has not been fully resolved yet concerns the selection of indicators. There is a wide range of road safety indicators used to show a road safety situation on a territory. Road safety performance index (RSPI) obtained on the basis of a larger number of safety performance indicators (SPIs) enable decision makers to more precisely define the earlier goal- oriented actions. However, recording a broader comprehensive set of SPIs helps identify the strengths and weaknesses of a country’s road safety system. Providing high quality national and international databases that would include comparable SPIs seems to be difficult since a larger number of countries dispose of a small number of identical indicators available for use. Therefore, there is a need for calculating a road safety performance index with a limited number of indicators (RSPIlnn) which will provide a comparison of a sufficient quality, of as many countries as possible. The application of the Data Envelopment Analysis (DEA) method and correlative analysis has helped to check if the RSPIlnn is likely to be of sufficient quality. A strong correlation between the RSPIlnn and the RSPI has been identified using the proposed methodology. Based on this, the most contributing indicators and methodologies for gradual monitoring of SPIs, have been defined for each country analyzed. The indicator monitoring phases in the analyzed countries have been defined in the following way: Phase 1- the indicators relating to alcohol, speed and protective systems; Phase 2- the indicators relating to roads and Phase 3- the indicators relating to trauma management. This will help achieve the standardization of indicators including data collection procedures and selection of the key list of indicators that need to be monitored. Based on the results, it has been concluded that the use of the most contributing indicators will make it possible to assess the level of road safety on a territory, with an acceptable quality score by focusing on the low-ranked countries. A smaller set of significant indicators defined in this manner can serve for a fast and simple understanding of a road safety situation and assessment of effects of measures undertaken. Also, this universal index approach is applicable in cases when a broader comprehensive set of indicators is analyzed, which provides a more accurate identification of weaker points and rank the countries in a more meaningful way.

A critical perspective on the empirical evidence toward economic performance indicators in vocational education and training

The starting point for this contribution is provided by the two central reporting series “National Reports on Education” as well as the “Report on Vocational Education and Training” with the corresponding “Vocational Education and Training Data Report”. These regularly published reports include a comprehensive set of indicators for the description of economic performance in Vocational Education and Training. Since 2016, both series have also been supplemented by the “Vocational Education and Training Report at Federal State Level”. This monitor provides additional and expanding insights into vocational education and training and focuses more on the governance level of the federal states policy and the regional conditions of vocational education and training. The aim of this article lies on a critical perspective on the empirical evidence toward the performance indicators of the previously mentioned report systems. The limits and challenges of these indicators are determined. Indeed, corresponding indicator-based reports are limited by deficient data, but it is questionable, whether the lack of differentiation by regions and professions does limit the validity of these indicators.

A socio-eco-efficiency analysis of integrated and non-integrated crop-livestock-forestry systems in the Brazilian Cerrado based on LCA

Crop-livestock-forest (CLFi) and crop-livestock (CLi) systems are among the most recent agricultural developments in Brazil, and aligned with the principles of cleaner production. Such integrated systems can provide at least three types of product from the same land area over a defined period. This paper presents a holistic sustainability evaluation using life cycle assessment to compare combinations of integrated and conventional systems in the Brazilian Cerrado region. The study assesses a comprehensive set of indicators in the three sustainability dimensions: environmental, economic, and social (socio-eco-efficiency). By prioritizing CLFi, the production area to meet the demand of grains, meat and energy for 500 Brazilians, from 2007 to 2014, reached 70 ha, while the conventional systems would need 420 ha to meet the same demand. This result shows that it is possible to increase production to meet the growing food global demand without the need of expanding the agricultural frontier, preserving the remaining forestland. CLFi combinations systems decreased 55% in climate change potential (2389 t of CO2 equivalent), when compared to the conventional systems. It was also observed that the more integrated systems improved the quality of employment, promoted future generation investments in society, and decreased the total production costs in 54%, when compared to conventional systems. Therefore, intensification achieved through good practices such as association, rotation, and succession by an agroforestry system, optimization of inputs (including water, energy, fertilizers, and crop protection agents), land use, soil quality, biodiversity and social aspects.

THE SET OF PERFORMANCE INDICATORS IN TRANSPORT AND FORWARDING SERVICES – CASE STUDY

This article applies to the set of performance indicators in companies operating in the transport and forwarding services. The authors described the importance of the process approach in the management of the organization, and its main requirements connected with the measurements and performance indicators. On this basis, the identification and analysis of the processes was carried out in small and medium-sized enterprises in the area of transport and forwarding. This is followed by a proposal to develop a performance measurement system dedicated to such companies. The system includes a comprehensive set of indicators to monitor the efficiency, effectiveness, timeliness and quality of the identified processes. The presented project is the original proposal of the authors, complementing the available literature knowledge. The paper depicts the research results which are based on a case study approach

A spatial evaluation of global wildfire-water risks to human and natural systems

The large mediatic coverage of recent massive wildfires across the world has emphasized the vulnerability of freshwater resources. The extensive hydrogeomorphic effects from a wildfire can impair the ability of watersheds to provide safe drinking water to downstream communities and high-quality water to maintain riverine ecosystem health. Safeguarding water use for human activities and ecosystems is required for sustainable development; however, no global assessment of wildfire impacts on water supply is currently available. Here, we provide the first global evaluation of wildfire risks to water security, in the form of a spatially explicit index. We adapted the Driving forces-Pressure-State-Impact-Response risk analysis framework to select a comprehensive set of indicators of fire activity and water availability, which we then aggregated to a single index of wildfire-water risk using a simple additive weighted model. Our results show that water security in many regions of the world is potentially vulnerable, regardless of socio-economic status. However, in developing countries, a critical component of the risk is the lack of socio-economic capability to respond to disasters. Our work highlights the importance of addressing wildfire-induced risks in the development of water security policies; the geographic differences in the components of the overall risk could help adapting those policies to different regional contexts.

IT-supported integrated care pathways for diabetes: A compilation and review of good practices.

IntroductionIntegrated Care Pathways (ICPs) are a method for the mutual decision-making and organization of care for a well-defined group of patients during a well-defined period. The aim of a care pathway is to enhance the quality of care by improving patient outcomes, promoting patient safety, increasing patient satisfaction, and optimizing the use of resources. To describe this concept, different names are used, e.g. care pathways and integrated care pathways. Modern information technologies (IT) can support ICPs by enabling patient empowerment, better management, and the monitoring of care provided by multidisciplinary teams. This study analyses ICPs across Europe, identifying commonalities and success factors to establish good practices for IT-supported ICPs in diabetes care.MethodsA mixed-method approach was applied, combining desk research on 24 projects from the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) with follow-up interviews of project participants, and a non-systematic literature review. We applied a Delphi technique to select process and outcome indicators, derived from different literature sources which were compiled and applied for the identification of successful good practices.ResultsDesk research identified sixteen projects featuring IT-supported ICPs, mostly derived from the EIP on AHA, as good practices based on our criteria. Follow-up interviews were then conducted with representatives from 9 of the 16 projects to gather information not publicly available and understand how these projects were meeting the identified criteria. In parallel, the non-systematic literature review of 434 PubMed search results revealed a total of eight relevant projects. On the basis of the selected EIP on AHA project data and non-systematic literature review, no commonalities with regard to defined process or outcome indicators could be identified through our approach. Conversely, the research produced a heterogeneous picture in all aspects of the projects’ indicators. Data from desk research and follow-up interviews partly lacked information on outcome and performance, which limited the comparison between practices.ConclusionApplying a comprehensive set of indicators in a multi-method approach to assess the projects included in this research study did not reveal any obvious commonalities which might serve as a blueprint for future IT-supported ICP projects. Instead, an unexpected high degree of heterogeneity was observed, that may reflect diverse local implementation requirements e.g. specificities of the local healthcare system, local regulations, or preexisting structures used for the project setup. Improving the definition of and reporting on project outcomes could help advance research on and implementation of effective integrated care solutions for chronic disease management across Europe.

Prevalence of production disease related indicators in organic dairy herds in four European countries

The aim of this study was to assess the prevalence of production disease related indicators on 192 organic dairy farms in Germany, Spain, France and Sweden. The following indicators were used: raised somatic cell count (>100,000 cells/ml, subclinical mastitis), high fat/protein ratio (risk of ketosis), low milk fat (risk of acidosis), prolonged calving interval, clinical lameness, and mortalities of calves and cows. Prevalence of the assessed indicators varied widely between farms and countries. The median prevalence (interquartile range) were 51.3% (15.4) for subclinical mastitis, 10% (7.7) for risk of ketosis, 3.2% (4.7) for risk of acidosis, 42% (20.7) for prolonged calving interval, and 14.2% (20.4) for clinical lameness. The incidence risk of calves dying between 1 and 90 days of age was 0.002 (0.043) per month of risk. Cow mortality was 0.026 (0.048) per year at risk. The assessment has shown that a comprehensive set of indicators can be calculated from readily available data, sparing the need to establish new and costly procedures. Future research should focus on strategies for using the information most effectively to reduce the level of production diseases in organic dairy farms.

A Systematic Literature Review Comparing Primary and Community Health Care Indicators and Measurement Frameworks

Measurement frameworks are essential in primary and community healthcare to help reduce unsustainable healthcare costs in many jurisdictions including Ontario, Canada. This paper presents a literature review of studies measuring the success of primary and community healthcare initiatives around the world carried out after 2003 in more than 15 countries. Some initiatives were fully deployed and others were in research or pilot mode. A comprehensive set of indicators is identified spanning four categories and nine domain areas. We discuss our observations showing the discrepancies that exist amongst the various studies and analyze the problems associated with these gaps. We proposed a new approach that we intend to pursue in more detail in future work. There is a lack of maturity in measuring the success of primary and community healthcare initiatives. There are opportunities in improving the situation by defining aggregate indices, working on standardization of indicators, and identifying measures that contribute to improving the system in place based on mining existing data and using a heuristics-based approach.

Ecosystem Health Assessment at County-Scale Using the Pressure-State-Response Framework on the Loess Plateau, China.

Assessing ecosystem health is helpful to determine reasonable eco-environmental restoration and resource management strategies. Based on a pressure-state-response (PSR) framework, a set of comprehensive indicators including natural, social and economic aspects was proposed and applied for assessing the ecosystem health of Yuanzhou County, Loess Plateau, Ningxia Province, China. The basic data used to calculate the values of the assessment indicators include Landsat TM image and socio-economic data, and remote sensing (RS) and the geographic information system (GIS) were used to process image data. The results showed that the ecosystem health conditions of most townships in Yuanzhou County were at the moderately healthy level, three townships were at the healthy level, and only two townships were at the unhelathy level; the areas (percentage) at the unhealthy, moderately healthy and healthy levels were 443.91 km2 (12.66%), 2438.75 km2 (69.54%) and 624.50 km2 (17.81%), respectively. The results could provide useful information for local residents and the government to take measures to improve the health conditions of their township ecosystem.

Multi-object approach and its application to adaptive water management under climate change

This paper addresses issues on adaptive water management under the impact of climate change. Based on a set of comprehensive indicators of water system, a decision making approach of multi-objects is developed and applied to quantify water adaptive management for the demands of water sustainable use, water environmental protection and eco-water requirement under the climate change. For this study in China, two key indicators are proposed, namely (1) the water resources vulnerability (V) that was represented by integrated sensitivity (S) and resilience (C) of climate change impact on water resources, and (2) the sustainability of socio-economy and water environment, marked by DD, that is integrated scaler of socio-economic development (EG) based on the amount of GDP and the water environment and relative eco-system quality (LI). To find a reasonable solution for adaptive water management, a multi-objective decision making model of adaptive water management is further developed and the multi-objective model was transformed into an integrated single optimization model through developing an integrated measure function, called as VDD=DD/V. This approach has been applied to adaptive water resources planning and management for case study of China with new policy, called as the strict management of water resources based on three red line controls, i.e., the control of total water use by the total water resources allocation, the control of lower water use efficiency by the water demand management and the control of the total waste water load by water quality management in the Eastern China Monsoon Region that covers major eight big river basins including Yangtze River, Yellow River, Haihe River and Huaihe River. It is shown that the synthetic representation of water resource vulnerability and socio-economic sustainability by the integrated objective function (VDD) and integrated decision making model are workable and practicable. Adaptive management effect of the criterion compliance rate and water use efficiency are more appreciable through new water policy of the three red line controls, which can reduce 21.3% of the water resources vulnerability (V) and increase 18.4% of the sustainability of socioeconomy and water environment (DD) for the unfavorable scenario of climate change in 2030.

Subjective Wellbeing, Objective Wellbeing and Inequality in Australia.

In recent years policy makers and social scientists have devoted considerable attention to wellbeing, a concept that refers to people’s capacity to live healthy, creative and fulfilling lives. Two conceptual approaches dominate wellbeing research. The objective approach examines the objective components of a good life. The subjective approach examines people’s subjective evaluations of their lives. In the objective approach how subjective wellbeing relates to objective wellbeing is not a relevant research question. The subjective approach does investigate how objective wellbeing relates to subjective wellbeing, but has focused primarily on one objective wellbeing indicator, income, rather than the comprehensive indicator set implied by the objective approach. This paper attempts to contribute by examining relationships between a comprehensive set of objective wellbeing measures and subjective wellbeing, and by linking wellbeing research to inequality research by also investigating how subjective and objective wellbeing relate to class, gender, age and ethnicity. We use three waves of a representative state-level household panel study from Queensland, Australia, undertaken from 2008 to 2010, to investigate how objective measures of wellbeing are socially distributed by gender, class, age, and ethnicity. We also examine relationships between objective wellbeing and overall life satisfaction, providing one of the first longitudinal analyses linking objective wellbeing with subjective evaluations. Objective aspects of wellbeing are unequally distributed by gender, age, class and ethnicity and are strongly associated with life satisfaction. Moreover, associations between gender, ethnicity, class and life satisfaction persist after controlling for objective wellbeing, suggesting that mechanisms in addition to objective wellbeing link structural dimensions of inequality to life satisfaction.

Analysis of lexical quality and its relation to writing quality for 4th grade, primary school students in Chile

Few studies have addressed vocabulary quality in developing writing skill in Spanish. Even less addressed it within the Chilean educational system. The specific objective of this study was to characterize, using a comprehensive set of indicators, the quality of the vocabulary produced by Chilean 4th grade students. Based on a national writing survey, a sample of 2056 texts written by 685 students was collected (narrative, persuasive, and informative texts). Current literature defines lexical quality as a composite of diverse factors that, while distinct, are interrelated. To represent the properties of the vocabulary, a set of indicators were selected: (a) lexical diversity; (b) lexical sophistication; and (c) lexical density. Using multilevel modeling (students and schools as levels 1 and 2) to explain a global writing score we found that diversity was a significant determinant for narrative and persuasive texts, density was a significant determinant for the three genres and sophistication was a significant determinant for narrative and expository text. In addition, indicators related to gender and socioeconomic conditions were only significant determinants of narrative stories. The parts of speech most often used also varied according to the purpose of each text. In all genres, words had a short extension and were very sensitive to the input presented in the stimuli. These results imply a significant challenge to this education system: how to promote the development of vocabulary in all children in order to support language learning.

Scaling of global input–output networks

Examining scaling patterns of networks can help understand how structural features relate to the behavior of the networks. Input–output networks consist of industries as nodes and inter-industrial exchanges of products as links. Previous studies consider limited measures for node strengths and link weights, and also ignore the impact of dataset choice. We consider a comprehensive set of indicators in this study that are important in economic analysis, and also examine the impact of dataset choice, by studying input–output networks in individual countries and the entire world. Results show that Burr, Log-Logistic, Log-normal, and Weibull distributions can better describe scaling patterns of global input–output networks. We also find that dataset choice has limited impacts on the observed scaling patterns. Our findings can help examine the quality of economic statistics, estimate missing data in economic statistics, and identify key nodes and links in input–output networks to support economic policymaking.

Development and initial validation of prescribing quality indicators for patients with chronic kidney disease

Quality assessment is a key element for improving the quality of care. Currently, a comprehensive indicator set for measuring the quality of medication treatment in patients with chronic kidney disease (CKD) is lacking. Our aim was to develop and validate a set of prescribing quality indicators (PQIs) for CKD care, and to test the feasibility of applying this set in practice. Potential indicators were based on clinical practice guidelines and evaluated using the RAND/UCLA Appropriateness Method. This is a structured process in which an expert panel assesses the validity of the indicators. Feasibility was tested in a Dutch primary care database including >4500 diabetes patients with CKD. An initial list of 22 PQIs was assessed by 12 experts. After changing 10 PQIs, adding 2 and rejecting 8, a final list of 16 indicators was accepted by the expert panel as valid. These PQIs focused on the treatment of hypertension, albuminuria, mineral and bone disorder, statin prescribing and possible unsafe medication. The indicators were successfully applied to measure treatment quality in the primary care database, but for some indicators the number of eligible patients was too small for reliable calculation. Results showed that there was room for improvement in the treatment quality of this population. We developed a set of 16 PQIs for measuring the quality of treatment in CKD patients, which had sufficient content and face validity as well as operational feasibility. These PQIs can be used to point out priority areas for improvement.

Measures of Quality of Care for People with HIV: A Scoping Review of Performance Indicators for Primary Care.

The healthcare of people with HIV is transitioning from specialty care to the primary healthcare (PHC) system. However, many of the performance indicators used to measure the quality of HIV care pre-date this transition. The goal of this work was to examine how existing HIV care performance indicators measure the comprehensive and longitudinal care offered in a PHC setting. A scoping review consisting of peer-reviewed and grey literature searches was performed. Two reviewers evaluated study eligibility and indicators in documents meeting inclusion criteria were extracted into a database. Indicators were matched to a PHC performance measurement framework to determine their applicability for evaluating quality of care in the PHC setting. The literature search identified 221 publications, of which 47 met inclusion criteria. 1184 indicators were extracted and removal of duplicates left 558 unique indicators. A majority of the 558 indicators fell under the ‘secondary prevention’ (12%) and ‘care of chronic conditions’ (33%) domains when indicators were matched to the PHC performance framework. Despite the imbalance, nearly all performance domains in the PHC framework were populated by at least one indicator with significant concentrations in domains such as patient-provider relationship, patient satisfaction, population and community characteristics, and access to care. Existing performance frameworks for the care of people with HIV provide a comprehensive set of indicators that align well with a PHC performance framework. Nonetheless, some important elements of care, such as patient-reported outcomes, are poorly covered by existing indicators. Advancing our understanding of how the experience of care for people with HIV is impacted by changes in health services delivery, specifically more care within the PHC system, will require performance indicators to capture this aspect of HIV care.

The evolution of Global Libraries’ performance measurement and impact assessment systems

Purpose – The purpose of this paper is to describe the evolution of a common approach to impact assessment across the Global Libraries (GL) portfolio of grants. It presents an overview of two systems, the Performance Metrics (PMs) and the Common Impact Measurement System (CIMS). By providing a standard set of definitions and methods for use across countries, these systems enable grantees to collect data that can be compared and aggregated for the purpose of collective learning, improvement, accountability, and advocacy. Design/methodology/approach – The PMs offer a standard methodology to collect library project performance management data, whereas the CIMS is a standard survey of public library users. The paper describes how the PM and CIMS data are being visualized and used, with examples of findings and lessons learned. Findings – The paper cites examples of the type of PM and CIMS data available, with a focus on employment, gender, and case studies from Botswana and Indonesia. These highlights illustrate how libraries’ user demographics differ from other types of public internet access venues and how libraries can contribute to strong employment and growth. Research limitations/implications – The measurement systems rely on different partners collecting data for the same metrics across different countries; while each grantee adheres to a standard methodology, small procedural, and methodological differences are inevitable. Future research could focus on conducting similar studies elsewhere, outside the cohort of countries in the GL portfolio of grants. Practical implications – The paper offers insights and lessons for library agencies or institutions interested in implementing a common measurement system. Recognizing that few library projects have the resources to track a comprehensive set of indicators, a case study is presented about how smaller initiatives can adapt these systems to their needs. Social implications – The indicators described in this paper enable public libraries to shift their focus from services provided to the outcomes they help individuals and communities realize, potentially increasing the potency of their programming and advocacy. Originality/value – Common measurement systems are not new, but their application in the public library field is novel, as is the Data Atlas, a platform grantees use to compare results across metrics, track progress, and conduct advocacy.

Performance Analysis of Hospital Managers Using Fuzzy AHP and Fuzzy TOPSIS: Iranian Experience.

Background and Objectives:Hospitals are complex organizations that require strong and effective management. The success of such organizations depends on the performance of managers. This study provides a comprehensive set of indicators to assess the performance of hospital managers in Iranian Ministry of Health owned hospitals.Methods:This research was a cross-sectional study. First, reviewing the literature and using experts’ viewpoints and convening a panel of experts, the dimensions of performance have been selected and came in the form of a performance model. Then, using Fuzzy Analytic Hierarchy Process (FAHP), the chosen dimensions were weighted. Finally, based on the weighted performance dimensions, a questionnaire was designed and after confirming the reliability and validity, through a census, 407 senior and middle managers from 10 hospitals in Yazd, Iran completed it and performance of CEOs in these hospitals was evaluated using the Fuzzy Technique for Order Preference by Similarity Ideal Solution (FTOPSIS).Results:To measure the performance of hospital managers, a performance assessment model consisted of 19 sub-dimensions in 5 main dimensions (Functional, Professional, Organizational, Individual and Human) was developed. The functional area had the most weight and the individual area had the least weight, as well. The hospital managers had different performance levels in each category and sub-dimensions. In terms of overall performance, the hospital managers C and H had the best and the worst performance, respectively.Conclusions:The use of appropriate dimensions for performance, prioritizing them and evaluating the performance of hospital managers using appropriate techniques, can play an effective role in the selection of qualified managers, identifying strengths and weaknesses in performance and continuous improvement of them.

A comparative analysis of global and national university ranking systems

Recent interest towards university rankings has led to the development of several ranking systems at national and global levels. Global ranking systems tend to rely on internationally accessible bibliometric databases and reputation surveys to develop league tables at a global level. Given their access and in-depth knowledge about local institutions, national ranking systems tend to include a more comprehensive set of indicators. The purpose of this study is to conduct a systematic comparison of national and global university ranking systems in terms of their indicators, coverage and ranking results. Our findings indicate that national rankings tend to include a larger number of indicators that primarily focus on educational and institutional parameters, whereas global ranking systems tend to have fewer indicators mainly focusing on research performance. Rank similarity analysis between national rankings and global rankings filtered for each country suggest that with the exception of a few instances global rankings do not strongly predict the national rankings.

On the Consequences of Pro‐Cyclical Fiscal Policy

AbstractThere is widespread evidence that pro‐cyclical fiscal policies have been prevalent in developing countries and often in some industrial nations. It is therefore surprising that, in contrast to the wealth of studies on the sources of pro‐cyclical policy, potential consequences of such seemingly suboptimal policies have been largely ignored in the existing literature. By utilising a comprehensive set of indicators from 114 countries for 1950–2010, we aim to address the following important question: does it matter whether a country adopts a pro‐cyclical fiscal policy stance rather than a counter‐cyclical one? Our results produce a resounding ‘yes’ to this question. We find that fiscally pro‐cyclical countries have lower rates of economic growth, higher rates of output volatility and higher rates of inflation.

Development of key indicators of hospital resilience: a modified Delphi study.

Hospital resilience is an emerging concept, which can be defined as 'a hospital's ability to resist, absorb, and respond to the shock of disasters while maintaining its critical health care functions, and then recover to its original state or adapt to a new one'. Our aim was to develop a comprehensive framework of key indicators of hospital resilience. A panel of 33 Chinese experts was invited to participate in a three-round, modified Delphi study to develop a set of potential measures previously derived from a literature review. In the first round, these potential measures were modified to cover the comprehensive domains of hospital resilience. The importance of proposed measures was scored by experts on a five-point Likert scale. Subsequently, the experts reconsidered their voting in light of the previous aggregated results. Agreement on measures was defined as at least 70% of the responders agreeing or strongly agreeing to the inclusion of a measure. A large proportion of preliminary measures (89.5%) were identified as having good potential for assessing hospital resilience. These measures were categorized into eight domains, 17 subdomains, and 43 indicators. The highest rated indicators (mean score) were: equipment for on-site rescue (4.7), plan initiation (4.6), equipment for referral of patients with complex care needs (4.5), the plan execution (4.4), medication management strategies (4.4), emergency medical treatment conditions (4.4), disaster committee (4.4), stock types and quantities for essential medications (4.4), surge capacity of emergency beds (4.4), and mass-casualty triage protocols (4.4). This framework identifies a comprehensive set of indicators of hospital resilience. It can be used for hospital assessment, as well as informing priority practices to address future disasters better.