Hospital Disaster Preparedness Research Articles

Exploring disaster preparedness in an obstetric unit in a district hospital in the Western Cape Province

BackgroundResearch on disaster preparedness in public hospitals is limited, and specialised units such as obstetric departments need to be even more prepared when rendering health care to vulnerable populations. Disasters can be natural, such as floods due to human interventions, sinkholes due to mining, or pandemic occurrences, such as the recent COVID-19 pandemic. Research on disaster preparedness is limited, and even more so in specialised units such as obstetrics and evacuating a ward of maternal and neonatal patients present unique challenges. Being prepared for any disaster is the only assurance of effective patient healthcare during a disaster. This study explored and described nurses’ knowledge and attitudes regarding preparedness for a disaster in an obstetric unit in a public institution. The study aimed to make recommendations to improve disaster preparedness in an obstetric ward based on the nurses’ knowledge and attitudes.MethodsThis study utilised an exploratory, descriptive qualitative design within a contextual approach. The data were acquired through individual interviews that were done using a semi-structured interview schedule. An observational walkabout was performed with the unit manager to validate interviewee responses. The study employed purposive sampling with a sample size of 17 nurses (N = 32, n = 17) and a response rate of 53%. The interviews were transcribed verbatim, and later, the data underwent analysis using theme analysis and a co-coder.ResultsThe results indicate that the participants demonstrate an awareness of disaster terminology but need more assertiveness in executing the institutional disaster policy. The results illustrate that more frequent training, disaster rehearsals, and simulations should be implemented to improve disaster readiness. Strategies are recommended to enhance preparedness for a disaster in the obstetric unit.ConclusionThe study findings recommend more education and training opportunities that should be regularly instilled as a practice within the obstetric ward. More disaster drills and simulation exercises should be performed to ensure confidence in disaster preparedness. Obstetric staff of all levels should be involved with policymaking and disaster plan development.

Knowledge, Attitudes and Practices among Medical Officers on Disaster Preparedness: Study from Base Hospital Panadura (BHP) and Kethumathi Maternity Hospital (KMH), Panadura in Western Province


 
 
 Climate change is contributing to increased disasters in the world. As the disaster events are rising, health, socio-economic and political consequences are inevitable. Therefore, managing disasters to reduce the risk and impacts is given high priority in any development agendas. In this context, emergency and disaster preparedness have become a vital element in disaster management. To manage disaster induced health impacts that include deaths and injuries, hospitals play a major role. The objective of this study was to investigate the knowledge, attitudes, and practices of medical officers on disaster preparedness in two key hospitals in the country. The present study focused on the medical officers in Base Hospital Panadura (BHP) and Kethumathi Maternity Hospital (KMH) regarding disaster preparedness. Cross-sectional research was designed to collect data from the health personnel working in two hospitals through a questionnaire which was prepared and distributed online. Data were collected from 95 and 17 doctors, who were randomly chosen, from BHP and KMH respectively. The majority of the respondents (93%) stated that hospital disaster preparedness plans could assist in reducing morbidity and mortality during an event of a disaster. In both hospitals, 40% of respondents were familiar with the disaster preparedness (DP) programs and 60 % were aware that such programs exist in their hospital. Around 67% and 65% of the medical officers from BHP and KMH respectively had stated that the prior experience of the medical officers is the key to handling a post disaster health management. The statistical analysis indicated that knowledge and practices of the medical officers were significantly linked to DP while the attitudes of the participants did not demonstrate any link to the DP programs. In summary, enhancing knowledge and good practices aiming at post disaster medical care as well as enhanced disaster preparedness activities among the medical officers contribute to disaster risk reduction.
 Keywords: Disaster preparedness, Knowledge, Attitudes, Practices, Medical officers
 
 

How the Creation of Healthcare Preparedness Measures Can Improve Community Medicine: The Link Between Healthcare Payment Policy and Disaster Preparedness

The Covid-19 pandemic highlighted the need to better understand the relationship between value-based payment programs and hospital disaster preparedness

Disaster Preparedness in Hospitals.

Disaster preparedness in hospitals is a critical global concern that involves proactive measures to mitigate the impact of natural or artificial disasters. The review emphasizes the role of organizations such as India's National Disaster Management Authorityin the development of response strategies. Hospitals face challenges in protecting facilities and healthcare workers during disasters, highlighting the need for effective training, equipment, and communication access. Differentiating disasters into natural, technological, and artificial types showcases the varied challenges each presents. Key challenges include resource allocation, interoperability of the communication system, evacuation strategies, and ethical considerations. Essential strategies include risk assessment, staff training, communication, and collaboration with external partners. Hospital disaster preparedness requires a comprehensive approach that involves strategies, training, and community participation to ensure safety during emergencies.

Examining the components and validity of hospital disaster preparedness tools

There are numerous gaps in hospital-disaster-preparedness in developing countries. Presently, there are no widely accepted tools to assess preparedness in Sri Lankan hospitals. As a first step towards developing a comprehensive tool for local hospitals, a thorough understanding of the existing tools is required. The purpose of this study was to examine the content and the validity and reliability of the tools used for hospital preparedness studies worldwide. A systematic review was conducted on three databases. The chosen study instruments were compared to the WHO's Hospital Emergency Response Checklist to identify the common components. The validity and reliability of those study instruments were also analysed. Out of the 53 selected studies, 26 did not reported either validity or the reliability. The majority of the tools had prioritized human resources and logistics management. Face validation was the frequently used validation method, and internal consistency was the frequently used reliability measure. However, the most hospital preparedness assessments had been conducted without using a reliable instrument. Crucial preparedness aspects were also neglected in majority of the tools. Different methods for assuring the validity and reliability were discovered. Findings of this study will guide future efforts in formulating a comprehensive hospital readiness tool.

Hospital Disaster Preparedness: A Comprehensive Evaluation Using the Hospital Safety Index

Mass-casualty incidents and disaster scenarios pose significant challenges for medical facilities, necessitating robust preparedness measures. This study aimed to evaluate the preparedness of a specific medical facility in Poland, using the hospital safety index (HSI). A comprehensive analysis of structural, functional, and organizational factors was conducted, assessing facility infrastructure, technical facilities, safety standards, work organization, cooperation with external facilities, human resource management, crisis planning, and communication strategies. The facility exhibited strengths in infrastructural requirements and inter-facility cooperation. Areas of improvement included adherence to safety procedures, crisis communication, and the frequency of evacuation drills. Furthermore, recommendations were provided for enhancing nurse reserves, adopting lean management, promoting a safety culture, and refining business continuity plans. The findings should be interpreted with caution, due to the single-facility focus, potential HSI protocol subjectivity, and the possible Hawthorne effect. This study underscores the importance of continuous research and improvement in crisis management strategies and disaster-victim care, emphasizing the pivotal role of the HSI as an evaluative tool.

Knowledge, attitude, and practices about disaster preparedness among resident doctors in a tertiary care teaching hospital in Delhi, India: A cross-sectional study.

Disasters pose various challenges to hospitals' functioning during calamities. Resilient health system is the need of the hour. To work as a safe hospital even during disasters, it is important to sensitize, orient, and train doctors and other medical professionals towards disaster preparedness. This study was conducted to study the knowledge, attitudes, and practices about disaster preparedness among resident doctors. It was a cross-sectional study conducted amongst 363 resident doctors of a tertiary care teaching hospital in Delhi, India. A pretested self-administered semistructured questionnaire was used to gather information. Analysis was done using the SPSS version 21.0 and employing descriptive -statistics. Mean age of the participants was 28.1 ± 2.8 years. Ninety-four (25.9 percent) study participants were found to have good/excellent knowledge about disaster preparedness, only 16.5 percent (60) had good awareness about the hospital's disaster preparedness, and 306 (84.3 percent) study participants had a favorable attitude towards disaster preparedness. Age and educational qualification were found to be significantly associated with knowledge about disaster preparedness. Only 11.6 percent (42) resident doctors attended any mock drill for disaster preparedness in the past 1 year and less than one-fifth (68, 18.7 percent) received training in disaster preparedness. A majority of study participants had a favorable attitude in spite of inadequate knowledge and aware-ness about disaster preparedness. There is a need to address this mismatch between knowledge and attitude through regular sensitization and retrainings along with frequent practical drills and simulation exercise.

Disaster response readiness assessment of public hospitals in Addis Ababa City, Addis Ababa, Ethiopia.

Introduction: Due to its diverse geography, climate, and political instability, Ethiopia is one of the countries most affected by disasters. However, there is a lack of evidence-based assessments of disaster preparedness, especially in Addis Ababa, where most tertiary-level referral hospitals are located. This study aims to evaluate disaster readiness in public hospitals in Addis Ababa using WHO standards, focusing on hospital characteristics, disaster plans, infrastructure, and human resources availability. Ultimately, the findings are expected to provide actionable recommendations for improving disaster preparedness in public hospitals in the city. Methods: A cross-sectional study design was utilized using quantitative and qualitative methods to assess disaster response readiness among public hospitals in Addis Ababa, the capital city of Ethiopia. Results: This study assessed ten public referral hospitals in Addis Ababa. In the last two years, all but one of the ten public referral hospitals in Addis Ababa have experienced a disaster. Road traffic accidents are responsible for half of all disasters. While 50% of the hospitals have trauma-specific plans, there are no disaster-specific guidelines for the remaining hospital. Moreover, all facilities and ambulances lack communication networks to receive assistance during disasters. A total of 88.8% of emergency and disaster facility level representatives (n=18) stated that their emergency care areas need improvement to be able to manage patients during disasters more effectively. While seven hospitals (70%) have separate disaster medication and equipment storage, only three (43%) are regularly restocked. Furthermore, nearly half of the respondents (44%) reported that their hospital does not have a functional disaster management team, and 61% are unprepared to handle a disaster. Lastly, 33% of the respondents mentioned the Ministry of Health and hospital leaders' commitment as an enabling factor to improve future disaster response readiness. Conclusion: Public referral hospitals in Addis Ababa have significant gaps in disaster management preparedness and response. A comprehensive disaster response plan, including staff training, regular restocking of medication and equipment, and functional communication networks, should be implemented in every public referral hospital. It is imperative that all stakeholders work together, including local government authorities, emergency response teams, and community members, to ensure hospitals are well-equipped to deal with disasters.

Assessing hospital disaster preparedness: A scoping review of available tools.

One of the problems faced after a disaster is health service for victims and hospitals play a critical role in handling disaster victims. Therefore, hospitals must enhance their preparedness and establish a disaster-safe environment to effectively fulfill their role as a provider of health services during a crisis. The aim of this scoping review was to identify hospital disaster preparedness tools used around the globe and to identify the critical aspects that need to be included in hospital disaster preparedness. This study used the five stages of Arksey and O'Malley's scoping review framework to determine what disaster preparedness tools can be used in a hospital setting. The electronic literature searches of English articles published between 2018 and 2023 were conducted using PubMed, Elsevier, ProQuest, ISI Web Science, and Google Scholar databases. The searched keywords were combined into several search terms such as sub-discipline, subtitle, year, language, and content type. The keywords of sub-title searching were "preparedness", "hospital" and "disaster". After applying some inclusion criteria, ten articles out of 1,221 identified records were included in the final analysis. The World Health Organization (WHO) Hospital Safety Index, WHO Hospital Emergency Checklist or their modified versions, and modified Public Health Emergency Preparedness were tools used in assessing hospital disaster preparedness. These tools evaluate some aspects such as structural safety, non-structural safety, and functional capacity. The studies indicated that each tool used to measure hospital disaster preparedness has strengths and weaknesses in each assessed aspect. Although some tools have been recommended to assess hospital disaster preparedness, assessing each tool validity and reliability are critical and needs to be conducted.

Development and update of hospital disaster preparedness and response plan of 25 hub hospitals of Nepal – process documentation

Hospital disaster preparation involves creating systems and processes to enhance a hospital's readiness for emergencies. The first step in crisis management is having a disaster management strategy, mandated by international agreements like the Sendai Framework. The 2015 Nepal earthquake highlighted hospitals' capacity concerns, leading to the inclusion of hub and satellite hospitals in disaster plans. Later, infectious disease management and lessons from COVID-19 were incorporated. The disaster plans for Nepal's 25 hub hospitals, collaborating with Health Emergency Operation Center (HEOC) and Provincial Health Emergency Center (PHEOC), were updated. Workshops aimed to empower participants to own hospital plans. The Hospital Disaster Preparedness and Response Plan (HDPRP) addresses preparedness, response, and recovery, including COVID-19 management. Developed through testing, the HDPRP, along with workshops and engagement strategies, bolsters hospitals' disaster response capabilities.

Management of Mass-Casualty Incidents in Nepal: A Qualitative Case Study of Three District Hospitals in Nepal.

The frequency of disasters world-wide has significantly increased in recent years, leading to an increase in the number of mass-casualty incidents (MCIs). These MCIs can overwhelm health care systems, requiring hospitals to respond quickly and effectively, often with limited resources. While numerous studies have identified the challenges in managing MCIs and have emphasized the importance of hospital disaster preparedness, there is a research gap in the preparedness level and response capacities of district hospitals in Nepal. This study attempts to fill this gap by understanding the perception of hospital staff in managing MCIs in district hospitals of Nepal. A qualitative case study was conducted in three district hospitals in Nepal. Semi-structured interviews were conducted with the hospital personnel, using an interview guide. An inductive thematic analysis was carried out to understand their perception on the most recent MCI management. Three themes emerged from the data analysis: enablers in MCI management, barriers in MCI management, and recommendations for the future. Use of multiple communication channels, mobilization of entire hospital teams, mobilization of police in crowd control, presence of disaster store, and pre-identified triage areas were the major enablers that facilitated successful MCI management. Nonetheless, the study also revealed challenges such as a lack of knowledge on MCI response among new staff, disruptions caused by media and visitors, and challenges in implementing triage. This study emphasized the importance of hospital disaster preparedness in managing MCIs and highlighted the significance of overcoming barriers and utilizing enablers for an efficient response. The findings of this study can provide the basis for the Ministry of Health and Population Nepal and district hospitals to plan initiatives for the effective management of MCIs in the future.

Developing a hospital disaster preparedness evaluation tool for Sri Lanka - A modified Delphi study

The 2005 World Conference on Disaster Reduction promoted the “Safe Hospitals” concept, which ensures that all new hospitals are built with a level of resilience that strengthens their capacity to remain operational in disaster situations. Also, the model endorsed the implementation of mitigation measures to strengthen existing health facilities. So far, there is no widely accepted and validated toolkit for conducting hospital disaster preparedness assessments in Sri Lanka. To address this shortcoming, this study aimed to create a comprehensive hospital disaster preparedness evaluation tool for Sri Lanka. A modified Delphi technique was used to develop this toolkit. The Delphi panel consisted of 18 local experts in health disaster management. A draft toolkit was prepared by the research team using the knowledge gained through an extensive literature review. The panel of experts rated the importance of each indicator in the draft toolkit on a five-point Likert Scale, ranging from extremely important to not at all important. Also, they were requested to suggest new indicators to improve the toolkit. Three rounds of Delphi process were conducted to obtain the consensus. To be included in the final toolkit ≥80% agreement was required for any indicator. All the indicators which failed to obtain 80% agreement were rejected at the third round. A comprehensive toolkit for hospital disaster preparedness was developed through the consensus of local experts based on an all-hazards approach. The finalized toolkit was comprised of 142 indicators under 15 themes designed on the 4S’s domains of preparedness; space, stuff, staff and systems.

Hospital disaster preparedness in sub-Saharan Africa: a systematic review of English literature

BackgroundDisasters are increasing worldwide, with Sub-Saharan Africa (SSA) being one of the most prone regions. Hospitals play a key role in disasters. This study provides a systematic review of the evidence on disaster preparedness by hospitals in SSA countries based on English literature.MethodsA systematic literature review was conducted of articles published between January 2012 and July 2022. We searched PubMed, Elsevier, Science Direct, Google Scholar, the WHO depository library and CDC sites for English language publications. The key inclusion criteria were: publications should have been published in the above period, deal with hospital disaster preparedness in SSA, the full paper should have been available, and studies should have presented a comparison between hospitals and/or a single hospital.ResultsResults indicate improvements in disaster preparedness over time. However, health systems in SSA are generally considered vulnerable, and they find it difficult to adapt to changing health conditions. Inadequately skilled healthcare professionals, underfunding, poor knowledge, the absence of governance and leadership, lack of transparency and bureaucracy are the main preparedness barriers. Some countries are in an infancy stage of their health system development, while others are among the least developed health system in the world. Finally, a major barrier to disaster preparedness in SSA countries is the inability to collaborate in disaster response.ConclusionsHospital disaster preparedness is vulnerable in SSA countries. Thus, improvement of hospital disaster preparedness is highly needed.

Hospital disaster preparedness in the Netherlands

IntroductionDespite having a good health care system, recent studies show that the Netherlands scores low on hospital disaster preparedness. A possible reason could be that there is a Dutch framework based on self-evaluation and intercollegiate evaluation but no formal set of requirements for hospital disaster preparedness plans. Study ObjectiveEvaluation of disaster preparedness of hospitals in the Netherlands by using the WHO Hospital Emergency Response Checklist to systematically assess the quality, strengths, and weaknesses of Dutch hospital disaster preparedness plans. MethodsHospital crisis coordinators sent their most recent disaster hospital plan and crisis plan. Two researchers independently studied and scored the content of the received plans according to the WHO Checklist. Overall scores per hospital and key components were calculated based on the number of points assigned to each priority action. ResultsTwenty hospitals (29% of all Dutch hospitals) participated in the study and scored between 33 and 97 out of 184 points. Twelve hospitals scored ‘insufficient’, eight scored ‘unacceptable’ according to WHO cutoff points. No hospital scored ‘effective’. The key components command and control, triage, and communication scored highest. Logistics and supply management, human resources, and continuity of essential services scored low. An unexpected finding was a large variety in configuration of the studied plans. ConclusionNone of the participating hospitals reached an effective preparedness score. Issues that received attention in response to previous disasters scored well on the WHO Checklist. Components that were not addressed in the Dutch evaluation framework for crisis management scored low.

Kesiapsiagaan Bencana Perawat di Rumah Sakit Rujukan pada Area Rentan Bencana di Indonesia: Studi Deskriptif

Background. Indonesia based on its geographical, geological, hydrological and demographic conditions is prone to disasters. Pre-disaster preparedness in health services are very important phases in reducing the impact of a disaster. Nurses are health workers with the largest number in a hospital, and have an important role in a disaster.The purpose of this study was to explore nurses’ perception regarding disaster preparedness in referral hospitals in disaster-prone areas in Indonesia.
 Methods. This study was a cross-sectional study. The cluster random sampling technique was used in the recruitment of 217 respondents from 4 referral hospitals in Indonesia. Self-report questioner were utilized and it was modified from Disaster Preparedness Evaluation Tool (DPET) and Emergency Prepardeness information Questionairre (EPIQ). Univariate and bivariate analyses were applied to describe the data.
 Results. The mean age of the respondents was 37.6 ± 8.9 years and the average length of service was 14 years ± 9.6 years. Respondents were mostly female, had vocational education level, were married, worked in wards, worked as clinical nurse, had no disaster experience but worked in hospitals that had experienced disasters. The average of nurses’ perception of disaster preparedness is 2.68 ± 0.32. Respondents have attended 88.5% BHD training, 76.5% APAR, 60.8% fire simulation and 42.4% earthquake simulation. Disaster experiences and research locations influence the disaster preparedness of nurses in referral hospitals in Indonesia. There were no statistically significant differences in nurses’ preparedness for disasters on gender, education level, marital status, place of work, position.
 Conclusion. Nurses’ experience in dealing with disasters increases the perception of disaster preparedness among nurses. Therefore, regular training and simulations are required in the health services of disaster-prone areas in Indonesia.

Factors influencing hospital preparedness and resilience for emerging infectious diseases: a systematic review

Hospitals have crucial roles during an outbreak of emerging infectious diseases. They are expected to manage the surge of patients while continuing essential health services. This study aims to investigate the factors that influence hospital disaster preparedness and resilience in facing emerging infectious disease threats. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) method. International electronic databases, including PubMed, Science Direct, ProQuest, and SAGE, were investigated for the research studies that were published between 2001 and 2022 in English-language. The inclusion and exclusion criteria were determined to extract factors or indicators influencing hospital disaster preparedness and resilience encounter emerging infectious diseases. For the initial 672 articles, we identified 16 articles that specifically addressed the aims of this review and formed the basis of the intended analysis. Seven factors influence hospital preparedness, with human resources and crisis management being the most important. The hospital’s resilience has 18 factors that are classified according to the disaster phase. Hospital resilience is concerned with all phases of a disaster (mitigation, preparedness, response, and recovery), not just operational management during a disaster (as is preparedness).

Implementation of Hospital Disaster Preparedness and Response Plan in Nepal: A Mixed Study in 3 Public Hospitals of Nepal

Introduction:Considering the need for hospital disaster preparedness post-Nepal earthquake 2015, the Ministry of Health and Population of Nepal developed a Hospital Disaster Preparedness and Response Plan (HDPRP) for mass casualty management. However, until now, there is no scientific literature on how the district hospitals, which are the major health service providers in Nepal, implemented their HDPRP during mass casualty incidents (MCIs). So, this study aims to understand how the HDPRP was implemented during MCIs in three district public hospitals of Nepal.Method:A mixed sequential QUANT-QUAL study was designed. Out of seven districts under the severely hit category by Nepal Earthquake 2015, three districts were selected randomly. For the quantitative component, the WHO hospital emergency response checklist was adapted which was self-administered in each hospital. Based on a scoring system, each hospital was placed in one of three categories (effective, insufficient, unacceptable), to assess the level of HDPRP implementation. For the qualitative component, semi-structured interviews were conducted to understand how the HDPRP was implemented in each hospital. An inductive thematic analysis was carried out. All information was collected for the most recent management of MCI reported in the hospital.Results:Out of three hospitals, two hospitals have effectively implemented their HDPRP, whereas one has insufficient implementation. Three themes emerged during the data analysis: enablers in implementation of HDPRP, barriers in implementation of HDPRP, and recommendations for the future. Multiple enablers and barriers were identified for the implementation of HDPRP, and the recommendations were identified for the hospital, hospital staff, and external stakeholders.Conclusion:Implementation of HDPRP as per the protocol is difficult due to many external and internal factors that arise while managing the MCIs. The findings of this study provide the basis for the Ministry of Health and Population and district hospitals for the future update of HDPRP and planning of MCIs.

A Qualitative Study on the Use of the Hospital Safety Index and the Formulation of Recommendations for Future Adaptations.

Introduction:Hospitals around the world need to be safe and prepared to face disasters, being these man-made or caused by natural hazards. The Hospital Safety Index (HSI) is a tool developed by the World Health Organization (WHO) that allows access to the level of preparedness of hospitals; it is the most widely used instrument of its kind. Although the HSI is frequently used by hospitals and healthcare facilities around the world, scientific literature on its application in real life is scarce and qualitative studies are absent. By adopting a qualitative methodology, this study aims to investigate the use of the HSI to assess disaster preparedness in hospitals and healthcare facilities, identify challenges and facilitators of the HSI use, and devise recommendations for future adaptations of the tool.Method:A retrospective qualitative study employing semi-structured online interviews was conducted to gather opinions and perspectives of professionals using the HSI to assess disaster preparedness. Participants were recruited by contacting via email the authors of scientific publications on the use of the HSI.Results:In total, nine people from three different countries (Serbia, Sri Lanka, and Indonesia) and having different professional backgrounds agreed to participate in this study. They shared the reasons for their choice of using the HSI, against other tools, as well as the steps taken before and during data collection. Strengths and weaknesses of the HSI were identified and authors reported the challenges they encountered in the preparatory phase and during data collection. Modifications of the tool and recommendations for the future were proposed targeting both researchers and hospital managers.Conclusion:As far as the authors know, this is the first qualitative study examining the methodological implications of using the HSI and providing practical recommendations that can advance the HSI tool and foster its use for disaster preparedness assessments worldwide.

Hospital Workforce Education and Training for Emergency Management and Disaster Response in Complex Settings.

Introduction:Understanding how to best prepare hospital staff for disasters or emergencies is critical, as there is increasing frequency and scope of these events. Considerations include: identifying key staff, their roles, strategies to support continuity of care, delivery mode of education, and resource allocation.Method:Participants experienced in disasters and major emergencies or preparation at three tertiary referral teaching hospitals were purposively selected during 2016 and 2019. An interpretive paradigm and case study design enabled the exploration of perspectives concerning effective and preferred methods for preparedness. Fifty-five allied health professionals, medical practitioners, and nurses participated in semi-structured interviews; and support staff participated in focus groups.Results:Key findings: 1. Recognition that allied health professionals and support staff are essential and must be included in disaster or major emergency preparation and plans. 2. Factors that increase the likelihood of staff deciding to be absent from work include: perception of danger, insufficient understanding of responsibilities, and hospital preparation is perceived inadequate. Staff understanding their role has a positive influence for attendance and coping during disasters. 3. Preferred and most effective method of disaster preparedness is practical learning, combined with other preparation methods. Online learning as the major mode was unpopular. 4. Challenges of inadequate resources limits managers’ ability to facilitate staff preparation and care delivery during disasters. Resources affect method, duration and multidisciplinary inclusion in disaster preparation.Conclusion:This research found disaster preparedness in hospitals is critical. Site and occupation specific differences need to be addressed. To mitigate impacts of disasters or major emergencies, preparation must include identification of required resources. Disaster preparedness and management must be inclusive of multidisciplinary staff, including allied health and support staff. Facilitation of role understanding to promote continuity of care during disasters or major emergencies is imperative to promote staff participation and effectiveness in response to disasters.

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

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.