Hospital Disaster Research Articles

IMMEDIATE BED AVAILABILITY IN CASE OF A DISASTER

Introduction: During a disaster, an increase in the number of casualties requiring hospital admission is recorded. This challenge the hospitals' management - there is a need for beds, rooms, consumables, drugs, and medical teams to support the increased number of patients arriving. Purpose: This study aims to analyze the awareness of hospital medical professionals about the required procedures described in the hospital contingency plan for increased bed availability in case of disaster. Materials and methods: 295 hospital medical professionals in the Plovdiv region, Bulgaria, participated in an anonymous survey that contained 55 questions. Results: Most of the respondents are not familiar with the approved procedures to optimize the availability of emergency beds after the disaster that impacts the hospital disaster resilience. Conclusions: Optimization of activities related to operational hospital disaster resilience must include training of medical specialists in immediate bed availability procedures.

Exploring Managers’ Experiences of Hospital Disaster Preparedness: A Qualitative Study

Background: Preparedness is one of the important and effective pre-crisis management stages and involves all actions and programs that enable the organization to respond quickly and effectively in critical situations. To this end, this study aimed to explore the experiences of crisis managers and experts in hospital disaster preparedness. Methods: This qualitative study was conducted using conventional content analysis in 2019. The research population included hospital managers and crisis specialists in Ardabil Province. The participants were 14 managers and crisis specialists who were selected using purposive sampling. The data were collected through semi-structured interviews and analyzed using Griesheim and Landman’s qualitative content analysis approach. Results: The analysis of the data revealed four main categories including management and planning, infrastructural development, human resources, and intersectoral coordination. Conclusion: The findings of the present study highlighted the significance of preparedness for emergencies, management and planning, having codified instructions, and implementation and evaluation to increase the preparedness of hospitals to deal with emergencies.

Establishing the Domains of a Hospital Disaster Preparedness Evaluation Tool: A Systematic Review.

Recent disasters emphasize the need for disaster risk mitigation in the health sector. A lack of standardized tools to assess hospital disaster preparedness hinders the improvement of emergency/disaster preparedness in hospitals. There is very limited research on evaluation of hospital disaster preparedness tools. This study aimed to determine the presence and availability of hospital preparedness tools across the world, and to identify the important components of those study instruments. A systematic review was performed using three databases, namely Ovid Medline, Embase, and CINAHL, as well as available grey literature sourced by Google, relevant websites, and also from the reference lists of selected articles. The studies published on hospital disaster preparedness across the world from 2011-2020, written in English language, were selected by two independent reviewers. The global distribution of studies was analyzed according to the World Health Organization's (WHO) six geographical regions, and also according to the four categories of the United Nations Human Development Index (UNHDI). The preparedness themes were identified and categorized according to the 4S conceptual framework: space, stuff, staff, and systems. From a total of 1,568 articles, 53 met inclusion criteria and were selected for data extraction and synthesis. Few published studies had used a study instrument to assess hospital disaster preparedness. The Eastern Mediterranean region recorded the highest number of such publications. The countries with a low UNHDI were found to have a smaller number of publications. Developing countries had more focus on preparedness for natural disasters and less focus on chemical, biological, radiological, and nuclear (CBRN) preparedness. Infrastructure, logistics, capacity building, and communication were the priority themes under the space, stuff, staff, and system domains of the 4S framework, respectively. The majority of studies had neglected some crucial aspects of hospital disaster preparedness, such as transport, back-up power, morgue facilities and dead body handling, vaccination, rewards/incentive, and volunteers. Important preparedness themes were identified under each domain of the 4S framework. The neglected aspects should be properly addressed in order to ensure adequate preparedness of hospitals. The results of this review can be used for planning a comprehensive disaster preparedness tool.

Editorial introductions.

Editorial introductions.

Hospital Disaster Resilience: a Conceptual Framework

This article analyses the concept of hospital resilience to natural disasters (earthquakes, global warming, pandemics, and man-made disasters such as war, conflict and cyber-attacks) in the context of theoretical insights in scholarly articles on the concept of resilience, and elements of its perception and other aspects. The research conducted identified that the concept of a resilient hospital encompasses its ability to maintain functionality at minimal resource costs, and reduce the likelihood of shock in the event of various disasters. This capacity to withstand hazard can be of various types, for example, constructive, infrastructural or administrative. The following four elements are most commonly identified levels of resilience: context, disturbance, capacity to deal with disturbance, and reaction to disturbance. A resilient hospital maintains the following characteristics: rapidity, robustness, redundancy, resourcefulness, awareness, diversity, self-regulation, unity and adaptiveness. A variety of means are used to amplify resilience to distinct disasters and it is relevant to manage different types of resilience, but the human factor is indisputably essential in this framework.

Nurses’ Willingness and Competence to Work During Disasters and Their Related Factors: Case Study of a State Hospital in Turkey

Background: Disasters put high burden on healthcare workers. This study aims to determine the willingness and competence of nurses to work during disasters who were employed in a state hospital in Bolu, Turkey and also investigate the related socio-demographic factors. Materials and Methods: This descriptive study was carried out on 311 nurses working in a state hospital in the center of Bolu city in Turkey. A researcher-made questionnaire with 35 items as well as a questionnaire with 45 items assessing the basic skills of nurses for preparation in disasters were used to collect data. Results: Most participants were undecided about working during disasters. Most of them were willing to work in earthquakes, while they had less willingness to work during pandemics. Nurses who were single, male, had no phobias, had hobbies, had no children, had a dependent person in the family, had membership in NGOs, and had Hospital Disaster Plan knowledge were more willing to work during disasters (P<0.05). Nurses who were single, male, had hobbies, and had a role in Hospital Disaster Plan had more competence to work during disasters (P<0.05). Conclusion: Most nurses in Turkey are undecided about working during disasters. Medical centers should use the nurses that have more willingness and competence to work during disasters.

Disaster medical support plan as an element of the hospital disaster resilience.

Abstract.

Level of emergency and disaster preparedness of public hospitals in Northwest Ethiopia: A cross-sectional study.

From time to time, the magnitude and type of health emergencies and disasters are increasing. Hospital emergency and disaster preparedness, on the other hand, is still in its early stages in many low- and middle-income countries. In Ethiopia, research on hospital disaster preparedness is severely limited. As a result, the purpose of this study was to determine the level of hospital emergency and disaster preparedness at public hospitals in the east Gojjam zone of Northwest Ethiopia. A census method was used to include ten hospitals in the East Gojjam zone in a cross-sectional descriptive study. An adopted World Health Organization observation checklist was used to assess disaster and emergency preparedness. Each question was assigned a score out of three points, with one indicating low readiness and three indicating the highest level of preparation. Finally, the level of preparedness was classified as "low" if the average percentage score ranged from 33.3% to 66.6 %, and as "high" if the percentage score ranged from 66.7 % to 100 %. The results were then presented in the form of texts, tables, and percentages. The evaluated hospitals' overall level of emergency and disaster preparedness falls into the low category, with an average calculated preparedness score of 54.75 %. The domain with the lowest preparedness is logistics and finance (43.33 %), while the domain with the highest preparedness is patient care and support services (60 %). According to the findings of this study, the level of emergency and disaster preparedness in the hospitals studied is low. It is therefore recommended that the ministry of health, regional health bureaus, and hospital administrators collaborate to develop an appropriate intervention strategy to address this issue.

Hospital Disaster Management – Evacuation of Perinatal Intensive Care Units Based on Emergency Management Plan

The purpose of this study is to illustrate the special cases of a fire in a hospital especially in a perinatal intensive department, that may be encountered by the firefighters. Due to these special circumstances, the evacuation time of the facility can be significantly increased. There are unusual evacuation and rescue methods, which require special devices and more intense human resources. The evacuation requirement of a hospital is more than a usual evacuation plan, the goal is to maintain the health care services during and after the evacuation, so it is necessary to apply the Evacuation Plan of the Hospital Disaster Plan during a fire evacuation. This requires much more accurate and complex training from both the firefighters and the medical staff. Also, its effectiveness depends to a large extent on the architectural and fire protection design of the building, its modernity, the available medical and rescue equipment and the number of medical staff. The study examines the approximation and joint applicability of the plans above, based on the experience of a hospital evacuation exercise.

Analysis of Hospital’s Emergency and Disaster Preparedness Using Hospital Safety Index in Indonesia

Indonesia is country with abundant high-risk areas for various disasters that can affect both the structural and non-structural safety of various vital establishments, particularly hospitals. This present study aims to examine the level of the hospital safety index in nine hospitals in four provinces based on the guidelines from the WHO/PAHO (World Health Organization/Pan American Health Organization). The Hospital Safety Index (HSI) guidelines consist of four parameters that include the types of hazards, structural safety, non-structural safety, disasters and emergency managements. This study was a cross-sectional study on data obtained through interviews, focus group discussions (FGDs), observations, and document reviews to assess the parameters of the HSI. Data were calculated for the HSI score, and descriptive statistics and multiple correspondence analysis (MCA) were carried out. The SPSS software version 25.0 was used for the statistical analysis. Results show that the overall safety index was 0.673 (Level A), meaning that it is likely the hospital will maintain functionality in emergencies and disasters. By province, the level A index was identified in DKI Jakarta (0.76), Yogyakarta (0.709), and West Java (0.673), showing that hospitals in these provinces will maintain functionality in emergency and disaster situations; however, in North Sumatera, the index was categorized in B category (0.507), demonstrating that the hospital’s ability to function during and after emergencies and disasters is potentially at risk. The multiple correspondence analysis shows that the hospitals in the provinces of Yogyakarta and West Java tend to achieve similar categories in almost all assessment modules; therefore, control measures of preparedness should be considered, such as improvements in equipment and facilities; hospital emergency and disaster response and recovery planning; communication and information management; training; and relevant stakeholders awareness.

The Policy Gap and Inefficiency in Public Volunteers' Response to Assist the Hospitals After Natural Disasters in Iran: A Grounded Theory Methodology.

This study aims to explore a public volunteer's hospital response model in natural disasters in Iran. This study employed grounded theory using the Strauss and Corbin 2008 method and data analysis was carried out in three steps, namely open, axial, and selective coding. The present qualitative study was done using semi-structured interviews with 36 participants who were on two levels and with different experiences in responding to emergencies and disasters as "public volunteers" and "experts". National and local experts were comprised of professors in the field of disaster management, hospital managers, Red Crescent experts, staff and managers of Iran Ministry of Health and Medical Education. The main concept of the paradigm model was "policy gap and inefficiency" in the management of public volunteers, which was rooted in political factions, ethnicity, regulations, and elites. The policy gap and inefficiency led to chaos and "crises over crises." Overcoming the policy gap will result in hospital disaster resilience. Meanwhile, the model covered the causal, contextual, and intervening conditions, strategies, and consequences in relation to the public volunteers' hospital response phase. The current public volunteers' hospital in Iran suffered from the lack of a coherent, comprehensive, and forward-looking plan for their response. The most important beneficiaries of this paradigm model will be for health policy-makers, to clarify the main culprits of creating policy gap and inefficiency in Iran and other countries with a similar context. It can guide the decision-makings in upstream documents on the public volunteers. Further research should carried out to improve the understanding of the supportive legal framework, building the culture of volunteering, and enhancing volunteers' retention rate.

Hospital Disaster and Emergency Plan in Biological Disasters (HDEP): Coronavirus (SARS-CoV-2) COVID-19 Pandemic System Model Example

Introduction and Objectives: Man-made disasters can be grouped as technology and violence origin such disasters occur as a result of conscious or unconscious mistakes where chemical, biological, radiological, and nuclear threats are used. It has become significant for hospitals to prepare a plan, which includes information and practical actions, including all situations that require urgency and actions to be taken in emergencies that may occur in workplaces. Coronaviruses are a diverse group of viruses that infect many different animals and can cause mild to severe respiratory infections in humans. Two highly pathogenic coronaviruses of zoonotic origin, the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV), emerged in humans in 2002 and 2012, respectively. At the end of 2019, the emergence of a new coronavirus, SARS-CoV-2, in the Chinese city of Wuhan caused an unusual viral pneumonia epidemic. In this study, hospital emergency management plan is examined to the currently effective pandemic element of COVID-19 disease. Methods: It reviews the current situation and recommended actions to improve the preparedness of hospitals in five critical hospital roles during disasters: executing planning and coordination, maintaining disaster capacity, training and disaster drills with the broader health and public safety communities, protection hospital and staff, and surveillance as showing. In this context, coranavirus (SARS-CoV-2) COVID-19 hospital disaster emergency plan system model has been tried to be created. While creating the system method, it proposes a model of how the primary diagnosis and intermediate treatments will be handled in the risk method for the emergency room cases and the clinic, by handling confirmed and suspected cases through both the healthcare personnel and the medical supply system. Results and Conclusions: As a result, the hospital emergency management plan can ease the emergency department workload, protect healthcare personnel, and control cross infection during the COVID-19 outbreak. Each hospital needs to create an emergency plan suitable for its own conditions. Hospitals can take interim measures, including online consultation, zoning, and epidemic priority to relieve pressure on clinical trials, reduce cross-infection, and strengthen protection of high-risk personnel.

Hospital disaster risk management improving strategies: A systematic review study.

Hospitals are the basic infrastructure for disaster response. While they themselves are exposed to disasters, they also play an important role during the disaster response period. Therefore, they are expected to be able to maintain their performance during and immediately after disasters. The aim of this study is to discover strategies to improve the hospital disaster risk management. This study is a systematic qualitative study with thematic analysis. Data sources including Persian and international databases were searched using the "Hospital, Disaster, Risk management, Risk reduction, Improvement, and Strategy" keywords and their combinations of them. The search time period ranged from January 2010 to January 2020. Data were extracted by two independent arbitrators for qualitative thematic analysis. In total, 889 articles and documents were retrieved. Of which, 166 articles were deleted due to duplication, 436 articles did not meet the objectives of the research, and 263 articles did not meet the eligibility criteria and were deleted. Finally, 24 articles were included in the study. After thematic analysis, 33 subthemes were obtained and classified into five themes of organizational-managerial strategies, preventive and risk reduction strategies, preparedness strategies, response strategies, and recovery strategies. Not all articles discuss all categories. Applying strategies to improve the hospital disaster risk management resulting from this study can be useful in improving the preparedness of hospitals in the face of disasters.

Psychological stress of emergency medical staff after the largest mass murder incident in post-World War II era.

BackgroundA mass‐casualty incident occurred on July 26, 2016, at Tsukui Yamayuri‐en, which is a welfare facility for people with intellectual disabilities. Nineteen residents with intellectual disabilities were killed, and 26 other residents and staff members were injured. Kitasato University Hospital Emergency and Disaster Medical Center treated many patients in serious condition at the site and in the hospital.AimsThe authors investigated the symptom severity and distributions of posttraumatic stress disorder (PTSD) among the emergency medical staff in charge.The subjects of this study were the staff members, mostly working at the Emergency and Disaster Medical Center, who treated the people injured in the incident.MethodsWe conducted a questionnaire survey using Impact of Event Scale‐Revised (IES‐R) on 104 staff members, and 79 responded.ResultsThe IES‐R scores of nurses were significantly higher than those of doctors. There was no significant difference in the scores between male and female staff members, and there was no correlation between the score of each IES‐R subscale and age.ConclusionResults suggest that mental care should be provided to emergency medical staff, especially nurses who treat trauma patients involved in disasters and heinous crimes.

ANALISIS TINGKAT EFISIENSI DAN OUTCOME PELAYANAN DI RS AISYAH SITI FATIMAH SIDOARJO SELAMA PANDEMI COVID-19

Background: Hospitals during the COVID-19 pandemic are trying hard to reduce the number of deaths and losses of COVID-19. Analysis of hospital efficiency and results of hospital services is needed to improve and assess the quality of hospital services provided to patients. In measuring the efficiency of the services provided by the hospital, an analysis of bed use was used through the Barber Johnson chart. To assess the outcome of a service through mortality and morbidity rates. Subjects and Method: This research were descriptive research with data collection by interview to health workers which includes Professional Care Providers (PPA) document study. The research was conducted during August-December 2021. The data obtained were processed into percentage data and Barber Johnson charts. Results: Research Results The mortality rate in June was 24.2% and July 41.7%. Johnson's barber chart is in an inefficient area. BTO in June and July 2021 is 5 and 3, TOI in June and July 2021 is 2.6 and 6.9. Conclusion: Aisyiyah Siti Fatimah Hospital Sidoarjo has not yet entered the efficient area of ??the Barber-Johnson Graph. Mortality and morbidity rates are also high due to the COVID-19 pandemic. Strategies that can be carried out are by increasing the number of available beds during the COVID-19 pandemic as an effort to mitigate the hospital disaster, and improving the addition of supporting equipment for medical services related to COVID-19 so that inpatient services are efficient. Keywords: BOR, Barber Johnson, Mortality, Morbidity

“Recovering, not recovered” Hospital disaster resilience: a case-study from the 2015 earthquake in Nepal

ABSTRACT Background Disasters are an increasing threat to human health, but we know little about their impact on health services, particularly in low and middle-income settings. ‘Resilient hospitals’ have been increasingly recognized as a cornerstone of disaster management. While various frameworks of hospital resilience exist, they emerged from pre-disaster considerations, and do not incorporate evidence from post-disaster settings. Objective This dissertation investigated the impact of a large-scale sudden onset disaster in a tertiary hospital in Nepal, and explored its resilience mechanisms. Methodology This consists of an in-depth case-study combining quantitative data from routinely generated hospital records and qualitative data from semi-structured interviews with hospital staff. We used both advanced statistical methods and mixed inductive and deductive coding to analyze the data. Results Most of the admitted earthquake victims required surgical interventions and long hospitalizations, considerably straining the hospital. For six weeks, the average number of daily admissions decreased. During this period, the share of injury-related admissions was particularly high, and such admissions were particularly long compared to the baseline. Admissions due to other conditions relatively decreased and were shorter. We found that the hospital’s resilience was highly dependent on emerging adaptations, in addition to the pre-existing disaster plan. Individual resilience of staff also played a major role, and was influenced by senses of safety, meaningfulness, and belonging. Conclusion Hospitals should prepare resources and plan for their known disaster risks, but should also allow for a certain flexibility to innovative adaptions to emerging, unforeseen challenges. Challenges faced by hospital workers should not be undermined, and addressing them will increase hospital resilience.

A fuzzy hybrid decision-making framework for increasing the hospital disaster preparedness: The colombian case

The recent increase in the number of disasters over the world has once again brought to the agenda the question of preparedness of the hospitals, which are the most necessary units of healthcare pillar to resist these disasters. The COVID-19 epidemic disease, which has affected the whole world, has caused a large number of people to die in some countries simply because of the inadequate and incomplete planning and lack of readiness of hospitals. For this reason, determining the disaster preparedness level of hospitals is an important issue that needs to be studied and it is important in terms of disaster damage reduction. In this study, a fuzzy hybrid decision-making framework is proposed to assess hospital disaster preparedness. The framework covers three important decision-making methods. For the first phase, Intuitionistic Fuzzy Analytic Hierarchy Process (IF-AHP) is used to assign relative weights for several disaster preparedness criteria considering uncertainty. Secondly, Intuitionistic Fuzzy Decision Making Trial and Evaluation Laboratory (IF-DEMATEL) is applied to identify interrelations among these criteria and feedback. Finally, via the VlseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) method, priorities of hospitals regarding disaster readiness are obtained. A case study involving the participation of 10 Colombian tertiary hospitals is carried out to show the applicability of this fuzzy hybrid approach.

The National Blood Shortage-An Impetus for Change.

The National Blood Shortage-An Impetus for Change.

Social work practice for COVID-19 in the acute hospital setting: Recommendations for psychosocial assessment

Abstract The global coronavirus SARS-CoV2 (COVID-19) pandemic outbreak caused immediate, far-reaching social schisms and created unprecedented challenges for hospital social work services worldwide. Existing hospital disaster plans were inadequately equipped for pandemics and organisational plans needed to quickly adapt to respond to the increased clinical demands and unique logistical considerations triggered by the virus. Literature reviews provided little in the way of precise guidance for practitioners. Hospital social workers responded not only to a new cohort of patients, but also to all patients affected by the societal repercussions of the pandemic and by governments’ attempts to mitigate the impacts of the virus. Psychosocial assessments, the bedrock of social work intervention, needed to adapt and evolve to encompass and address the exacerbation of existing social risks in new ways. This article originated from the authors’ interest in identifying practice implications for hospital social work during the COVID-19 pandemic. The authors briefly outline the distinct impact of COVID-19 on psychosocial issues such as domestic and family violence, elder abuse, child protection, financial stress and social isolation. They create a forum of international hospital social work centres to develop a consensus approach for addressing these issues in the context of a social work psychosocial assessment.

Hospital Universiti Sains Malaysia's Disaster Preparedness Activation During COVID-19 Pandemic: The Communication Response and Mapping Against World Health Organization Hospital Disaster Preparedness in Pandemic Influenza Checklist Key Component Criteria

Hospital Universiti Sains Malaysia's Disaster Preparedness Activation During COVID-19 Pandemic: The Communication Response and Mapping Against World Health Organization Hospital Disaster Preparedness in Pandemic Influenza Checklist Key Component Criteria