Hospital Safety Index Research Articles

Assessment of internal disaster and emergency preparedness in hospitals using the Hospital Safety Index tool

BackgroundWhile being vital infrastructure in circumstances of crisis, health and treatment facilities' equipment is at risk of destruction, and harm to healthcare structures may prevent medical services from being delivered. Enhancements could promote resilience, and assessing current facilities for internal disaster preparedness is crucial. An evaluation of three hospitals' internal emergency and disaster preparedness is presented in this paper. MethodsHospital safety and preparedness were assessed using the World Health Organization's (WHO) Second Edition of Hospital Safety Index (HSI) tool. The safety indices were determined by three modules: emergency and disaster management, non-structural, and structural. A safety rating, represented as a probability with a maximum value of one and a minimum value of zero, is determined by adding up the weighted results. Over three days, a multi-disciplinary team performed three hospital assessments through staff interviews and visual inspections. ResultsThe study hospitals' safety indices were 0.90, 0.60, and 0.73; two were classified as Classification A, meaning they will probably be able to function in emergencies and disasters, and one was classified as Classification B, meaning that short-term intervention measures would be required to ensure the hospital's proper operation in the event of an internal disaster. This study has identified areas that must be prepared for internal disasters to increase resilience. These areas include (a) infrastructure, which has weaker protection, access, and physical security due to relatively old buildings; (b) critical systems, which have emergency response committees established by hospitals and can be improved by hospital staff receiving emergency response training; and (c) non-structural issues, which include the need to improve fuel storage, cupboard safety, shelf contents, and fitting protection. ConclusionClassification A applies to hospitals 1 and 3, whereas Classification B applies to Hospital 2. The HSI tool is a user-friendly, all-inclusive instrument offered by a reputable organisation that should be frequently used to evaluate the internal preparation of different hospitals for disasters.

Improving the non-structural preparedness of the selected hospital based on the FOCUS-PDCA1 model: action research

IntroductionWith the intensification of the country’s development process, the expansion of cities and population, and the inclusion of Iran in the accident-prone category, reducing the vulnerability of non-structures has received more attention from the organizations involved. In addition to damage to communities and infrastructure, accidents can affect hospitals and their non-organizational components. Hospitals, as the front line of providing medical services after accidents, must maintain their stability, ensure the safety of their patients and employees, and continue to operate without interruption as in normal conditions. Therefore, it is necessary to evaluate the non-structural safety and their preparedness to ensure they can perform acceptable in critical conditions.MethodsThis applied research was conducted in 2023 (September to December) using the participatory action research method in all selected hospital departments. The level of non-structural preparedness of the hospital was checked using the valid “Hospital Safety Index” questionnaire and the non-structural weaknesses of the hospital were identified. Then, in action research using the FOCUS-PDCA model, a program was implemented to improve the non-structural preparedness of different departments of hospitals in the face of accidents and disasters. The non-structural readiness level of the hospital was compared before and after the implementation of the change.ResultsBased on the evaluation conducted in the present study, the lowest level of safety was observed in the water supply system, office furniture and appliances, and fuel storage. The waste management systems, the fire protection system, and the long-distance communication systems were at a desirable performance level. Although in the evaluation before the change, the overall score of the hospital was 71.01%, and it had a desirable performance level in non-structural factors, in all the involved parts of the hospital, the sensitive, critical, and practical parts in the operation of the hospital had an average and sometimes low safety level. According to the obtained safety score, the safety level of the selected hospital before the change was 7 out of 10 (level seven of safety evaluation = medium). After the change and corrective measures, the non-structural safety assessment score was 76.93, and the hospital’s safety level was raised by one step to 8 out of 10 (8th level of safety assessment = relatively favorable).ConclusionThe present study showed that the application of Total Quality Management (TQM), primarily its application tool FOCUS-PDCA, is efficient and helpful in improving the non-structural preparedness of hospitals. Using action research in the health field in accidents and disasters can open blind knots in different dimensions of preparedness (structural, non-structural, and functional).

Hospital safety index: evaluation of the readiness and safety of hospitals in Isfahan province, Iran

Objective: Hospitals play a vital role in disaster management and their function must be maintained during crises. Isfahan province is susceptible to major crises and disasters at any time of the year. The study aimed to investigate the hospital safety index (HSI) in hospitals in Isfahan province. Methods: This cross-sectional study was conducted using the HSI questionnaire of the world health organization. The safety of all 55 hospitals in Isfahan province was evaluated with the Persian version of the questionnaire from 2017 to 2022. In this study, all hospitals were evaluated by a group of experts from the emergency operations center (EOC) of Isfahan University of Medical Sciences, and the checklists were completed with the cooperation of the hospital disaster committee, visiting the hospitals, and interviewing the personnel. Results: The safety level of hospitals has improved from 2017 to 2022 so in 2022, 38 hospitals (69.09%) had a high safety level, and 17 hospitals (30.91%) had a medium safety level. This increase in safety has happened in all three components of safety (functional, non-structural, and structural safety). There was no significant difference in the overall hospital safety score between academic-educational, non-academic governmental, social security and military, and private and charity hospitals (P<0.05). Conclusion: Although the safety in the hospitals of Isfahan province has improved due to the continuous disaster prevention and preparedness activities, hospitals still need to improve to achieve higher levels of safety. The HSI shows how well a hospital can maintain its organization and performance during disasters. This index will be useful for decision-making and policy-making to prioritize administrative and civil interventions.

Investigating the Functional, Non-structural, and Structural Safety Status in Selected Hospitals in Ahvaz

Background: Hospitals are primary centers providing services during unexpected events and should maintain their operational capabilities during and after disasters. Therefore, continuous evaluation of the safety status of these centers is vital. Objectives: This study investigated the functional, non-structural, and structural safety status in selected hospitals in Ahvaz and determined the most significant safety challenges across three dimensions. Methods: This descriptive-cross-sectional study was conducted in three hospitals in Ahvaz. The World Health Organization's (WHO) “Hospital Safety Index” checklist was used to collect data across three dimensions: Functional, non-structural, and structural safety. Descriptive statistics, such as mean percentages and frequency distribution tables, were utilized to investigate the quantitative objectives. Results: The safety level of the studied hospitals was estimated at 30.81% in the functional dimension, 59.17% in the non-structural dimension, and 71.69% in the structural dimension. According to the WHO classification, they were categorized in levels C, B, and A, respectively. The overall safety was 52.48% and was placed in category B. In the functional safety dimension, the highest score was related to hospital 2 at 35.24%, and the lowest score was related to hospital 3 at 24.59%. In the non-structural safety dimension, the highest score was related to hospital 3 at 66.66%, and the lowest was related to hospital 1 at 48.55%. In the structural safety dimension, the highest score was related to hospital 2 at 84.61%, and the lowest was to hospital 1 at 50%. Regarding overall safety, hospital 2 obtained the highest score at 57.61%, and hospital 1 obtained the lowest at 43.90%. Conclusions: The results revealed a moderate safety status in the three investigated hospitals. Although the safety status of these hospitals is not critical regarding disaster preparedness, there is a need for better planning and implementation to improve their safety levels.

Comparative analysis of two disaster risk assessment tools for primary health care centers: The case of Iran

AimAssessing disaster risk in primary health care (PHC) centers is essential for ensuring continuity of operations during disasters. There is a lack of internationally recognized methods for conducting this assessment in PHC centers. In Iran, the SARA tool, a modified version of the Hospital Safety Index, has been utilized, but its effectiveness is being questioned. This study aims to evaluate the SARA by comparing it with the Kaiser Permanente Hazard Vulnerability Analysis (KP HVA) tool to identify differences and potential issues. Methodology: The cross-sectional study was conducted in two stages. First, the expert panel was used to compare the two tools' instructions and inputs and extract similarities and differences. In the second phase, the outputs of the two tools were compared by implementing them in 156 PHC centers supervised by Semnan University of Medical Sciences. Data was collected using SARA and KP HVA tools and analyzed using Excel software. ResultsThe findings illustrated the disparities in the results obtained from the two tools. Although significant similarities exist in the instructions and inputs, the SARA results indicated the safety and preparedness of PHC centers without considering the hazards. On the other hand, the KP HVA results highlighted hazard risk priorities based on comparable dimensions. ConclusionThe leading cause of the differences is the multiple-hazard and all-hazard approaches of KP HVA and SARA tools. It is recommended that the SARA tool be upgraded based on the advantages of the KP HVA tool for better resource allocation.

ANALISIS KAPASITAS FUNGSIONAL RSU PKU MUHAMMADIYAH BANTUL DALAM PENANGGULANGAN BENCANA

PKU Muhammadiyah Bantul Hospital has been developing a disaster management hospital concept since 2008. A training through HOPE (Hospital Preparedness for Emergency and Disaster) has been conducted successfully. This research was aimed to measure the functional capacity of the PKU Muhammadiyah Bantul hospital in responding disaster and awareness of the staff as in Contingency Plan. The Hospital Safety Index criteria were used as the measurement instrument, which was consisted of five group indices. A descriptive survey technique was applied by means purposive sampling method. The samples were the staff in the Hospital Disaster Management Boards. A number of 61 questions were required by interview, observation and documents identification method. The hospital’s functional capacity index was calculated as 0.66. The scores varied for each group indices from 0.25 to 0.87. The highest score of 0.87 was obtained for group index of the operational plan, preventive maintenance and critical service restoration, whilst, the disaster emergency plan was assigned to the lowest score as 0.25. The mean score of all staffs about their job descriptions in contingency plan was 75.45 out of 100. Knowledge mean score of formulator staffs was 100 (high), while non formulator staffs was 69.7 (average). The core staff positioned in disaster management gained highest score (80.2), while the supporting staff was 74.7 (average). Hospital functional capacity index was 0.66 assessed in A class, indicating deemed to keep functioned during disaster situation. Awareness of the staffs, who designed Contingency Plan, were higher than the others. Deviation in awareness was also found among the staff involved in Contingency Plan. The manager level had a higher understanding in disaster preparedness if compared to the supporting staff.

General hospital preparedness in facing flood disasters

Hospitals had a very important function in disaster management, especially in providing health services to reduce the suffering of disaster victims in the form of deceases and injuries. Hospital preparedness in facing disasters was contained in the Hospital Disaster Plan which was prepared based on the Safe Hospital Framework [1], and the Hospital Safety Index[2]. The purpose of this study was to analyze the preparedness of Aceh Tamiang General Hospital in facing flood disasters from 4 (four) aspects or evaluation modules namely, Hazard Affecting, Structural Safety, Non-Structural Safety, Emergency and Disaster Management, specifically analyzing the aspect of “Emergency and Disaster Management” according to the research focus namely, hospital policies, human resources preparedness and hospital infrastructure readiness in facing flood disasters. The research methodology was qualitative with a phenomenological design by 7 (seven) informants. The results of the study showed that the policies of the hospital leadership had been good, with the existence of a Leadership Decree concerning the Formation of a Hospital Disaster Management Team, since 2019 ago. However, there were still hospital personnel who did not know about the organizational structures, goals and functions as team members. Many hospital health workers could not go to work because their homes and access to the hospital were flooded. Besides that, hospital infrastructure, especially motorized vehicles such as ambulances and other operational vehicles, could not operate due to flood conditions that reached up to 1 meter. Therefore it was suggested that the socialization of the Disaster Management Team and Disaster Management Simulation should be carried out periodically, for example, twice a year. It should be suggested that the hospital proposed procuring an ambulance with certain specifications and a rescue boat, so that it could break through the floods that occur almost every year.

A Longitudinal Study of Hospital Safety From Disasters in Kermanshah Province, Iran: Insights for Disaster Risk Reduction.

The Hospital Safety Index (HSI) developed by the World Health Organization (WHO) was adopted by most countries to evaluate the safety of hospitals against disasters. This study aimed to assess the status of hospital safety from disasters between 2016 and 2022 in Kermanshah province in Iran. This is a retrospective longitudinal study which investigated HSI data from 23 hospitals. Data were gathered by Farsi Hospital Safety Index (FHSI) and analyzed with a repeated measures analysis of variance (ANOVA). The risk of hydro-meteorological (from 43.1 to 32.7) and biological hazards (51.3 to 35.5) significantly decreased. Although structural safety remained constant (from 67.8 to 70.1), nonstructural (from 51.5 to 71.2), and functional (from 47.1 to 71.2) safety scores increased significantly over study period. The findings revealed hospitals safety in Kermanshah province gradually improved. However, the health-care stakeholders should pay the necessary attention to improving the structural safety of hospitals.

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.

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.

Assessing Hospital Safety Index in the Iranian Hospitals

Background: Hospital preparedness for accidents and disasters is vital in maintaining and promoting community health. However, the country’s hospitals are not well prepared for disasters. The hospital safety index (HSI) was 42% in Iranian hospitals in 2014. This study aims to investigate the HSI in Iranian hospitals in 2020 and to provide solutions to improve it. Materials and Methods: This cross-sectional descriptive study was performed for the country’s hospitals. The results recorded in the Farsi version of the hospital safety index (FHSI) software in 2020 were used. Hospital teams used the FHSI checklist (151 options) in three areas of structural, non-structural, and functional safety to assess the hospital and register in the FHSI system. The registered results of the hospitals were collected based on the medical universities of the country. Descriptive statistics were used to analyze the data. Results: A total of 604 hospitals registered safety index information in the system. The mean score of the HSI of the country’s hospitals was 60.84. A total of 130 hospitals (21.5%) had low safety levels, 418 hospitals (69%) had moderate safety levels, and 56 hospitals (9.2%) had high safety levels against disasters. The mean scores were in structural safety (57.20), non-structural (65.24), and functional safety (63.36). Hamedan (76.81) and Kerman (75.61) Provinces had the highest score, and Yazd (53.74), and Lorestan (57.31) Provinces had the lowest score in the country. Conclusion: The HSI against disasters in 2020 compared to 2014 has reached 6 out of 10 and we have about a 41.5% increase in safety (from 43 to 60.84). However, the HSI is moderate. Strengthening the safety and resilience of hospitals, improving the safety of medical equipment, improving the knowledge and skills of managers in the scientific development of preparedness, response and recovery programs, funding and support of crisis programs, attention to security programs, pollution, and evacuation are among the solutions of development and enhancement of hospital preparedness against disasters.

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.

Evaluating the Level of Disaster Preparedness of Tunisian University Hospitals Using the Hospital Safety Index: A Nationwide Cross-sectional Study

Introduction:Midway through the ‘Sendai Framework for Disaster Risk Reduction 2015-2030’, many nations are spending time, money and effort to enhance their level of preparedness when facing disasters, on the other hand communities, countries and even continents are being left behind. This study was conducted aiming at evaluating the level of disaster preparedness and response of Tunisian University Hospitals.Method:This is a cross-sectional nationwide study conducted in Tunisia, from November 2020 to April 2021. Including nine Tunisian University Hospitals and using the Hospital Safety Index. The data were analyzed using the 'Module and safety index calculator'.Results:This study showed that seven out of the nine University Hospitals were assigned the ‘B’ category of safety with overall safety indexes that ranged between 0.37 and 0.62. Also, four out of nine University Hospitals had safety scores less than 0.20 regarding their emergency and disaster management.Conclusion:This is the first study to evaluate disaster preparedness and response of university hospitals in Tunisia and in north Africa. It showed that the lack of knowledge, resources and willingness, are the most important issues that need to be addressed in order to enhance the preparedness of Tunisian hospitals.

Preparation of Hospital Disaster Plan in Indonesia: The Mentoring Challenges from Offline to Online Program

Introduction:Located in a disaster-prone country, more than 3000 hospitals in Indonesia must have a Hospital Disaster Plan (HDP). Instead of pursuing only the hospital accreditation requirements, HDP should be beyond that. Since 2008, CHPM UGM has been providing various HDP training. However, during the COVID-19 pandemic, there was a change in offline assistance that shifts to online. This study reports the learning activities, output, and challenges.Method:There were three batches of HDP-paid online courses in 2021. Each batch consists of three series courses. The first series was a basic HDP seminar. The second series was for intensive HDP mentoring for two months. In the second series, the participants focused on analyzing risk and hospital safety index (HSI), detailing job action sheets, and detailing disaster standard operating procedures. Moreover, the third series in the fourth month was an online tabletop exercise (TTX).Results:25 hospitals and 112 people participated. However, only five hospitals that committed finalized the HDP document. The learning process challenges were the participant’s unstable network and their focus on who was on duty while attending the courses. Although the TTX online was a new trial, it worked to asses hospital preparedness for disaster management through well preparation, detailed scenario and proper evaluation instrument. However, it was still difficult to assist participants in completing the HDP documents online, because observation of the hospital environment cannot be carried out while the evidence provided by participants were limited, for example supporting evidence for the HSI indicators.Conclusion:The online series of HDP is feasible because it saves accommodation and transportation costs. However, the intensive online mentoring should be carried out longer to allow participants to do assignments and collect evidence of indicators that must be shown to the facilitators.

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

The Hospital Safety Index is a tool developed by the World Health Organization and the Pan American Health Organization in 2008 and updated in 2015. Although it is the most widely used instrument of its kind to assess the level of hospital preparedness, scientific literature on its application in real life is scarce. This study aimed to investigate the use of the Hospital Safety Index to assess disaster preparedness in healthcare facilities. A retrospective, qualitative study employing semi-structured online interviews was conducted to gather the opinions and perspectives of professionals who have experience in applying the Hospital Safety Index. Authors of scientific publications using the Hospital Safety Index were recruited. A semi-structured interview guide was developed. It addressed different phases of data collection with the Hospital Safety Index, the challenges and facilitators of using it, and recommendations for future adaptations. Data were analysed using inductive thematic analysis. Nine participants who were from three countries (Serbia, Sri Lanka, and Indonesia) and had different professional backgrounds (medical doctors, engineers, spatial planners, etc.) participated in this study. A total of 5 themes and 15 subthemes emerged during data analysis. Most of the participants reported their reasons for choosing the Hospital Safety Index as being its comprehensiveness and the fact that it was issued by the World Health Organization. The tool appears to be very specific and allows investigators to spot details in hospitals; however, it is not easy to use, and training is highly encouraged to learn how to navigate the different components of the tool. Governmental support is a crucial facilitator for investigators to be able to enter hospitals and conduct their evaluations. Overall, the tool has a lot of potential, and it should be used to reach a broader audience, such as community members, and assess the preparedness of other facilities that can take part in the response to disasters (hotels, stadiums, schools, etc.). Nevertheless, it still needs more adaptations to be tailored to different contexts and settings.

Fire Safety Challenges in Hospital Safety Index (HSI)

Hospitals are a symbol of social welfare and the last refuge of patients, which is the most important issue of the health system. Patient safety is the first and most important issue for the health system. Before COVID-19, the World Health Organization (WHO) defined the Hospital Safety Index (HSI) to measure hospital preparedness for disasters. During the COVID-19 crisis, hospitals faced many problems, including safety. Governments and health officials need to pay attention to fire safety. In the Covid-19 crisis, different conditions were experienced in hospitals, and the number of patients, inpatients, medical staff, equipment, and machinery in these critical conditions has increased significantly. This article in the form of a letter to the editor tries to point out the challenges and opportunities of hospital safety index tools to reduce hospitals’ vulnerability to improve their performance and resilience to disasters.

Determination of hospital security index for emergencies and evaluation indicators

Introduction: Today, a lot is said and written about the hospital as a health institution. Various international bodies and organizations, including the World Health Organization, deal with the problem of work, functions, and organizations.Aim: This paper aims to perform a situational analysis of the organization of the hospital for emergencies; determine the availability of material and personnel resources in the hospital available in emergencies; examine the types of hazards that may have an impact on the safety of the hospital; determine the state of constructive and non-constructive safety of the hospital; examine the organization of services and support for patients and staff during emergencies.Methods: The research is descriptive and analytical. Standardized evaluation lists prescribed by the World health organization (WHO), which determines the hospital safety index, and the original survey questionnaire, according to the defined methodology of the WHO, were used as research instruments.Research results: For this work, a survey was conducted of 117 respondents, employees of the Clinical Center of the University of Sarajevo, who work in responsible positions. The majority of respondents believe that the conditions for preparing the hospital for emergencies can be improved by providing more human resources, educating staff, and ensuring important modern technologies. The situational analysis at the Clinical Center of the University of Sarajevo was carried out with an internal self-assessment of the hospital's safety index. The evaluation of the safety index for emergencies was calculated based on the defined WHO methodology.Conclusion: It is important to point out that there are many dangers (hazards) that can have an impact on the safety of hospitals and that different factors have a significant role in the preparedness of hospitals for an emergency or disaster.

Building Toward a Disaster Resilient Health System: A Study of Hospital Resilience.

This research evaluated the resilience of 6 tertiary and rural health facilities within a single Australian Health Service, using the World Health Organization (WHO) Hospital Safety Index (HSI). This adaptation of the HSI was compared with existing national accreditation and facility design Standards to assess disaster preparedness and identify opportunities for improvement. This cross-sectional descriptive study surveyed 6 hospitals that provide 24/7 emergency department and acute inpatient services. HSI assessments, comprising 151 previously validated criteria, were conducted by Health Service engineers and facility managers before being externally reviewed by independent disaster management professionals. All facilities were found to be highly disaster resilient, with each recording high HSI scores. Variances in structure, architectural safety, continuity of critical services supply, and emergency plans were consistently identified. Power and water supply vulnerabilities are common to previously reported vulnerabilities in health facilities of developing countries. Clinical, engineering, and disaster management professionals assessed 6 Australian hospitals using the WHO HSI with each facility scoring highly, genuine vulnerabilities and practical opportunities for improvement were identified. This application of the WHO HSI, intended for use primarily in developing countries and disaster-affected regions, complimented and extended the existing Australian national health service accreditation and facility design Standards. These results support the expansion of existing assessment tools used to assess Australian health facility disaster preparedness and resilience.

Evaluating the level of disaster preparedness of Tunisian University Hospitals using the Hospital Safety Index: a nationwide cross-sectional study.

Mid-way through the 'Sendai Framework for Disaster Risk Reduction 2015-2030', many nations are spending time, money and effort to enhance their level of preparedness facing disasters, on the other hand communities, countries and even continents are being left behind. This study was conducted aiming at evaluating the level of disaster preparedness and response of Tunisian University Hospitals. This is a cross-sectional nationwide study conducted in Tunisia, from November 2020 to April 2021. Including 9 Tunisian University Hospitals and using the Hospital Safety Index. The data were analysed using the 'Module and safety index calculator'. This study showed that 7 out of the 9 University Hospitals were assigned the 'B' category of safety with overall safety indexes that ranges between 0.37 and 0.62. Also, 4 out of 9 University Hospitals had safety scores less than 0.20 regarding their emergency and disaster management. This is the first study to evaluate disaster preparedness and response of university hospitals in Tunisia and in north Africa. It showed that the lack of knowledge, resources and willingness, are the most important issues that needs to be addressed in order to enhance the preparedness of Tunisian hospitals.

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.