Document Type : Original Article

Authors

1 Department of Health in Disasters & Emergencies, Faculty of Nursing, Aja University of Medical Sciences, Tehran, Iran

2 Health in Disasters & Emergencies, Research Center, University of Social Welfar and Rehabilitation Sciences, Tehran, Iran

3 Department of Emergency Medicine, School of Medicine Beasat Hospital, AJA University of Medical Sciences, Tehran, Iran

Abstract

BACKGROUND: Disaster can pose significant challenges to the health infrastructure in the
community. Hospitals are the central unit for providing health services in the disaster response
plan. With regard to the vital role of military hospitals in health response to disaster, this study was
carried out with the aim of investigating the disaster risk management (DRM) challenges in military
hospitals in Iran.
MATERIALS AND METHODS: The current study was qualitative research performed in 2020 in
military hospitals in Iran. Participants consisted of 12 managers and staff of the military hospitals in
Tehran and professionals in health in emergencies and disasters who were included in the study by
the purposive sampling technique. Semistructured individual interviews based on the interview guide
were exploited for the data collection, and a content analysis method was used to analyze them.
RESULTS: DRM challenges in military hospitals were explained in the form of six categories:
“management and leadership, planning, prevention and mitigation, preparedness, response, and
recovery” and 22 subcategories.
CONCLUSION: Managers’ awareness of DRM challenges in hospitals, particularly military hospitals,
and the design and implementation of solutions can lead to the promotion of hospital DRM and
hospital preparedness to deal with disasters.

Keywords

1. Giri S, Risnes K, Uleberg O, Rogne T, Shrestha SK, Nygaard ØP,
et al. Impact of 2015 earthquakes on a local hospital in Nepal:
A prospective hospital‑based study. PLoS One 2018;13:e0192076.
2. Bambarén C, Uyen A, Rodriguez M. Estimation of the demand
for hospital care after a possible high‑magnitude earthquake in
the city of Lima, Peru. Prehosp Disaster Med 2017;32:106‑11.
3. King HC, Spritzer N, Al‑Azzeh N. Perceived knowledge, skills,
and preparedness for disaster management among military health
care personnel. Mil Med 2019;184:e548‑54.
4. Aminizadeh M, Farrokhi M, Ebadi A, Masoumi GR, Kolivand P,
Khankeh HR. Hospital management preparedness tools in
biological events: A scoping review. J Educ Health Promot
2019;8:234.
5. Mehta S. Disaster and mass casualty management in a hospital:
How well are we prepared? J Postgrad Med 2006;52:89‑90.
6. Pouraghaei M, Jannati A, Moharamzadeh P, Ghaffarzad A,
Far MH, Babaie J. Challenges of hospital response to the twin
earthquakes of August 21, 2012, in East Azerbaijan, Iran. Disaster
Med Public Health Prep 2017;11:422‑30.
7. Sauer LM, McCarthy ML, Knebel A, Brewster P. Major influences
on hospital emergency management and disaster preparedness.
Disaster Med Public Health Prep 2009;3:S68‑73.
8. Mirzaee F. Investigation on the safety status and preparedness
of Ilam’s hospitals against disasters in 2012. Journal of Ilam
University of Medical Sciences. 2014; 22(7): 14‑23.
9. Aminizadeh M, Farrokhi M, Ebadi A, Masoumi G, Kolivand P,
Khankeh H. Hospital preparedness challenges in biological
disasters: A qualitative study. Disaster Med Public Health Prep
2020;Nov 5:1‑5.
10. Paganini M, Borrelli F, Cattani J, Ragazzoni L, Djalali A,
Carenzo L, et al. Assessment of disaster preparedness among
emergency departments in Italian hospitals: A cautious warning
for disaster risk reduction and management capacity. Scand J
Trauma Resusc Emerg Med 2016;24:101.
11. Seyedin H, Abadi ZA, Sorani M, Naghdi S, Rajabfard MF.
Vulnerability assessment of general hospitals of Tehran University
of Medical Sciences. J Health Promot Manage 2014;3:65‑71.
12. Ochi S, Tsubokura M, Kato S, Iwamoto S, Ogata S, Morita T,
et al. Hospital staff shortage after the 2011 triple disaster in
Fukushima, Japan‑An Earthquake, Tsunamis, and nuclear
power plant accident: A case of the Soso district. PLoS One
2016;11:e0164952.
13. Abd Elazeem H, Adam S, Mohamed G. Awareness of hospital
internal disaster management plan among health team members
in a university hospital. Life Sci J 2011;8:42‑52.
14. Khankeh H, Mosadeghrad AM, Abbasabadi Arab M. Developing
accreditation standards for disaster risk management: An
approach for hospital preparedness improvement‑editorial. J Mil
Med 2019;20:574‑6.
15. Zarka S, Furman E, Polyakov O. Hospital operation
during a disaster – Hospital Multi‑Component Emergency
Center(HMCEC). Disaster Med Public Health Prep 2021;15:92‑8.
16. Asefzadeh S, Rajaee R, Ghamari F, Kalhor R, Gholami S.
Preparedness of Iranian hospitals against disasters. Biotechnol
Health Sci 2016;3:1‑6.
17. Etchegaray JM, Thomas EJ. Comparing two safety culture surveys:
Safety attitudes questionnaire and hospital survey on patient
safety. BMJ Qual Saf 2012;21:490‑8.
18. Sharifi M, Arab M, Khosravi B, Hojabri R. Proactive risk
management assessment in selected hospitals in Tehran. Health
Inf Manag 2015;12:229‑35.
19. Standard H. ASTM E2413‑04 Standard Guide for Hospital
Preparedness and Response. The American Society for Testing
and Materials (ASTM) 2009; 2013.
20. Hendrickx C, Hoker SD, Michiels G, Sabbe MB. Principles of
hospital disaster management: An integrated and multidisciplinary
approach. B‑ENT 2016;Suppl 26:139‑48.
21. Yarmohammadian MH, Atighechian G, Haghshenas A, Shams L.
Establishment of Hospital Emergency Incident Command
System (HEICS) in Iranian hospitals: A necessity for better
response to disasters. Iran Red Crescent Med J 2013;15:e3371.
22. Munasinghe NL, Matsui K. Examining disaster preparedness at
Matara district general hospital in Sri Lanka. Int J Disaster Risk
Reduct 2019;40:101154.
23. Nekoie‑Moghadam M, Kurland L, Moosazadeh M, Ingrassia PL,
Della Corte F, Djalali A. Tools and checklists used for the
evaluation of hospital disaster preparedness: A systematic review.
Disaster Med Public Health Prep 2016;10:781‑8.
24. Adini B, Goldberg A, Laor D. Assessing levels of hospital
preparedness for emergencies. Prehosp Disaster Med
2006;21:451‑7.
25. Avery GH, Zabriskie‑Timmerman J. The impact of federal
bioterrorism funding programs on local health department
preparedness activities. Eval Health Prof 2009;32:95‑127.
26. Moran‑Rodriguez S, Novelo‑Casanova DA. A methodology to
estimate seismic vulnerability of health facilities. Case study:
Mexico City, Mexico. Nat Hazards 2018;90:1349‑75.
27. Montejano‑Castillo M, Moreno‑Villanueva M. Hospitals safe from
disasters: A glimpse into the Mexican coastal zones. Int J Saf Secur
Eng 2018;8:329‑41.
28. Faghisolouk F, Jazani RK, Sohrabizadeh S. Hospital disaster risk
management: The case of Urmia hospitals. 2018;11(3):447‑450.
29. Krishnan S, Patnaik I. Health and disaster risk management in
India. In: Public Health and Disasters. Springer Nature Singapore
Pte Ltd. 2020. p. 155‑84.
30. Mortelmans LJ, Van Boxstael S, De Cauwer HG, SabbeMB, Belgian
Society of Emergency and Disaster Medicine (BeSEDiM) study.
Preparedness of Belgian civil hospitals for chemical, biological,
radiation, and nuclear incidents: Are we there yet? Eur J Emerg
Med 2014;21:296‑300.
31. Olu O, Usman A, Manga L, Anyangwe S, Kalambay K, Nsenga N,
Woldetsadik S, Hampton C, Nguessan F, Benson A. Strengthening
health disaster risk management in Africa: Multi‑sectoral and
people‑centred approaches are required in the post‑Hyogo Framework of Action era. BMC Public Health 2016;16:691.
32. Reilly M, Markenson DS. Education and training of hospital
workers: Who are essential personnel during a disaster? Prehosp
Disaster Med 2009;24:239‑45.
33. Sammy IA, Paul JF, Watson H, Williams‑Johnson J,
Bullard C Quality assurance in emergency medicine: A Caribbean
perspective. Clin Gov 2013;18:293‑9.
34. Amiri M, Mohammadi G, Khosravi A, Chaman R, Arabi
MHospital preparedness of Semnan province to deal with
disasters. Knowledge and Health 2011;6(3): 44‑50.
35. Radovic V, Vitale K, Tchounwou PB. Health facilities safety in
natural disasters: Experiences and challenges from South East
Europe. Int J Environ Res Public Health 2012;9:1677‑86.
36. Torani S, Majd PM, Maroufi SS, Dowlati M, Sheikhi RA. The
importance of education on disasters and emergencies: A review
article. J Educ Health Promot 2019;8:85.