Disaster Risk Management in the Iranian Hospitals: Challenges and Solutions

Document Type : Original Research

Authors

1 National Emergency Medical Organization, Ministry of Health and Medical Education, Tehran, Iran

2 Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

3 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background and Aim: Hospital disaster risk management accreditation standards have been developed since 2016. However, the country's hospitals are still not well prepared in this regard. This study aimed to identify the implementation challenges of the disaster Risk Management Program in the country's hospitals and provide solutions to improve it.
Methods: This study was conducted as qualitative research in 2019. Purposeful semi-structured interviews were conducted with 35 managers of disaster management centers of the Ministry of Health, medical universities, and hospitals in the country and continued until the saturation stage. Graneheim and Landman's contractual content analysis method was used for data analysis and MAXQDA 12 software was used for data management. Lincoln and Guba's criteria were used to ensure the accuracy and reliability of the data.
Results: By analyzing the interviews, 6 main challenges (gap in the policy of the Ministry of Health, limited resources, weakness in planning, lack of coordination and information management, negative attitude at the managerial level, challenges of knowledge, skills, and attitude of human resources) and 31 sub-challenges in disaster risk management were identified in hospitals. Inadequate structures and weaknesses in planning at various levels, lack of transparency of laws, burnout of hospitals, weaknesses in the information management process, weaknesses in knowledge, skills and attitudes of managers and employees were the main side challenges. twenty-seven solutions were detected that reforming management structures, securing hospitals, effective and efficient management of resources, reforming policies, creating databases, and using new methods in training and practicing hospital preparedness were among the most important solutions presented.
Conclusion: The implementation of disaster risk management programs in the country's hospitals at the levels of policy-making, planning, and implementation is associated with challenges and problems. Paying attention to the structure and organization of disaster management at the Ministry of Health, universities, and hospitals, reforming the structure, laws and national instructions and processes in the programs of the Ministry of Health can lead to improving disaster preparedness in hospitals.

Keywords

References

1. The EM-DAT higher resolution disaster data. Centre for Research on the Epidemiology of Disasters. CRED 2021; 62 https://cred.be/sites/default/files/CredCrunch62.pdf 2. Khankeh H, Masoumi G. National Hospital Disaster Risk Management Program based on Accreditation Indicators. First ed. University of Social Welfare and Rehabilitation Sciences 2018 [in Persion] 3. ENN EN. Real time evaluation of Pakistan Flood Response. Field Exchange 32. 2008 Jan :1-25 4. Bajow NA, Alkhalil SM. Evaluation and analysis of hospital disaster preparedness in Jeddah, Health 2014 Nov 7; 6; 19; 2668 5. Pesaro G. The economic impacts of natural hazards: Lessons learnt from the PDNA international damage assessment project implemented in Haiti after the earthquake of 2010. InSustainable Urban Development and Globalization 2018 : 321-332 6. UNISDR U, editor Sendai framework for disaster risk reduction 2015–2030. Proceedings of the 3rd United Nations World Conference on DRR, Sendai, Japan; 2015 7. Rahmanian F, Abbasi, B., Bolvardi, E., Maleki, F., Habibzadeh, S. R, et al. The level of Disaster Preparedness of Iranian Hospitals; a Systematic Review. Iranian Journal of Emergency Medicine 2021, 8; 1; e13 [in Persion] 8. Asefzadeh S, Rajaee R, Ghamari F, Kalhor R, Gholami S. Preparedness of Iranian Hospitals Against Disasters. Biotechnology and Health Sciences. 2016; 3; 3[in Persion] 9. Khankeh H, Mosadeghrad AM, Abbasabadi Arab M. Developing Accreditation Standards for Disaster Risk Management: An Approach for Hospital Preparedness Improvement–Editorial. Journal of Military Medicine. 2019; 20; 6:574-6 [in Persion] 10. Abbasabadi M, Khankeh H, Mosadegh Rad AM. Designing of Disaster Risk Management Accreditation Standards in Iranians Hospitals. International Journal for Quality in Health Care 2018 Sep; 30;suppl 2:45-6 11. Abbasabadi M, Alireza A, Mosadeghrad AM, Developing Accreditation Standards in Iran; Trend of quality improvement in Hospitals. ISQua 2021 Virtual Conference Poster Abstract Book. 12. Wise RA. The creation of emergency health care standards for catastrophic events. Academic Emergency Medicine 2006; 13; 11:1150-2 13. Abbasabadi-Arab M, Mosadeghrad AM, Khankeh HR, Biglarian A. Development of hospital disaster risk management accreditation standards. Tehran University Medical Journal TUMS Publications 2021 Oct 10; 79; 7:533-45 [in Persion] 14. ISQua. Guidelines and Principles for the Development of Health and Social Care Standards 2015, International society for quality in health care, 4th Edition 15. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today 2004;24;2 :105-12 16. Hsieh HF, Shannon SE, Three approaches to qualitative content analysis. Qualitative Health Research 2005; 15; 9 : 1277-88 17. Ardalan A, Kandi Keleh M, Saberinia A, Khorasani-Zavareh D, Khankeh H, et al.Estimation of Hospitals Safety from Disasters in I.R.Iran: The Results from the Assessment of 421 Hospitals. PloS one. 2016;11;9:e0161542 18. Mosadeghrad AM, Dehnavi H. Evaluation of hospital performance in Iran: A systematic review and meta-analysis.Payesh 2018; 17:603-615 [in Persian] 19. Adelaine SA, Shoaf K, Harvey C. An Assessment of Collaboration and Disasters: A Hospital Perspective. Prehosp Disaster Med 2016;31;2:121-5 20. Mosadeghrad AM. Hospitals organizational resiliency: From Theory to Practice. Payesh (Health Monitor) 2020 Dec; 15;19;6 :749-51 [in Persian] 21. Kolivand P, Motlagh Me, Ashrafian Amiri H, Jalali SF, Yousefi Khoshsabegheh H, et al. Strengths, Weaknesses, Opportunities, and Threats of Crisis and Disaster Management in Iranian Public Hospitals. Hakim Health System Research Journal 2020;23;3:270-81 [in Persian] 22. Mosadeghrad A, Janbabaei G, Kalantari B, Darrudi A, Dehnavi H. Equity in distribution of hospital beds in Iran. Scientific Journal of Kurdistan University of Medical Sciences. 2020 Jan 1;24(6):12-36 [in Persian] 23. Khankeh HR, Khorasani-Zavareh D, Johanson E, Mohammadi R, Ahmadi F, Mohammadi R. Disaster health-related challenges and requirements: a grounded theory study in Iran. Prehospital and Disaster Medicine 2011;26; 3:151-8 24. Amiri M, Chaman R, Raei M, Shirvani SD, Afkar A. Preparedness of hospitals in north of iran to deal with disasters. Iranian Red Crescent Medical Journal 2013 Jun;15;6 :519 25. Zhong S, Clark M, Hou X-Y, Zang Y, FitzGerald G. Progress and challenges of disaster health management in China: a scoping review. Global Health Action 2014;7;1 :24986 26. Maher A, Yeganeh SM, Lari MA, Sayedin SH. The study of the quality and capacity of equipments' functionality and non-structural vulnerability in selected Tehran general hospitals during an earthquake. International Journal of Health System and Disaster Management 2014 Apr 1; 2;2 :93 27. Mosadeghrad AM, Tajvar M. Ehteshami F. Donors’ Participation in Financing Health System of Iran, Hakim Research Journal 2019, 22 ;1 :26-42 [in Persian] 28. Ayazi MH, Jamali M, Javadi MH, Hoseini nejad J, Rafiefar Sh, et al. Deputy for social affair at a glance, Ministry of Health and Medical Education. Barta publication, Tehran 2018; p.18 [in Persian] 29. Landi F, Gambassi G, Pola R, Tabaccanti S, Cavinato T, Carbonin P, Bernabei R. Impact of integrated home care services on hospital use. Journal of the American Geriatrics Society 1999;47;12:1430-4 30. Abdollahi Gh,Mahin N,Mokhtarzadeh S,Jamshidi M, Zoning of Tehran in order to optimally establish hospitals in normal and disaster conditions (earthquake), Scientific Journal of Rescue and Relief 1391;4;2:1-15 31. Ghanizadeh G, Bahadori M, Hosseini-Shokouh SM. Comparison of Earthquake Disaster Preparedness in Tehran Military and Non-military Hospitals. Journal of Military Health Promotion. 2020 Nov 10;1(3):135-46 [in Persian] 32. Jahani MA, Bazzi HR, Mehdizadeh H, Mahmoudi G. Assessment of hospital preparedness and mangers’ awareness against disaster in southeast Iran in 2017. Journal of Military Medicine 2019 Nov; 19;21;5:538-46 [in Persian] 33. Amiri M, Chaman R, Raei M, Shirvani SD, Afkar A. Preparedness of hospitals in north of iran to deal with disasters. Iranian Red Crescent Medical Journal. 2013 Jun;15(6):519 34. Azarmi S, Pishgooie AH, Sharififar S, Khankeh HR, Hejrypour SZ. Challenges of Hospital Disaster Risk Management: A Systematic Review Study. Disaster medicine and public health preparedness 2021:1-8 35. Usher K, Mills J, West C, Casella E, Dorji P, et al. Cross‐sectional survey of the disaster preparedness of nurses across the Asia–Pacific region. Nursing & Health Sciences 2015; 17;4: 434-43 36. Ingrassia PL, Mangini M, Azzaretto M, Ciaramitaro I, Costa L, et al. Hospital Disaster Preparedness in Italy: a preliminary study utilizing the World Health Organization Hospital Emergency Response Evaluation Toolkit. Minerva anestesiologica 2016 Jun 7;82;12:1259-66 37. Rahmati H, Rambod M, Zare M, Moradian MJ. The effect of crisis management training in traffic accidents with a high rate of mortality using simulated training on knowledge and attitude of nursing personnel. Iranian Journal of Emergency Medicine 2018;5;18:1-7
Journal of Military Medicine
Volume 24, Issue 3 - Serial Number 112
May and June 2022
Pages 1150-1165

Files

Share

How to cite

Statistics