Identifying and Prioritization of Effective Factors on Functional Preparedness of Hospitals of Tabriz University of Medical Sciences in Response to Disasters

Abstract

ABSTRACT Background: Hospitals' preparedness is the first crossroad for people in the health sector to reduce mortality caused by disasters. The present study aimed to identify and prioritize effective factors on the functional preparedness of hospitals in response to disasters. Methods: This multi-methods study was conducted in four steps. In the first step through systematic review and using Mesh keywords in the Web of Science, Scopus, ProQuest, PubMed, SID and elment databases, effective factors on functional preparedness of hospitals were extracted. Then, in the second stage, a qualitative study (semi-structured interviews with participants) was used to identify effective factors on the functional preparedness of local hospitals. In the next step, by using the prioritization matrix and using the experts’ view, the affecting factors were prioritized. Lastly, the potential relationship between the identified effective factors and the functional preparedness of hospitals was measured and evaluated. Results: Based on systematic review results (100 studies), 89 influential factors were extracted that classified into seven categories: coordination control and commanding (8 factors); guidelines and preparedness plans (16 factors); regulations (6 factors); resource provision (39 factors); education and training (10 factors); multi-layered information management and communication systems (7 factors), and contextual factors (3 factors). Results of interviews with 17 experts led to the development of 138 codes. By integrating similar codes, eleven main categories were extracted. Including 1- leadership, command, and coordination, 2- risk assessment, 3- legislating and developing protocols, guidelines, and programs, 4- estimating and storing the necessary supplies and equipment, 5- human resource management, 6- education, training, and development, 7- vital routes and facilities, 8- communication, 9- security and safety, 10- locating of safe zones, 11- Underlying disaster risk factors. The result of prioritization showed that education, training, and development had the most weight, and locating of safe zones had the least weight. After evaluating the level of functional preparedness of the hospitals under investigation, the average performance evaluation score was 64.23 (17.83) and 61.61 (17.83) based on the two standard and researcher-created checklists, respectively. The result of the intraclass correlation coefficient (ICC) with the two-way mixed-effects model method to check the level of agreement showed that the agreement of the total score between the two instruments was low (Average Measures ICC= .08). Conclusion: Hospital preparedness for disasters has different aspects, each affected by several factors. The level of hospital preparedness is also affected by mentioned factors. Attention to these factors can be effective in improving the functional preparedness of hospitals against disasters. Hospital managers and decision-makers should consider these factors to ensure the proper provision of medical services in disasters.