Table 3 Domains, sub-domains and indicators of hospital disaster resilience
From: Towards developing a model for the evaluation of hospital disaster resilience: a systematic review
| Domain | Sub-Domain | Indicators |
|---|---|---|
| Constructive Resilience | Stability | Building Structural System, Retrofitting the building, Construction materials, Structural redundancy, Laboratory test results, Plan and vertical irregularities, Structural configuration and lateral resistance system, Structural integrity of the building, Building’s age, Soil type, Reduced stress and fatigue, Withstand disaster-induced damage and disruption |
| Design | Open spaces, Hazards maps and zones, The space between buildings, Proper zoning of building areas, Building regulations and design codes, Hospital design and layout (location, slope, sea level, water ground, seismicity, configuration etc.), Permit and clearance process, Interstitial space for utility installations, Occupancy or usage type of different parts of hospital | |
| Architectural | Safety of internal path (stairs, corridors and, elevators), Safety of the architectural elements such as doors, windows, internal and exterior walls, facings etc. | |
| Transportation and Transition System | Space for the ambulance stopping and passing, Safety of the access routes, Space for the helicopter landing, Capacity of hospital parking, Ramps for moving patients’ bed and for the people with disabilities. | |
| Infrastructural Resilience | Power | Maintenance and safety of the electrical power systems, lightning systems and the generators, Automatic test equipments, Power conservation activities, The age of power systems, Continuous electric load analysis and monitoring, Redundancy for most critical areas, Monitoring systems for the power outage or power failure, Protecting from terrorist attack, Length of power outage. |
| Water and Sewage system | Maintenance and safety of the water system and the sewage system, Water saving and conservation activities, Time and length of water interruptions, The age of water and sewage system, Providing water from outside sources, Automatic test equipments, Plans for prioritize critical water consuming activities, Monitoring systems for water outage or water contamination, | |
| Communication and IT System | Maintenance and safety of IT and Communicationsystem, Automatic test equipments, Maintenance of alternative and backup communication and, IT system. | |
| Heating, Ventilation and air conditioning (HVAC) | Maintenance and safety of HVAC systems, Automatic test equipment, Monitoring systems to provide warning of HVAC system failure. | |
| Fuel | Fuel reservation, Safe location of the fuel storage. | |
| Medical gas | Maintenance and safety of the medical gas system, Providing alternative sources of medical gases. | |
| Equipment and furniture elements | Equipment anchorage and fixing, Safety of rooms’ furniture and equipment, Safety of medical and laboratories equipments. | |
| Hazardous Material | Hazardous material forms and documents, Safety of hazardous solid waste, wastewater, and liquid waste. | |
| Fire system | Condition and safety of the fire systems, Water supply for fire protection. | |
| Administrative Resilience | Disaster Plan | Emergency preparedness, Emergency response, Contingency plans, Emergency regulations, Emergency recovery, Emergency evacuation, Standard operating procedures (SOP). |
| Risk assessment and reduction | Hazards identification and analyses, Hospital initial condition, Structural and non-structural risk reduction measures, Estimation of structural and non-structural damages, Estimation of losses due to an interruption in services, Developing the measures for risk reduction in future, Amount of consumable commodity. | |
| Response | The proper response, Timely response, Early Warning, Ability to discharge noncritical patients. | |
| Command | Establishing the incident command system (ICS). | |
| Coordination | Create a framework for the participation of local authorities, Effective implementing information and communication system, Access of operational personnel to expert opinions, Personnel partnership in finding solutions for defections, The coordination between different parts of the hospital. Accreditation standards, Performance of the other hospitals in the region. Dissemination of Personnel Incident Information to Staff During an Incident. | |
| Evacuation | Proper and timely response according to the emergency evacuation plans. | |
| Need assessment | Medical services demands, The rate of patient arrivals. | |
| Logistic and supplies | Logistic management of requirements, Personnel recalling and transmitting system, Agreement with suppliers, Resources availability, Mental health and psycho-social treatment for patients, families, and health workers, Details of the types, amounts and quality of the equipment and stocks, Applying alternative systems in a safe mode. | |
| Safety committee | Establishing and developing the emergency committee, List of personnel contact information, Human protection from fire, chemical and radiological hazards, Infection Surveillance, Prevention and control procedures, Insurance status. | |
| Continuity of services | Preventing reduction in the system operation, Ability to adapt timely to emergency state, Self-organization and re-structuring. | |
| Volunteers | Consider community-based activities, management and mobilization, Societal preparedness, Participation of donors community | |
| Finance | Management of the disaster financial and administration system, Direct and indirect economic loss, Cost of repair and reconstruction, Mitigation budget. | |
| Recovery | Maintenance and repair plan for equipment, Priorities of repair and reconstruction, Psychosocial services for emergency staff. | |
| Training | Educational courses, Exercise, Promote research and studies, Lesson learned from past disasters. |