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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. [ABSTRACT FROM AUTHOR]

Background: Hospitals play an important role in protecting the health and survival of people during disasters. Despite the development of risk management programs worldwide in recent years, hospital preparedness in disasters is low and one reason for that is the lack of hospital standards for disaster preparedness. This study aims to develop hospital accreditation standards for hospital disaster risk management based on national and international experiences. Materials and Methods: We used a mixed-method explanatory sequential approach. At first, a comparative study was conducted and the disaster risk management (DRM) hospital standards were extracted from 10 selected countries, namely the United States, Canada, Australia, Malaysia, India, Thailand, Egypt, Turkey, Saudi Arabia, and Denmark. Standards were analyzed according to the DRM life cycle and the most comprehensive framework was chosen. For national experiences, purposeful semi-structured interviews were conducted with 22 experts in disastrous events in the country and continued until the saturation stage. In addition, Graneheim and Landman's contractual content analysis method was used for data analysis. After combining international standards and national experiences, the proposed standards were introduced and the content validity index and content validity ratio were done by 25 experts. Results: Differences were observed in the quality and quantity of the selected countries' DRM standards. The national accreditation standards of the United States, Australia, and Canada had comprehensive standards and covered all aspects of the disaster risk management cycle. A total of 27 standards from the International Standards Review and 31 standards from interviews were added (a total of 58 standards). The content validity results of the standards were within acceptable limits. After editing and determining the measurement criteria, the final standards were introduced. Conclusion: This study introduces comprehensive DRM standards based on international and national documents and experiences that can be useful for policymakers and accreditation organizations in both developed and developing countries for hospital evaluation. This is also useful for hospitals as a roadmap for promoting preparedness in disasters. [ABSTRACT FROM AUTHOR]

Background and Aim: Hospital preparedness in disasters is an important role in maintaining and promoting community health. Hospital disaster risk management accreditation standards have been developed since 2016. This study was conducted to investigate the implementation of these standards in the country's hospitals to identify the strengths and weaknesses of hospitals and provide practical solutions. Methods: This descriptive cross-sectional study was performed in hospitals throughout the country. The results of the evaluation of the third round of accreditation in 2017 were used. Hospitals were evaluated by national accreditation surveyors of the Ministry of Health using a checklist related to accreditation standards and measures based on disaster risk management (seven standards and 37 criteria) and registered in the country's accreditation system. Descriptive statistics were used to analyze the data. Results: The average score of the country's hospitals in the field of disaster risk management was 48.82. Zanjan (58.27) and Qazvin (56.44) provinces have the highest score and Ilam (25.36) and Lorestan (38.39) provinces have the lowest score. The highest score was in the first standard (disaster risk assessment and prioritization) with an average of 67.78 and the second standard (fire prevention and control) with an average of 67.05. The lowest scores were related to the fifth standard (reporting accidents and dangerous situations) (29.38) and the seventh standard (activating response systems) (32.33). More than 75% of the country's border provinces (Ilam, Kermanshah, Khuzestan, Kurdistan, Khorasan Razavi, North Khorasan, Sistan and Baluchestan, East and West Azerbaijan) have scored less than 50%. Conclusion: The results of this study showed that the average scores of the country's hospitals in disaster risk management was low and the country's hospitals, especially hospitals in border provinces, are not adequately prepared to deal with disasters. The biggest weaknesses of hospitals in the scientific formulation of preparedness and response programs are the lack of knowledge about the national instructions of preparedness and response, lack of education and training, non-structural vulnerability, and infrastructure of hospitals. Strengthening the safety and resilience of hospitals, improving the level of knowledge and skills of managers and staff, and improving the quality and continuous review of standards based on the challenges of the hospital, are among the strategies for developing and improving hospital preparedness for disasters. [ABSTRACT FROM AUTHOR]

Purpose: Disasters are increasing worldwide and hospitals should be prepared to respond well to such disasters. An effective hospital disaster risk management program saves peoples' lives, reduces damage to the hospital properties and assures hospital service continuity. This article aimed to develop and verify a Hospital Disaster Risk Management Evaluation model (HDRME). Methods: A mixed-method explanatory sequential approach was used to develop and verify the HDRME model. The first draft of the HDRME model was introduced through a comprehensive literature review of major databases (i.e., PubMed, Scopus, Web of Science, and Science Direct), using appropriate keywords. Furthermore, 18 in-depth individual interviews were conducted with well-known experts in DRM to identify more HDRME constructs, sub-constructs, and standards. Then, three rounds of Delphi were conducted with 22 experts in hospital disaster risk management to verify the proposed model. Results: The proposed HDRME consists of eight constructs, including seven enablers (management and leadership; risk assessment; planning; prevention and mitigation; preparedness; response, and recovery) and one result (key performance results). These constructs were further broken into 27 sub-constructs. The enablers and results scored 85% and 15% of the model's total scores. Conclusion: A comprehensive conceptual framework for the evaluation of hospital disaster risk management was introduced and verified. Standards and measurable elements can be embedded in this conceptual model to measure a hospital's preparedness in disasters and accordingly, corrective actions can be taken to strengthen the hospitals' responses to the disasters. However, the proposed model should be validated in a hospital setting through implementation. [ABSTRACT FROM AUTHOR]