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Barzanji A, Farrokhi M, Ebadi A, Saatchi M, Ahmadi S, Khankeh H. Exploring influential components and indicators in hospital resilience assessment: a scoping review protocol. BMJ Open 2024; 14:e089054. [PMID: 39557560 PMCID: PMC11574471 DOI: 10.1136/bmjopen-2024-089054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 10/25/2024] [Indexed: 11/20/2024] Open
Abstract
INTRODUCTION Hospitals are vital infrastructures that provide health services during emergencies and disasters. However, in recent years, disasters have led to hospital losses and interruptions in medical services. Consequently, the concept of resilience has garnered significant attention. Despite extensive research, the lack of clarity in explaining hospital resilience poses challenges in effective assessment and identifying key priorities for enhancing disaster risk management. Recently, the WHO's Eastern Mediterranean Regional Office (EMRO) introduced a conceptual framework for the conceptualisation of hospital resilience, defining it through six interconnected components and four resilience capacities. Identifying specific indicators and characteristics for hospital resilience components based on the EMRO framework. This protocol outlines the method for conducting a scoping review to identify such indicators and characteristics to develop a comprehensive hospital resilience assessment tool. METHODS AND ANALYSIS This scoping review will adhere to the six-step protocol proposed by Arksey and O'Malley. It aims to comprehensively understand current knowledge about resilient hospital characteristics and identify effective components and indicators for assessing hospital resilience. The review will encompass available articles indexed in PubMed, Scopus and Web of Science. Additionally, searches will explore the grey literature on Google Scholar, the WHO's website and regional offices. There will be no publication date restrictions applied to the search. Quantitative and qualitative content analyses will assess and categorise the study results. Our protocol was drafted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols extension for scoping reviews. ETHICS AND DISSEMINATION This protocol describes a scoping review within a doctoral thesis focused on health in emergencies and disasters, specifically hospital resilience. The study, associated with ethics code number (IR.USWR.REC.1402.120), aims to develop a comprehensive assessment tool for hospital resilience. Once peer-reviewed and published, the findings will inform experts, policymakers and relevant organisations in emergency and disaster management.
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Affiliation(s)
- Arvin Barzanji
- Health in Emergency and Disaster Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Science, Tehran, Iran (the Islamic Republic of)
| | - Mehrdad Farrokhi
- Health in Emergency and Disaster Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Science, Tehran, Iran (the Islamic Republic of)
| | - Abbas Ebadi
- Nursing Care Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Mohammad Saatchi
- Health in Emergency and Disaster Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Science, Tehran, Iran (the Islamic Republic of)
| | - Shokoufeh Ahmadi
- Health in Emergency and Disaster Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Science, Tehran, Iran (the Islamic Republic of)
| | - Hamidreza Khankeh
- Health in Emergency and Disaster Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Science, Tehran, Iran (the Islamic Republic of)
- QUEST Center for Responsible Research, Berlin Institute of Health at Charité, Berlin, Germany
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Carbonara N, Pellegrino R, De Luca C. Resilience of hospitals in an age of disruptions: a systematic literature review on resources and capabilities. Health Syst (Basingstoke) 2024; 13:192-228. [PMID: 39175496 PMCID: PMC11338213 DOI: 10.1080/20476965.2024.2365144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/02/2024] [Indexed: 08/24/2024] Open
Abstract
Hospitals play a critical role in ensuring continuous and effective healthcare delivery, especially during crises. However, the COVID-19 pandemic exposed vulnerabilities in hospital systems, prompting a need to enhance resilience-the ability to withstand, absorb, respond to, recover from, and learn from disasters. A systematic literature review, grounded in the resource-based view, identified organizational characteristics, in terms of resources and capabilities, and their synergistic effects that bolster hospital resilience. The results demonstrate that digital technologies impact on anticipation and adaptation abilities, organizational capabilities to reorganize roles, tasks, and spaces enhance adaptability, and Inter-organizational collaborations increase the responsiveness of the hospitals. The study provides substantial theoretical and practical contributions. It expands knowledge of hospital resilience in light of recent disruptive events and promotes integration capabilities as determinants for the majority of resilience dimensions. All organisational and inter-organisational collaboration, cooperation, and coordination are deemed crucial for hospital resilience.
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Affiliation(s)
- Nunzia Carbonara
- Department of Mechanics Mathematics and Management, Polytechnic University of Bari, Bari, Italy
| | - Roberta Pellegrino
- Department of Mechanics Mathematics and Management, Polytechnic University of Bari, Bari, Italy
| | - Cristina De Luca
- Department of Mechanics Mathematics and Management, Polytechnic University of Bari, Bari, Italy
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Seyghalani Talab F, Ahadinezhad B, Khosravizadeh O, Amerzadeh M. A model of the organizational resilience of hospitals in emergencies and disasters. BMC Emerg Med 2024; 24:105. [PMID: 38914937 PMCID: PMC11197230 DOI: 10.1186/s12873-024-01026-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 06/19/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND In the health system, hospitals are intricate establishments that offer vital medical services. Their resilience plays a crucial role in mitigating the societal repercussions of disasters. A hospital must possess the capacity to withstand risks, preserve its fundamental structure and operations, and enhance its preparedness by augmenting various capabilities and promptly recovering from the impacts of potential risks. It enables the hospital to attain a heightened level of readiness. Therefore, this study aimed to develop a resilience model tailored for hospitals to navigate crises and disasters effectively. METHODS This mixed-method study was conducted in 2023 in three phases: (1) Identification of the factors influencing the organizational resilience of the hospital, (2) Evaluation of the influential factors by an expert panel. (3) Following the standardization process, we administered 371 questionnaires to individuals, such as university staff managers and supervisors, nursing managers, and research unit managers. The sample size was determined by multiplying the components by 10, resulting in 360 (10 * 36). Therefore, we selected a sample size of 371 participants. Structural Equation Modeling (SEM) was employed to examine the causal relationships between variables. These steps were performed using SPSS 25.0 and AMOS 22 software. Finally, we identified and presented the final model. We utilized AMOS 22 and applied the SEM to assess the correlation between the variables, with a significance level of 0.05. RESULTS Findings indicate that the appropriate modeling identified five dimensions comprising 36 components. These dimensions include vulnerability, preparedness, support management, responsiveness and adaptability, and recovery after the disaster. The model demonstrates a good fit, as indicated by the X2/d indices with a value of 2.202, a goodness of fit index (GFI) of 0.832, a root mean square error of estimation (RMSEA) of 0.057, an adjusted comparative fit index (CFI) of 0.931, and a smoothed fit index (NFI) of 0.901. CONCLUSION Enhancing hospital resilience is crucial for effective preparedness and response to accidents and disasters. Developing a localized tool for measuring resilience can help identify vulnerabilities, ensure service continuity, and inform rehabilitation programs. The proposed model is a suitable framework for assessing hospital resilience. Key factors include human resource scarcity, hospital specialization, and trauma center capacity. Hospitals should prioritize efficient resource allocation, information technology infrastructure, in-service training, waste management, and a proactive organizational framework to build resilience. By adopting this approach, hospitals can better respond to crises and disasters, ultimately reducing casualties and improving overall preparedness.
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Affiliation(s)
- Fatemeh Seyghalani Talab
- Student Research Committee, Department of Healthcare Management, School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Bahman Ahadinezhad
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Omid Khosravizadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Mohammad Amerzadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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Sari N, Omar M, Pasinringi SA, Zulkifli A, Sidin AI. Developing hospital resilience domains in facing disruption era in Indonesia: a qualitative study. BMC Health Serv Res 2023; 23:1395. [PMID: 38087264 PMCID: PMC10714512 DOI: 10.1186/s12913-023-10416-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The studies of hospital resilience have been of increasing importance during the last decade due to disasters and pandemics. However, studies in developing the domain and indicators of hospital resilience were limited mainly on disaster response. A few studies of hospital resilience focused on how to deal with disruptions such as environmental turbulence, rapid technological changes, and changes in patient preferences. This study aims to develop domains and indicators of hospital resilience in facing the disruption era. METHODS This qualitative study focused on exploring the domains and indicators to face disruptions that have been identified in the first exploratory phase of the studies. Key informants included hospital experts from the government, medical practitioners, and academics. A total of 20 key informants were involved in semi-structured interviews which were conducted face-to-face, via telephone and Zoom. Data was analyzed using a grounded theory approach to discover domains for a resilient hospital. RESULTS The study identified a number of domains that are fundamental for a hospital to become a resilient in the face of disruption. These include readiness to face digital transformation, effective leadership, and flexibility in managing resources among others. Situation awareness and resilience ethos, implementation of marketing management, networking, and disaster anticipation are found to be equally important. These domains focused on the hospital's ability to deal with specific shocks from different perspectives as the result of changes from disruptions which are inevitable within the organizational business environment. CONCLUSIONS The domains identified in the study are able to respond to the limitations of the concept of hospital resilience, which is currently more focused on hospital disaster resilience. They can be used to measure hospital resilience in the context of the volatility, uncertainty, complexity, and ambiguity (VUCA), which are relevant to the context of the Indonesia hospital industry.
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Affiliation(s)
- Nurmala Sari
- Hospital Management Department, Public Health Faculty, Hasanuddin University, Makassar, Indonesia.
| | - Maye Omar
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
| | - Syahrir A Pasinringi
- Magister of Hospital Administration Study Program, Public Health Faculty, Hasanuddin University, Makassar, Indonesia
| | - Andi Zulkifli
- Magister of Hospital Administration Study Program, Public Health Faculty, Hasanuddin University, Makassar, Indonesia
| | - Andi Indahwaty Sidin
- Magister of Hospital Administration Study Program, Public Health Faculty, Hasanuddin University, Makassar, Indonesia
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Zhong Q, Chen Y, Yan J. Comprehensive evaluation of community human settlement resilience and spatial characteristics based on the supply-demand mismatch between health activities and environment: a case study of downtown Shanghai, China. Global Health 2023; 19:87. [PMID: 37974200 PMCID: PMC10655422 DOI: 10.1186/s12992-023-00976-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/26/2023] [Indexed: 11/19/2023] Open
Abstract
INTRODUCTION Under globalization, human settlement has become a major risk factor affecting life. The relationship between humans and the environment is crucial for improving community resilience and coping with globalization. This study focuses on the key contradictions of community development under globalization, exploring community resilience by analyzing the mismatch between residents' health activities and the environment. METHODS Using data from Shanghai downtown, including land use, Sports app, geospatial and urban statistics, this paper constructs a comprehensive community resilience index (CRI) model based on the DPSIR model. This model enables quantitative analysis of the spatial and temporal distribution of Community Human Settlement Resilience (CR). Additionally, the paper uses geodetector and Origin software to analyze the coupling relationship between drivers and human settlement resilience. RESULTS i) The scores of CR showed a "slide-shaped" fluctuation difference situation; ii) The spatial pattern of CR showed a "pole-core agglomeration and radiation" type and a "ring-like agglomeration and radiation" type. iii) Distance to bus stops, average annual temperature, CO2 emissions, building density and number of jogging trajectories are the dominant factors affecting the resilience level of community human settlement. CONCLUSION This paper contributes to the compilation of human settlement evaluation systems globally, offering insights into healthy community and city assessments worldwide. The findings can guide the creation of similar evaluation systems and provide valuable references for building healthy communities worldwide.
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Affiliation(s)
- Qikang Zhong
- School of Architecture and Art, Central South University, Changsha, 410083, China
| | - Yue Chen
- School of Architecture and Art, Central South University, Changsha, 410083, China.
| | - Jiale Yan
- Irvine Valley College, Irvine, CA, 92618, USA
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Maha LG, Stoian IC, Bejenar S. The resilience of Romanian companies in the context of the COVID-19 pandemic: Relevant experiences and good practices. Heliyon 2023; 9:e21951. [PMID: 38045171 PMCID: PMC10692772 DOI: 10.1016/j.heliyon.2023.e21951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 10/29/2023] [Accepted: 11/01/2023] [Indexed: 12/05/2023] Open
Abstract
The increasing number and diversity of crises in the world economy, both at the macroeconomic and the microeconomic level, justify the consistent theoretical and practical concerns regarding resilience. Our paper aims to evaluate Romanian companies' resilience by investigating the way they addressed the recent pandemic crisis. More concretely, our research is focused on identifying the most important crisis affecting each company and its industry. We analyze their impact on the firm's activity and performance, identify the perceived factors that could help the company to overcome the crisis, and investigate the efficiency of the measures implemented by the Romanian companies in order to overcome the most significant crises they faced. To achieve our research objectives, we conducted in-depth interviews on a sample of 63 respondents who are decision makers in their companies (entrepreneurs, managers, administrators, sales directors, and brand managers), and we used the interview guide as a research instrument for collecting the relevant qualitative data. The main results indicate that the most important crisis affecting these companies are related to issues in their specific field of activity (such as legal regulations, political factors), general country characteristics (socio-demographic or legislative factors) and global factors (such as a global economic crisis, the recent COVID-19 pandemic). These crises affected the firms on the financial, organizational, and marketing levels, but most of the analyzed companies found different ways to adjust and to overcome the crisis. The results are all the more important, as there is a lack of studies on how companies reacted to the recent pandemic in emerging economies, especially in Romania, in order to identify best practices and relevant experiences for potential future crises.
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Affiliation(s)
- Liviu-George Maha
- Alexandru Ioan Cuza University of Iasi, Faculty of Economics and Business Administration, Department of Economics and International Relations, Romania
| | - Iuliana Claudia Stoian
- Alexandru Ioan Cuza University of Iasi, Faculty of Economics and Business Administration, Department of Management, Marketing and Business Administration, Romania
| | - Silviu Bejenar
- Alexandru Ioan Cuza University of Iasi, Faculty of Economics and Business Administration, Doctoral School of Economics and Business Administration, Romania
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Lamine H, Lamberti-Castronuovo A, Singh P, Chebili N, Zedini C, Achour N, Valente M, Ragazzoni L. A Qualitative Study on the Use of the Hospital Safety Index and the Formulation of Recommendations for Future Adaptations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4985. [PMID: 36981894 PMCID: PMC10049632 DOI: 10.3390/ijerph20064985] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
The Hospital Safety Index is a tool developed by the World Health Organization and the Pan American Health Organization in 2008 and updated in 2015. Although it is the most widely used instrument of its kind to assess the level of hospital preparedness, scientific literature on its application in real life is scarce. This study aimed to investigate the use of the Hospital Safety Index to assess disaster preparedness in healthcare facilities. A retrospective, qualitative study employing semi-structured online interviews was conducted to gather the opinions and perspectives of professionals who have experience in applying the Hospital Safety Index. Authors of scientific publications using the Hospital Safety Index were recruited. A semi-structured interview guide was developed. It addressed different phases of data collection with the Hospital Safety Index, the challenges and facilitators of using it, and recommendations for future adaptations. Data were analysed using inductive thematic analysis. Nine participants who were from three countries (Serbia, Sri Lanka, and Indonesia) and had different professional backgrounds (medical doctors, engineers, spatial planners, etc.) participated in this study. A total of 5 themes and 15 subthemes emerged during data analysis. Most of the participants reported their reasons for choosing the Hospital Safety Index as being its comprehensiveness and the fact that it was issued by the World Health Organization. The tool appears to be very specific and allows investigators to spot details in hospitals; however, it is not easy to use, and training is highly encouraged to learn how to navigate the different components of the tool. Governmental support is a crucial facilitator for investigators to be able to enter hospitals and conduct their evaluations. Overall, the tool has a lot of potential, and it should be used to reach a broader audience, such as community members, and assess the preparedness of other facilities that can take part in the response to disasters (hotels, stadiums, schools, etc.). Nevertheless, it still needs more adaptations to be tailored to different contexts and settings.
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Affiliation(s)
- Hamdi Lamine
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università Del Piemonte Orientale, 28100 Novara, Italy
- Department for Sustainable Development and Ecological Transition, Università Del Piemonte Orientale, 13100 Vercelli, Italy
- Ibn El Jazzar Medical Faculty of Sousse, University of Sousse, Sousse 4002, Tunisia
| | - Alessandro Lamberti-Castronuovo
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università Del Piemonte Orientale, 28100 Novara, Italy
- Department for Sustainable Development and Ecological Transition, Università Del Piemonte Orientale, 13100 Vercelli, Italy
| | - Prinka Singh
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università Del Piemonte Orientale, 28100 Novara, Italy
- Department for Sustainable Development and Ecological Transition, Università Del Piemonte Orientale, 13100 Vercelli, Italy
| | - Naoufel Chebili
- Ibn El Jazzar Medical Faculty of Sousse, University of Sousse, Sousse 4002, Tunisia
- Urgent Medical Aid Service (SAMU 03), Sahloul University Hospital, Sousse 4052, Tunisia
| | - Chekib Zedini
- Ibn El Jazzar Medical Faculty of Sousse, University of Sousse, Sousse 4002, Tunisia
| | - Nebil Achour
- School of Allied Health, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK
| | - Martina Valente
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università Del Piemonte Orientale, 28100 Novara, Italy
- Department for Sustainable Development and Ecological Transition, Università Del Piemonte Orientale, 13100 Vercelli, Italy
| | - Luca Ragazzoni
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università Del Piemonte Orientale, 28100 Novara, Italy
- Department for Sustainable Development and Ecological Transition, Università Del Piemonte Orientale, 13100 Vercelli, Italy
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Ravaghi H, Khalil M, Al-Badri J, Naidoo AV, Ardalan A, Khankeh H. Role of hospitals in recovery from COVID-19: Reflections from hospital managers and frontliners in the Eastern Mediterranean Region on strengthening hospital resilience. Front Public Health 2023; 10:1073809. [PMID: 36743170 PMCID: PMC9889830 DOI: 10.3389/fpubh.2022.1073809] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/28/2022] [Indexed: 01/19/2023] Open
Abstract
Background COVID-19 highlighted the critical role that hospitals play throughout the prolonged response and continuous recovery stages of the pandemic. Yet, there is limited evidence related to hospitals in the recovery stage, particularly capturing the perspectives of hospital managers and frontliners in resource-restrained and humanitarian settings. Objective This paper aims to capture the perspectives of hospital managers and frontliners across the Eastern Mediterranean Region on (1) the role of hospitals in recovering from COVID-19, (2) Hospitals' expectations from public health institutions to enable recovery from COVID-19, (3) the Evaluation of hospital resilience before and through COVID-19, and (4) lessons to strengthen hospital resilience throughout the COVID-19 recovery. Methods A multi-methods approach, triangulating a scoping review with qualitative findings from 64 semi-structured key-informant interviews and survey responses (n = 252), was used to gain a deeper context-specific understanding. Purposeful sampling with maximum diversity supported by snowballing was used and continued until reaching data saturation. Thematic analysis was conducted using MAXQDA and simple descriptive analysis using Microsoft Excel. Findings In recovering from COVID-19, hospital managers noted hospitals' role in health education, risk reduction, and services continuity and expected human resource management, financial and material resource mobilization, better leadership and coordination, and technical support through the provision of updated clinical evidence-based information from their public health institutions. Qualitative findings also indicated that hospital managers attributed considerable changes in hospitals' resilience capacities to the pandemic and suggested that strengthening hospitals' resilience required resilient staff, sustainable finance, and adaptive leadership and management. Conclusion Hospitals are the backbone of health systems and a main point of contact for communities during emergencies; strengthening their resilience throughout the various stages of recovery is critical. Hospitals cannot be resilient in silos but rather require an integrated-whole-of-society-approach, inclusive of communities and other health systems actors.
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Affiliation(s)
- Hamid Ravaghi
- Department of Universal Health Coverage and Health Systems, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Merette Khalil
- Department of Universal Health Coverage and Health Systems, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt,*Correspondence: Merette Khalil ✉
| | - Jehan Al-Badri
- Health Emergencies Program, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | | | - Ali Ardalan
- Department of Universal Health Coverage and Health Systems, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Hamidreza Khankeh
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran,Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden
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Khalil M, Ravaghi H, Samhouri D, Abo J, Ali A, Sakr H, Camacho A. What is "hospital resilience"? A scoping review on conceptualization, operationalization, and evaluation. Front Public Health 2022; 10:1009400. [PMID: 36311596 PMCID: PMC9614418 DOI: 10.3389/fpubh.2022.1009400] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/27/2022] [Indexed: 01/27/2023] Open
Abstract
Background COVID-19 underscored the importance of building resilient health systems and hospitals. Nevertheless, evidence on hospital resilience is limited without consensus on the concept, its application, or measurement, with practical guidance needed for action at the facility-level. Aim This study establishes a baseline for understanding hospital resilience, exploring its 1) conceptualization, 2) operationalization, and 3) evaluation in the empirical literature. Methods Following Arksey and O'Malley's model, a scoping review was conducted, and a total of 38 articles were included for final extraction. Findings and discussion In this review, hospital resilience is conceptualized by its components, capacities, and outcomes. The interdependence of six components (1) space, 2) stuff, 3) staff, 4) systems, 5) strategies, and 6) services) influences hospital resilience. Resilient hospitals must absorb, adapt, transform, and learn, utilizing all these capacities, sometimes simultaneously, through prevention, preparedness, response, and recovery, within a risk-informed and all-hazard approach. These capacities are not static but rather are dynamic and should improve continuously occur over time. Strengthening hospital resilience requires both hard and soft resilience. Hard resilience encompasses the structural (or constructive) and non-structural (infrastructural) aspects, along with agility to rearrange the space while hospital's soft resilience requires resilient staff, finance, logistics, and supply chains (stuff), strategies and systems (leadership and coordination, community engagement, along with communication, information, and learning systems). This ultimately results in hospitals maintaining their function and providing quality and continuous critical, life-saving, and essential services, amidst crises, while leaving no one behind. Strengthening hospital resilience is interlinked with improving health systems and community resilience, and ultimately contributes to advancing universal health coverage, health equity, and global health security. The nuances and divergences in conceptualization impact how hospital resilience is applied and measured. Operationalization and evaluation strategies and frameworks must factor hospitals' evolving capacities and varying risks during both routine and emergency times, especially in resource-restrained and emergency-prone settings. Conclusion Strengthening hospital resilience requires consensus regarding its conceptualization to inform a roadmap for operationalization and evaluation and guide meaningful and effective action at facility and country level. Further qualitative and quantitative research is needed for the operationalization and evaluation of hospital resilience comprehensively and pragmatically, especially in fragile and resource-restrained contexts.
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Affiliation(s)
- Merette Khalil
- Department for Universal Health Coverage and Health Systems, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Hamid Ravaghi
- Department for Universal Health Coverage and Health Systems, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Dalia Samhouri
- Health Emergencies Programme, World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - John Abo
- Asian Disaster Preparedness Center, Bangkok, Thailand
| | - Ahmed Ali
- Health Emergencies Programme, World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Hala Sakr
- Department of Healthier Populations, World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Alex Camacho
- Health Emergencies Programme, World Health Organization, Regional Office for the Americas, Washington, DC, United States
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Jin A, Li G, Yu Y, Wang J, Nie Q. Establishment of hospital resilience framework in urban China: insight from Wuhan City. COMPUTATIONAL URBAN SCIENCE 2022; 2:31. [PMID: 36160756 PMCID: PMC9483400 DOI: 10.1007/s43762-022-00060-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/25/2022] [Indexed: 11/24/2022]
Abstract
AbstractSince the Corona Virus Disease 2019 (COVID-19) swept the world, many countries face a problem that is a shortage of medical resources. The role of emergency medical facilities in response to the epidemic is beginning to arouse public attention, and the construction of the urban resilient emergency response framework has become the critical way to resist the epidemic. Today, China has controlled the domestically transmitted COVID-19 cases through multiple emergency medical facilities and inclusive patient admission criteria. Most of the existing literature focuses on case studies or characterizations of individual facilities. This paper constructs an evaluation system to measure urban hospital resilience from the spatial perspective and deciphered the layout patterns and regularities of emergency medical facilities in Wuhan, the city most affected by the epidemic in China. Findings indicate that the pattern of one center and two circles are a more compelling layout structure for urban emergency medical facilities in terms of accessibility and service coverage for residents. Meanwhile, the Fangcang shelter hospital has an extraordinary performance in terms of emergency response time, and it is a sustainable facility utilization approach in the post-epidemic era. This study bolsters areas of the research on the urban resilient emergency response framework. Moreover, the paper summarizes new medical facilities’ planning and location characteristics and hopes to provide policy-makers and urban planners with valuable empirical evidence.
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Affiliation(s)
- Annan Jin
- College of Urban and Environmental Sciences, Northwest University, 710127 Xi’an, China
- Shaanxi Key Laboratory of Earth Surface System and Environmental Carrying Capacity, 710127 Xi’an, China
| | - Gang Li
- College of Urban and Environmental Sciences, Northwest University, 710127 Xi’an, China
- Shaanxi Key Laboratory of Earth Surface System and Environmental Carrying Capacity, 710127 Xi’an, China
| | - Yue Yu
- College of Urban and Environmental Sciences, Northwest University, 710127 Xi’an, China
- Shaanxi Key Laboratory of Earth Surface System and Environmental Carrying Capacity, 710127 Xi’an, China
| | - Jiaobei Wang
- College of Urban and Environmental Sciences, Northwest University, 710127 Xi’an, China
- Shaanxi Key Laboratory of Earth Surface System and Environmental Carrying Capacity, 710127 Xi’an, China
| | - Qifan Nie
- Alabama Transportation Institute, 248 Kirkbride Lane, Tuscaloosa, AL 35487 USA
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Advancing Resilience of Critical Health Infrastructures to Cascading Impacts of Water Supply Outages—Insights from a Systematic Literature Review. INFRASTRUCTURES 2021. [DOI: 10.3390/infrastructures6120177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The current understanding of critical health infrastructure resilience is still dominated by a technical perspective. Reality however is different, as past events including the COVID-19 pandemic have revealed: emergency situations are only rarely exclusively technical in nature. Instead they are a product of prior circumstances, often linked to natural hazards, technical mishaps, and insufficient social and organizational preparedness structures. However, experiences and lessons learned from past events are still largely overlooked and have not sufficiently found their way into conceptual understandings of critical health infrastructure resilience. This paper addresses this gap by challenging the one-sided and technically oriented understanding of resilience in the context of critical health infrastructure. Based on a systematic literature review, it assesses real-world cases of water supply failures in healthcare facilities, a serious threat largely overlooked in research and policy. The results underscore the need for targeted organizational strategies to deal with cascading impacts. The overall findings show that addressing technical aspects alone is not sufficient to increase the overall resilience of healthcare facilities. Broadening the dominant resilience understanding is hence an important foundation for healthcare infrastructures to improve risk management and emergency preparedness strategies to increase their resilience towards future disruptions.
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