Planning and assessment approaches towards disaster resilient hospitals: A systematic literature review

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Mohtady Ali, H
Desha, C
Ranse, J
Roiko, A
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Background: Hospitals play a critical role as a frontline agency in disasters, with staff often working within extraordinary circumstances in these facilities to deliver care. This study was inspired by the authors' interdisciplinary experiences in health and resilience engineering. Observing increasing dialogue about how hospitals could improve their resilience to disasters we sought to understand the construct of ‘hospital resilience during disasters’ and how it could be improved. Method: The study involved a systematic literature review of publications related to hospital resilience during disasters, conducted at the end of January 2020. Of the 553 articles found initially, 49 remained after applying inclusion and exclusion criteria. Quality appraisal tools designed for different types of research were used. Results: The findings are described using language and constructs drawn from the Plan-Prepare-Respond-Recover (PPRR) discourse and Resilience Engineering Theory. The review found broad consensus that staff awareness, education, and training about disaster-related plans need to be improved. The articles documented a wide variety of approaches to evaluating hospital resilience to disasters, wherein the importance of infrastructure and organisational resilience is clear. This included insightful guidance for developing, disseminating, communicating, and implementing disaster plans. Conclusion: Through distilling the literature review findings, we propose a ‘Decision-Support Model for Disaster Resilient Hospitals’ to foster proactive and systemic improvements, from anticipating to managing and monitoring organisational performance during disasters. We also propose a hybrid of two methods towards a more holistic evaluation of hospital disaster resilience. The findings have immediate implications for supporting hospital leadership strategically and operationally.

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International Journal of Disaster Risk Reduction

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© 2021 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.

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Environmental management not elsewhere classified

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Health services and systems

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Mohtady Ali, H; Desha, C; Ranse, J; Roiko, A, Planning and assessment approaches towards disaster resilient hospitals: A systematic literature review, International Journal of Disaster Risk Reduction, 2021, 61, pp. 102319