|Year : 2013 | Volume
| Issue : 1 | Page : 22-25
A survey on preparation of Sanandaj training hospitals to face crisis and the evaluation of passive defense in the summer of 2012
Mohammad Keshvari1, Himan Fallahi2, Fariba Fallahi3
1 Department of Management, Management and Health Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Management, School of Allied Health Sciences, Kurdistan, Iran
3 School of Nursing and Midwifery, Research Expert, Kurdistan University of Medical Sciences, Kurdistan, Iran
|Date of Web Publication||30-Nov-2013|
Department of Management, School of Allied Health Sciences, Tehran University of Medical Sciences, Tehran
Source of Support: None, Conflict of Interest: None
Introduction: The first objective of crisis management is to minimize loss of lives and damages caused by the disaster. Hence, health management is an integral part of the crisis management in disasters. Several organizations are involved in health management in disasters among which hospitals are very important ones. This study aims to determine the readiness of training hospitals in Sanandaj city to face crisis and the evaluation of passive defense in them in the summer of 1391. Materials and Methods: This is a cross-sectional study and the statistical population includes all training hospitals in Sanandaj city. Questionnaires were used as the main tool to collect data. The validity of data was verifies according to previous studies and the reliability was confirmed using Cronbach's alpha coefficient. The questionnaires were answered by the hospitals' crisis committee. Data collected were first processed by Statistical Package for the Social Sciences (SPSS) and then, were illustrated using available methods in descriptive statistics including tables and charts. Results: Of three hospitals studied, Be'sat Hospital readiness in facing crises was the best (83.4% favorable, 16.6% in development), and Quds Hospital had the worst situation (36.7% favorable, 47.2% unfavorable, 16.1% in development). Conclusions: Given that the complete performance of organizations like hospitals is necessary in crisis, arrangements should be made to establish systems such as drugs supply systems and equipments, alternative communication system, ambulatory operating rooms, and personnel call systems.
Keywords: Crisis management, hospitals, passive defense
|How to cite this article:|
Keshvari M, Fallahi H, Fallahi F. A survey on preparation of Sanandaj training hospitals to face crisis and the evaluation of passive defense in the summer of 2012. Int J Health Syst Disaster Manage 2013;1:22-5
|How to cite this URL:|
Keshvari M, Fallahi H, Fallahi F. A survey on preparation of Sanandaj training hospitals to face crisis and the evaluation of passive defense in the summer of 2012. Int J Health Syst Disaster Manage [serial online] 2013 [cited 2020 Jun 1];1:22-5. Available from: http://www.ijhsdm.org/text.asp?2013/1/1/22/122435
| Introduction|| |
Each year, an average of 200 million people get involved in disasters and hundreds die. Disaster-prone countries in average suffer a financial loss of 3% of their gross income annually to deal with disasters.  Iran is considered as the 10 th disaster-prone country in Asia.  Iran is always facing threat of crisis caused by the earthquakes. Of 300 populated cities in the country, 77% are located on an earthquake fault line, and 35% of the whole cities are exposed to flooding and storms. Geographical maps of International Seismological Research Institute of Tehran has identified six major faults in Tehran. 
Despite advances in science and technology, yet no one is able to accurately predict the disasters, and disasters may occur any time at any places. In such situations, lots of deaths and damages occur, causing a sudden rise in the demands for healthcare. In such cases, medical centers especially hospitals, must respond to this increased demand. 
When disasters occur, working conditions in hospitals are completely altered. The entire health system must be checked to be able to admit and cure patients injured due to disasters. Required changes include all activities and the hospital's compliance with disaster situations should be based on predetermined plans. Therefore, the way to organize hospitals in normal situations and in crisis completely varies. 
When disasters occur, what seems important is the readiness of officials and the measures set before to deal with such situations. In other words, crisis management and management in crisis are two separate and still related categories, so that the first one is prior on the second one. That is because the crisis is not the only determinant in the amount of damages, but the extent of the officials readiness to appropriately respond to crisis is determinant and any nonchalance may result damages to extend.  In fact, the crisis management means management (structural) and engineer (physical) measures to prepare and cope with the harmful effects of disasters, so that the effects reduce.  Crisis management in healthcare refers to a variety of measures to improve the quality and to ensure safety of services for patients.  Healthcare organizations are responsible for providing services to needy people and providing a safe environment for patients and staff. 
Among organizations having a key role in disasters are hospitals and medical centers. Managers of such health centers must have the required knowledge of crisis management and learn effective informing measures to act wisely and appropriately in times of crisis. 
The primary goal of crisis management is to minimize human casualties and damages caused by the disasters. Hence, health management is an integral part of crisis management in all disasters. Several organizations are involved in health management in disasters among which hospitals are of very important ones. 
The aim of this study is to assess the preparedness of training hospitals of Sanandaj city in facing crisis and passive defense in the summer of 2012.
| Materials and Methods|| |
This is a cross-sectional study conducted in summer 2012. Questionnaire was used as the main tool to collect data. The questionnaire asked about the hospital pathology, crisis committee, staff organization, the capacity of different units, information and communication system in crisis time, crisis management, training, registration and recording injuries and deaths, and facilities and requirements (financial and backup); which totally included 98 questions.
The questionnaire were previously used by Javad Sarvari and Saeid Maenavi in a research entitled "Comparative assessment of the readiness level in crisis management in selected hospitals in Tehran in the second half of 2009", and its calculated validity and reliability are also used in current study. 
The statistical population includes all training hospitals in Sanandaj city which are three hospitals of Tohid, Be'sat, and Quds. After questionnaires were answered by the secretaries of the crisis committees, collected data were processed using Statistical Package for Social Sciences (SPSS) and then were illustrated using available methods in descriptive statistics including tables and charts.
| Results|| |
Of three hospitals studied, Be'sat Hospital's readiness in facing crises was the best (83.4% favorable, 16.6% in development), and Quds Hospital had the worst situation (36.7% favorable, 47.2% unfavorable, 16.1% in development). In Be'sat Hospital, the highest preparation was in the "capacity of the critical units" and "crisis management and command system" (100% favorable), and the lowest preparation was in "registration and reception system of deaths" (50% favorable). In Quds Hospital, the highest preparation was in "defense measures and financial and backup requirements" (77.8% favorable) and the lowest was in "information and communication systems in times of crisis" (93.4% unfavorable, 6.6% in development). Finally, in Tohid Hospital, the answers to 44.4% of questions were favorable, 7% were unfavorable, and 48.6% were in development. The highest and lowest preparations were in "information and communication systems in times of crisis" and "crisis management and command system", respectively [Table 1],[Table 2] and [Table 3].
|Table 1: The situation of different units of hospitals studied during crisis|
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|Table 2: The situation of crisis committee of hospitals in time of crisis|
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| Discussion|| |
Crisis management tries to reduce the damaging effects caused by disasters through a scientific and systematic approach towards crisis and preventive strategies in times of crisis. Thus, organizing crisis management, particularly in relation to disasters, is among the top priorities of societies.  All organizations face crisis. These crises are caused by internal and external factors, but in any case, it is the way to deal with crisis which determines the success or failure of an organization. 
The results showed that the Be'sat Hospital is best prepared to deal with the crisis. None of the questions were answered with unfavorable. That is because good measures were done in the hospital, and significant measures are in development which would result in a significant improvement on the hospital preparedness to deal with the crisis. This hospital has the highest preparedness in the "capacity of critical units and crisis management and command system", and has the lowest preparedness in "registration and recording deaths and accidents". Results suggest that earthquakes, fires, physical events such as destruction and collapsing of hospitals buildings, chemical accidents, and explosions are the most dangerous threat to the hospitals. Assessments showed the resistance of hospital against earthquakes and explosions as "moderate" and against fire as "high". The extent of the damages to hospital buildings in the event of disaster and the impact on hospital facilities were also assessed as "high". These incidents had a "high" impact on communication network around the hospital. A study by Mallson et al., in Manchester, England showed that hospitals are in a good situation in facing with crisis such as fires. 
Also, the results showed that Quds Hospital has the worst situation compared to two other hospitals in terms of crisis management and majority of the answers were unfavorable. The highest preparedness in the hospital was in passive measures and financial and backup requirements, and the lowest preparedness was in information and communication systems in times of crisis. Results indicate that earthquakes, fires, storms, physical events such as destructions and collapses, and chemical accidents and explosions are the most important threats to Quds Hospital.
Assessments showed the hospital's strength against earthquakes and explosions as "moderate" and the strength against fire as "high". The extent of the damages on hospital buildings in the event of disaster and the impact on hospital facilities were also assessed as "high". These incidents had a "high" impact on communication network around the hospital.
Dr. Sayed Habibollah Koari and colleagues in their study entitled "Informing measures to face crisis in hospitals of Shiraz University of Medical Sciences" showed that Iran due to its strategic position in Middle East, is a country inevitable of facing crisis. That is while the administrative preparedness of the hospitals in Iran to face crisis is poor. Thus, the administrative managers are required to pass training courses in crisis management.  Also, Stenberg's studies in Netherland showed that for preparedness prior to crisis, and reduced losses and damages after crisis, an integrated planning is required. 
Habibi and colleagues investigated the risks involved in radiology units of hospitals in Isfahan city. They evaluated the status of risk management in these units as moderate to poor, and suggested that investments are necessary to improve the current situation of risk management in diagnostic units. 
According to results obtained, Tohid Hospital was not favorably prepared to face crisis. However, good measures were done in the crisis committee of the hospital and many were in development which could result in a significant improvement when finished. Results showed that earthquakes, fires, and physical events such as destructions and collapses were the most dangerous threats to the hospital.
Assessments showed the hospital's resistance against earthquakes, fires, and explosions as "very high", "high", and "moderate", respectively. The extent of the damages on hospital buildings in the event of disaster and the impact on hospital facilities were also assessed as "moderate". These incidents had a "high" impact on communication network around the hospital.
| Conclusions|| |
Considering the undeniable impact of health centers, particularly hospitals, in reducing and preventing health damages and losses, the importance of crisis management and gaining required skills in times of crisis is irrefutable. In addition, hospitals must have preparedness in terms of structure and staff. Considering the possible vulnerability of hospital buildings in disasters, devising a plan to transfer health facilities outside the hospital seems necessary. Also, since financial sectors play a major role in the procurement of equipments and supplies, devising an especial organization plan for this sector seems necessary for its correct performance in times of crisis.
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[Table 1], [Table 2], [Table 3]