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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 4  |  Issue : 2  |  Page : 58-62

An investigation of the status of preparedness and crisis management restrictions in hospitals of Isfahan University of Medical Sciences


1 Professor, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 PhD Human Resource Management, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
3 Faculty of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran

Date of Web Publication1-Jun-2016

Correspondence Address:
Azadeh Alavi
Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2347-9019.183230

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  Abstract 

Introduction: The recent events throughout the world have brought about an increase in paying attention to the planning area of study and getting ready against catastrophes. Health care organizations and hospitals have to do their best so that they can face the worst crises. The staffs and leaders can response to these crises by precise planning. The state of preparation and the restrictions should be identified in each hospital so that there would be more preparation to counter the unexpected phenomena by identifying the strong points and removing the restrictions. This article aimed to specifying the status of preparation and the restrictions of the crisis management in the hospitals of Isfahan university of Medical Sciences in 2014. Materials and Methods: this study was descriptive-analytical. The statistic community of this study comprises of the directors and managers of the hospital, the nursing managers and the authorities of the crisis committee of 11th section of educational hospitals in Isfahan. The tool of data collection was a researcher-made questionnaire on 8 scope on the basis of the Likert Scale which was prepared based on the research litrature and the crisis management standards which was approved by experts. Its reliability was calculated 0.7 by cronbach alpha. The data were interpreted by descriptive statistics and Pearson Correlation analysis. Findings: The comparative study of the crisis management restrictions and preparation dimensions on the basis of the hospitals under investigation suggest that there had been a significant difference among the hospitals only in two dimensions of the crisis committee status and the preparation maneuver (P-Value <0.05). Also Command system dimension in critical situations in Amin hospital has had the most average while preparation maneuver dimension in Feyz Hospital has had the least mean. In general, the crisis management restrictions preparation of the hospitals under study has not been significantly different in general (P-Value 0.05). Conclusion: According to the Participants'views the preparation status and the crisis restrictions were at a desirable level and only lack of new technologies have been apparent in the critical situations. Hence, the hospital director not only have to invest more in providing and preserving the new technologies to use in the critical situations, but also to provide some arrangements to educate and empowerment the hospital's staff in order to use these technologies.

Keywords: Crisis, management, preparation, restriction


How to cite this article:
Yarmohammadian MH, Alavi A, Ahmadi F, Fatemi M, Moghadasi M. An investigation of the status of preparedness and crisis management restrictions in hospitals of Isfahan University of Medical Sciences. Int J Health Syst Disaster Manage 2016;4:58-62

How to cite this URL:
Yarmohammadian MH, Alavi A, Ahmadi F, Fatemi M, Moghadasi M. An investigation of the status of preparedness and crisis management restrictions in hospitals of Isfahan University of Medical Sciences. Int J Health Syst Disaster Manage [serial online] 2016 [cited 2024 Mar 28];4:58-62. Available from: https://www.ijhsdm.org/text.asp?2016/4/2/58/183230


  Introduction Top


The recent events throughout the world have brought about an increase in paying attention to planning and getting ready against catastrophes. [1] Although major human's progresses have increased his power to counter accidents and to respond to the unexpected events, he has not totally been able to have control over the accidents yet. Appropriate response toward the unexpected events requires providing facilities and suitable plans. Different societies always look for managing the damages of the unexpected events. [2] Therefore, the organization's manager always needs to be prepared to encounter the crisis and think to decrease the effects of crises on his/her organization. They need to understand that the organizations under their management should be secured from the crises as far as possible. [3] As the main aim of the crisis management plan is to provide the most appropriate services to most of injured people, it is necessary to develop a specified plan with scientific and precise management at all stages before, in progress and after crisis by taking precautionary actions, establishing the crisis management committee, education familiarizing the staffs, and doing the periodical maneuver to get prepared and facing the crisis, giving an appropriate response while the crisis occurs and taking actions for rebuilding after the crisis occurs. [4] These actions should be on the basis of the activities, strategies, and the crisis plans at the national level. [5] Regarding the new procedures, stemming from the communication technology evolutions in the environment and the new features of the human power, the organizations' atmosphere and the interaction with the society require the new managerial strategies to encounter crises. [6] The main aim of crisis management is to access an acceptable solution to remove the unusual situations in such a way that the society's benefits and basic values can be preserved. [7] In an organization, where no continuous plan happens to predict the imminent crises, crisis will be considered as an unacceptable and incomprehensible and the shorter the time of crisis, the more serious the management faces risk. However, in case of planning and continuous prediction to deal with possible crisis, crisis is assumed just as the occurrence of unforeseen circumstances, which must be managed with special interaction. [6] The main objective of the crisis management is to provide plan for hospitals, quick and in time health care organizations, in order to reduce mortality and morbidity due to unexpected events. [2] Hospitals and health care organizations should have the best performance to cope with the worst crisis and staff and leaders can respond to the crisis with careful planning. [8] In this regard, hospitals turn into therapy frontline by attracting more therapy capitals into the country's health system into the most expensive unit of health. [2] Today, in hospitals and health care systems that compete with each other, factors such as negative coverage of media, cash cows and competitors, and the ability to manage the crisis affect the reputation of the hospital and health care systems. Hospitals play the most important role in the surgical treatment. Since the crisis often damaged local hospital, the hospital near the location should be readyto help victims. About 60% of the victims are in need ofhospital treatment, including the treatment and surgicalinterventions. [9] Hospitals should have an action plan to deal effectively with the crisis caused by the disaster that has already been developed. [4] Bazrgar et al., (2013) in a study entitled the effect of crisis management model based on harmony on readiness of hospital Shiraz Rajai Martyr Hospital concluded that crisis management model based on harmony increase disaster preparedness in the hospital. [10] Studies have shown that the first step in preparing health care centers is to estimate the vulnerability of these centers in the disaster. In the meantime, hospitals as fixed centers and specialized health care services by having facilities and expertise personnel are one of the important components of the process of responding to disaster who are responsible for maintaining life and health of victims. As the status of hospitals completely changes in crisis, hospitals must adapt to the new situation on the basis of predictions made and everyone gets enough preparation based on his responsibility. [11] Qaribi and Tabrizi (2012), the study entitled disaster management position in a national hospital functional accreditation model in resulted that this model has capability for performance promotion especially regarding disaster management and hospitals preparedness in emergency situations after meeting the necessary issues. [12] Hospitals must incorporate the topic of crisis management in their strategic planning, [13] train their personnel in this regard, and adopt right management in this respect. [14] Lack of planning and organization to deal with accidents, unpreparedness of hospitals, and lack of training for crisis control, could cause irreparable damages to the health care system. [4] One of the most important challenges of our time in the metropolis is the need to determine the level of preparedness and crisis management system restrictions in dealing with natural and abnormal disasters. Preparation and limitations must be recognized in every hospital to identify strengths and overcome the limitations, more preparation to deal with unexpected events. Given that Isfahan is one of the most important metropolises as well as studies show that preparedness of educational hospitals is weak in dealing with disasters; the purpose of this paper is to examine the preparedness and crisis management restrictions in hospitals of Isfahan University of Medical Sciences in the year 2014.


  Methods Top


The study was descriptive-analytical; the population included all directors, hospital administrators, nursing managers, and officials of Crisis Committee 11 of Medical Center University of Medical Sciences (n = 55), respectively. Due to the small size of population census, sampling method was used. The data gathering tool was a self-made checklist, based on previous studies and standards of disaster management including seven demographic questions and forty main questions on eight areas. The validity of the checklist content validity was used, which is approved by ten teachers. Cronbach's alpha for the validity of variables of the questionnaire was over 7.0. Checklist was distributed among respondents and 51 people out of 55 cases respond to the questions. To analyze the data using SPSS Version 16.0 for windows (IBM SPSS, 2007 Microsoft Corp, Birstol, UK), descriptive and inferential statistics was used. Responses were measured using descriptive statistics through frequency tables and descriptive charts of histogram columns, central average indexes in different parts, and average standard deviation and variance. Inferential statistics was used such as ANOVA and Pearson correlation coefficient.


  Results Top


Of the total of 51 participants, thirty cases were men (58.8%), 17 women (33.3%), and four nonrespondents (7.8%). Most participants had graduate degree (60%) and the lowest had general doctoral or professional degree (20%). In terms of organizational position, organizational manager with the frequency of 16 (31.4%) was the most frequent and considering that the study was conducted in the census, any number of employees in any positions were included in the study. In terms of employment status, type of employment of participants in the sample was studied in three categories: Formal, tenure, and contractual; of which 32 people was (62.7%) tenure, eight (15.7%) promise, and seven (13.7%) contracted. Results showed that the Crisis Committee status in every six component values has been more than the hypothetical criterion 2.0 component of the "selecting the committee members appropriate to Crisis Committee chart" had the highest average and the "communication of Crisis Committee decisions to all sectors" had the lowest. However, in general, the average of Crisis Committee was 2.25 ± 0.36, which is more than the hypothetical average 2 (somewhat). In the field of management, policies component and support affairs results showed that the mean values have been more than hypothetical criterion 2.0 (somewhat). "Including crisis management program on hospital strategic plan" components have had highest average; "specifying time limit for sending the basic needs in terms of crisis situations" have had the lowest average; in other words, the strength point of managerial policy and support affairs components is "including crisis management program on hospital strategic plan" and the weakness point is "prediction of a time limit for sending the basic needs in crisis situations". On the other hand, the average general of managerial policies and support was 2.48 ± 0.38, which is more than the average hypothetical two (somewhat). Results of command system in times of crisis are presented in [Table 1].
Table 1: Components in the staff command system


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In conjunction with the maneuvering preparation, the results showed elements of "holding preparation maneuver with appropriate timing in hospital" and "passing the training course required for the maneuver" with an average of 2.04 ± 0.74 and 2.04 ± 0.82 had lowest values and the "participation of personnel in crisis maneuver" with an average of 2.14 ± 0.83 had the highest value; so we can say that the employees participated in the crisis maneuvers exercises, but the timing was inappropriate and required training courses have not been held; but, in general, all the components had the average of more than 2, which are desirable and acceptable. The overall average maneuvering readiness was 2.07 ± 0.68, respectively. It has been shown the average of four components of disaster preparation maneuver in [Figure 1].
Figure 1: Bar graph of the mean value of the components in holding the preparation maneuver among staffs

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The results of the training related to crisis management showed that the component of "embed brochures and educational pamphlets available to everyone" with an average of 1.9 ± 0.85 is the lowest and the component "participation of personnel in crisis management courses" with an average of 2.29 ± 0.78 is the highest; so, we can say that the staff were active at holding training classes related to crisis management, but general education was not available for everyone. Therefore, faces extreme weakness (sub-optimal) in this area. The overall average of training to crisis management was 2.21 ± 0.69, respectively. The status of the use of new technologies in a crisis is presented in [Table 2].
Table 2: The components of applying the modern technology when facing a crisis among staffs


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Findings from research on the status of immunization in times of crisis showed that "ramps to transfer victims in the sections" and "predicting safe places and marking them with precise and readable symptoms" with an average of 1.82 ± 0.86 and 1.75 ± 0.82 were lowest values; "taking advantage of easy and fast rescue" with an average of 2.29 ± 0.83 had the highest value; in other words, perhaps, inappropriate and unsafe environmental conditions in critical condition were low; on the other hand, there is advantage to use easy and fast emergency exits in times of crisis at an acceptable level. The overall average of security situation in crisis was 2.03 ± 0.59, respectively.

The results in regard the status of registration, information, and communication system showed that "an specific program to inform the media and the public during the crisis" with an average of 2.14 ± 0.78 was at minimum and "enabling rapid information with crescent, fire" with an average of 2.51 ± 0.61 had the highest value; in other words, perhaps, it could be said that necessary facilities to inform the relevant organizations is possible in critical situations, but it was less effective in informing the media and public. The overall average of registration system status and Information and communication in times of crisis was 2.38 ± 0.54, respectively.


  Discussion Top


Pearson correlation results in the field of crisis management readiness status and limitations of crisis management dimension with each other shows a strong and direct relationship between the two in dimensions of the crisis management readiness status and restrictions (P < 0.05), so that each of these dimensions can mutually influence each other and has direct relationship, so to improve each area can have a positive impact on other aspects. A comparative study of the state of readiness in terms of crisis management restrictions of hospitals under study showed that there is significant difference only in two dimensions of preparation maneuvering and the Crisis Committee status significant between the hospitals (P < 0.05). The command system dimension in critical situations at Amin Hospital has the highest average and the preparation maneuver at the hospital had the lowest. The overall general state of preparedness and crisis management constraints in terms of hospitals under study had a significant difference (P < 0.05). Mastaeh et al. in a study entitled limitations and capabilities for crisis management in hospitals of Hormozgan University of Medical Sciences concluded that the most important problems of the hospitals is to cope with committee weaknesses crisis, lack of organization and human resources, and lack of the use of new technologies, which is consistent with the use of new technologies in crisis situation of this study.

In the present study, maneuvering status was desirable but it does not held at the proper time. The training has not been fully available to everyone. In a study by Malekshahi and Mardani (2008), entitled capabilities and limitations of crisis management in Tribal Martyrs and Social Security Hospitals of Khorramabad, they come to the conclusion that holding maneuvers, training, identifying safe places are recommended. [8]


  Conclusions Top


According to the findings, general status of readiness and crisis management constraints in educational-therapy hospitals was in a satisfactory condition and that only the use of new technologies has been demonstrated in times of crisis. Therefore, it is recommend that in addition to invest in preparedness of health-therapy sections of hospitals, in terms of identification and implementation of new technologies responsive in critical condition and the hospital staff training on the use of these technologies, necessary measures are should be taken.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

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2.
Mastaeh Z, Mooseli l, Jahangiri M, Doost M, Eshghi A. Strength and weakness of crisis management in Hormozgan medical university's hospitals. J Med Univ Fasa 2011;1:244.  Back to cited text no. 2
    
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Habibzadeh MA, Javadian R. Media Approach in Crisis Management; Quarterly Development 2010. p. 5, 18.  Back to cited text no. 3
    
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Vardinezhad F, Bahrami RS. Crisis management in medias. Tehran: SAMT, Human Science Research and Development; 2009.  Back to cited text no. 4
    
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Naghibosadat R. Media Threats and Management Crisis. Communication Research 2008;15:113-35.   Back to cited text no. 5
    
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Sullivan K. 3 crisis management tool to protect hospital reputations. J Fierce Healthc Newton 2014 Sep 19.  Back to cited text no. 6
    
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Qodsieh H, Mardani M. Focusing on health emergencies. Translated by Abaszadeh, Jalili, and Borhani. Tehran: Salemi; 2007.  Back to cited text no. 7
    
8.
Malekshahi F, Mardani M. Strength and weakness of crisis management in Khorramabad Medical University's Hospitals named Shohadaye Ashayer and Ta'min Ejtemaie. J Nurs Spec Care 2008;1:29-34.  Back to cited text no. 8
    
9.
Toe J. Disaster management in Singapore - Role of nurse at disaster site. Accid Emerg Nurs 1993;1:199-203.  Back to cited text no. 9
    
10.
Bazregar R, Khankeh HR, Ahmadi Sh, Hosseini MA, Rahgozar M, Moradian MJ. The impact of the crisis management model based on coordination, on the readiness of Shahid Rajai Hospital in Shiraz. Iran Nurs Res 2013;8:10-18.  Back to cited text no. 10
    
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Vardinezhad F. Crisis management and media. Tehran: SAMT; 2009.  Back to cited text no. 11
    
12.
Qaribi F, Tabrizi JS. The status of national accreditation model for crisis management in hospital performance. Sci J Rescue Relief 2012;4:35-46.  Back to cited text no. 12
    
13.
Khojasteh H, Ahmadi Z. The principles of professional ethics of journalists and mass media in crisis management Communication Research 2007;15:47-68.  Back to cited text no. 13
    
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Qolamhoseini E. Role of police in the management of natural disasters. Police Manag J 2011;7:594-68.  Back to cited text no. 14
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2]


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