Does hospital preparedness work? An analysis of hospital preparedness and its effectiveness during disaster response
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Introduction Hospitals are a vital asset of the health system, and are the frontline responders in disaster situations. Much work has been put in to prepare hospitals to be able to respond to disasters. However, comparatively little work exists to evaluate the true effectiveness of hospital preparedness, in view of its desired response in disaster situations. This dissertation aims to test the possibility of assessing the effectiveness of different hospital preparedness efforts in reaching the desired response outcomes, and understand the policy drivers for hospital preparedness. Method The dissertation aimed to address three questions using mixed methodologies. The first question, on what are the outcome measures for measuring hospitals’ desired response outcomes, is addressed through an integrative literature review. The second question looked to assess different hospital preparedness actions in a real disaster situation, and this was done using statistical methods. The third question, on the policy drivers for preparedness, was approached using an integrative literature review methodology. Result The results showed the following: 1) There is a lack of standard outcome measures for hospital response in disasters, however, a list of key sets of measures that cut across multiple documents has been identified. This includes service delivery, referral, evacuation and safety of patients and staff, access, and time factors. 2) The statistical review of the linkages between preparedness and response outcomes shows that coordination structures and plans in the surveyed hospital played a role in ensuring the staff were able to respond on time (outcome measures). 3) Certain policies play a key role in driving hospital preparedness work. The type of policies that played the more important role differed depending on the context. Nonetheless, having the right type of policies with the mechanisms for implementation is important to hospital preparedness. Discussion The results show that hospital preparedness can have an impact on achieving the desired response outcomes. It is important to have the right type of policies to drive the hospital preparedness work, in order to make sure hospitals are available and ready to respond to disaster situations where they are most needed. Further research in this area of work would be needed to identify the most critical preparedness actions that can have an impact on achieving a clearly identified hospital response outcome.