Hospital safety index (HSI) analysis in confronting disasters: A case study from Iran
2014
Background: The ability of hospitals to continue functioning without interruption in disaster situations is a matter of life and death. The Hospital Safety Index (HSI) provides an overview of the probability of a hospital or healthcare facility to remain operational in emergency situations. Aims: This study has been performed in one of the hospitals associated with Social Security Organization in Tehran in order to assess the HSI in disasters. HSI helps authorities to quickly determine where interventions can improve safety. Materials and Methods: In this applied study, both qualitative and quantitative methods were used. Settings and Design: A specialized hospital in Tehran was studied regarding its structural, nonstructural and functional aspects using the World Health Organization/Pan American Health Organization (WHO/PAHO) standard checklists. Various wards and personnel of the hospital were included in this study. Statistical Analysis Used: Different types of hazards were analyzed, which are related to the location of the hospital. For determining the amount of risk in different wards, the occurring probability of each risk was scored based on the section status, previous records and events according to the Likert scale in one of the 4 levels and the total scores was considered as the section risk amount. Afterward, among each sections with similar tasks (administrative, financial, managerial and professional, supportive, clinical, surgery room and intensive care unit, emergency unit, and inpatient sections), the least and most amount of risk were clarified with regard to the following scores. Regarding the total scores, the minimum risk amount was 17 and the maximum was 68 in each section. If the total score was less than 17, no risk (safe), 17-34 low risk, 35-52 moderate risk, and in case of 53-70, the high risk was considered for that section. Results: According to the results, the final Hospital Safety Index score places this hospital in category "C" among three existing classifications of safety, which means that the hospital's current safety levels are inadequate to protect the lives of patients and hospital staff during and after a disaster. Conclusions: Urgent intervention measures and rapid assessment will give decision-makers a starting point to identify priorities in order to reduce risk and vulnerability in hospitals and health care facilities.
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