Building resilience: The role of enterprise security risk management in developing a resilient organisation.

Enterprise security risk management (ESRM) has continued to gain global acceptance as a management philosophy for the development and implementation of an enterprise-wide corporate security programme. As organisations continue to rebuild and recover from COVID-19, the value of assessing the resilience of an organisation through regular testing of its response to events has gained prominence. There are opportunities to link the development and implementation of a risk-based approach for designing a security programme, to assessing an organisation's resilience to future events. Organisations can benefit from the complementary approaches of ESRM and organisational resilience once the commonalities are identified and embraced. This paper expands upon the ESRM management approach, linking the concepts of ESRM to the design of a resilient enterprise.

Operational resilience towards a global alignment.

Operational resilience lies between operational risk and business continuity. This paper provides a view on the implementation of the operational resilience framework, and its relationship with operational risk and business continuity. It analyses the similarities and differences between these exercises and how management information from these exercises can be leveraged and aligned. The paper also provides answers to three important questions: (1) What pushed the international regulators to add additional oversight? (2) What benefits and challenges are brought by operational resilience? (3) Why is it important to harmonise operational resilience within the international regulatory landscape?

Strategic dilemmas when managing cyber attacks.

Cyber attacks have a significant business impact, with the potential to escalate into crises if poorly managed. A recurring pattern is strategic dilemmas that cannot be resolved satisfactorily. Some dilemmas are more pronounced, others less so, and therefore often catch decision-makers unprepared, leaving only bad options for decision-making. Something that all dilemmas have in common is that the associated decisions can have a lasting impact on relationships with stakeholders. This paper introduces four recurring dilemmas; shows the typical considerations; lists options for mitigating these dilemmas; and describes the basic requirements for implementing mitigations. The dilemmas and options, in turn, are rooted in the organisation-specific design of: cyber security incident management and response; IT service continuity and disaster recovery management; business continuity management; and crisis management and communication.

Mine the past: How to make better risk-based decisions and improve outcomes with historical threat data.

The impact of every crisis has the potential to cascade throughout an organisation's operations, supply chain and market ecosystem. To properly understand and mitigate this ripple of dynamic risk, business continuity, security and risk management leaders need to know where to focus their attention. Looking at historical threat data provides a clearer picture of the risk landscape, helping leaders better anticipate and plan for the future. To date, however, there have been challenges in this process. As the volume of data about critical events continues to grow at an alarming rate, sifting manually through data puts organisations - and business continuity - in jeopardy. This paper discusses the value of historical threat data and innovations in data-mining technology that can unlock the true power of historical data for informed, strategic decision-making and better outcomes during a crisis.

An assessment of nurses' perceived and actual household emergency preparedness.

Nurses' household preparedness is critical if they are to avoid role conflict and report for duty during an emergency. To date, the alignment between nurses' perceived and actual household preparedness remains under examined. Investigating one of these variables in isolation fails to consider that perceived and actual household preparedness must be high and aligned. If misaligned, vulnerabilities could surface during emergencies, like concerns about family safety, potentially impacting a nurse's commitment to duty during a crisis, or nurses may lack the actual preparedness to continue working long hours during an emergency. An online questionnaire was distributed to registered nurses in Ireland. The questionnaire was informed by a review of the literature and captured nurses' perceived and actual household preparedness, attitudes towards and exposure to a range of emergencies, and pertinent demographic characteristics. The results showed a relationship between how nurses view their household preparedness and their actual preparedness. Regression analyses indicate that while there is an overlap, the factors associated with how prepared nurses think they are and how prepared they are can differ. This means that strategies to boost actual preparedness may differ from those needed to boost perceived preparedness. This finding underscores the importance of psychosocial preparedness. Feeling prepared is crucial as it can influence how one responds in an emergency. Considering both the perceived and actual aspects of household preparedness can lead to a more effective response during emergencies.

Hospital preparedness assessment for road traffic accidents with mass casualties: a cross-sectional study in Kurdistan Province, Iran.

BACKGROUND: Road traffic accidents (RTAs) are predicted to become the world's seventh leading cause of death by 2030. Given the significant impact of RTAs on public health, effective hospital preparedness plays a pivotal role in managing and mitigating associated health and life-threatening issues. This study aims to meticulously evaluate the preparedness of selected hospitals in western Iran to handle road traffic accidents with mass casualties (RTAs-MC). METHODS: The study employed a descriptive-analytical approach, utilizing a reliable and valid questionnaire to measure hospitals' preparedness levels. Descriptive statistics (frequency distribution and mean) were utilized to provide an overview of the data, followed by analytical statistics (Spearman correlation test) to examine the relationship between hospital preparedness and its dimensions with the hospital profile. Data analysis, performed using SPSS software, categorized preparedness levels as weak, moderate, or high. RESULTS: The study found that hospitals in Kurdistan province had a favorable preparedness level (70.30) to respond to RTAs-MC. The cooperation and coordination domain had the highest preparedness level (98.75), while the human resource management (59.44) and training and exercise (54.00) domains had the lowest preparedness levels. The analysis revealed a significant relationship between hospital preparedness and hospital profile, including factors such as hospital specialty, number of beds, ambulances, staff, and specialized personnel, such as emergency medicine specialists. CONCLUSION: Enhancing preparedness for RTAs-MC necessitates developing response plans to improve hospital profile, considering the region's geographic and topographic features, utilizing past experiences and lessons learned, implementing of Hospital Incident Command System (HICS), providing medical infrastructure and equipment, establishing communication channels, promoting cooperation and coordination, and creating training and exercise programs.

How can the Sendai framework be implemented for disaster risk reduction and sustainable development? A qualitative study in Iran.

BACKGROUND: The Sendai Framework is the United Nations' most significant approach to reducing the risk of disasters from 2015 to 2030. This framework designed for all communities. However, communities should create operational and remedial strategies based on their unique circumstances. Considering the gaps in the implementation of Sendai framework strategies in Iran, as a developing country, the present study was designed. METHOD: This study was conducted by using a qualitative direct content analysis method to find out the expert's opinions on the implementation of the Sendai framework in Iran from 2021 to 2023. 35 experts in the focus group discussion and 9 experts in the interview were the participants of the study. RESULTS: Study findings were merged and reported as one main theme entitled Executive actions for implementing the Sendai Framework, four categories, and 37 codes. Eleven codes for the strategy of understanding disaster risk, 11 codes for the strategy of strengthening disaster risk governance to manage disaster risk, eight codes for the strategy of Investing in disaster risk reduction for resilience, and finally, seven codes for the strategy of enhancing disaster preparedness for effective response and to "Build Back Better" in recovery, rehabilitation, and reconstruction were identified as implementation solutions. CONCLUSION: The Sendai Framework has not provided any detailed implementation solutions because the countries' economic, social, level of development, etc., are different. The study's findings can be used as a guide for other developing countries.

Assessment of Disaster Preparedness at the Household Level in a Pediatric Cardiology Clinic Population.

Natural and human-provoked disasters pose serious health risks to children, particularly children and youth with special healthcare needs, including many cardiology patients. The American Academy of Pediatrics (AAP) provides preparedness recommendations for families, but little is known about recommendation adherence. Caregivers of children seen in a pediatric cardiology clinic network were recruited to complete an electronic survey. Participants self-reported child medical history and their household's implementation of AAP recommended disaster preparedness items. Families received a link to AAP resources and a child ID card. Data were analyzed using descriptive statistics with Fisher's exact and Wilcoxon rank sum tests. 320 caregivers participated in the study, of whom 124 (38.8%) indicated that their child has a diagnosed cardiac condition, and 150 (46.9%) indicated that their child had special healthcare needs. The average preparedness item completion rate was 70.7% for household preparedness, 40.1% for reunification preparedness, and 26.3% for community preparedness. Households of children with medical needs had similar rates of preparedness compared to overall rates. Of all respondents, 27.8% previously received disaster preparedness resources, 67.7% would like resources on discussing disaster preparedness, and 93.0% intend to talk with their household about disaster preparedness after completing the survey. These results demonstrate a gap between AAP recommendations and household-level disaster preparedness, including patients with cardiac conditions and those with special healthcare needs. Families expressed that they were interested in getting resources for disaster preparedness. Pediatric cardiologists may consider asking about disaster preparedness and providing disaster preparedness resources tailored to the needs of their patients.

Trauma systems in high socioeconomic index countries in 2050.

Considerable political, structural, environmental and epidemiological change will affect high socioeconomic index (SDI) countries over the next 25 years. These changes will impact healthcare provision and consequently trauma systems. This review attempts to anticipate the potential impact on trauma systems and how they could adapt to meet the changing priorities. The first section describes possible epidemiological trajectories. A second section exposes existing governance and funding challenges, how these can be met, and the need to incorporate data and information science into a learning and adaptive trauma system. The last section suggests an international harmonization of trauma education to improve care standards, optimize immediate and long-term patient needs and enhance disaster preparedness and crisis resilience. By demonstrating their capacity for adaptation, trauma systems can play a leading role in the transformation of care systems to tackle future health challenges.

Mapping study for health emergency and disaster risk management competencies and curricula: literature review and cross-sectional survey.

BACKGROUND: With the increasing threat of hazardous events at local, national, and global levels, an effective workforce for health emergency and disaster risk management (Health EDRM) in local, national, and international communities is urgently needed. However, there are no universally accepted competencies and curricula for Health EDRM. This study aimed to identify Health EDRM competencies and curricula worldwide using literature reviews and a cross-sectional survey. METHODS: Literature reviews in English and Japanese languages were performed. We searched MEDLINE, EMBASE, CINAHL (English), and the ICHUSHI (Japanese) databases for journal articles published between 1990 and 2020. Subsequently, a cross-sectional survey was sent to WHO Health EDRM Research Network members and other recommended experts in October 2021 to identify competency models and curricula not specified in the literature search. RESULTS: Nineteen studies from the searches were found to be relevant to Health EDRM competencies and curricula. Most of the competency models and curricula were from the US. The domains included knowledge and skills, emergency response systems (including incident management principles), communications, critical thinking, ethical and legal aspects, and managerial and leadership skills. The cross-sectional survey received 65 responses with an estimated response rate of 25%. Twenty-one competency models and 20 curricula for managers and frontline personnel were analyzed; managers' decision-making and leadership skills were considered essential. CONCLUSION: An increased focus on decision-making and leadership skills should be included in Health EDRM competencies and curricula to strengthen the health workforce.

A Pediatric-Focused Self-Assessment Tool on Vulnerabilities to Aid Regional Disaster Planning.

OBJECTIVE: A significant number of disaster and emergency victims are children. Yet, many hospitals are ill-prepared to care for these patients during disasters, as identified by the National Pediatric Readiness Project's survey of hospital pediatric disaster plans. The Region V for Kids Center of Excellence created a self-assessment tool to help regions identify vulnerabilities and ways to enhance care for vulnerable children and families. METHODS: Region V for Kids identified 9 key domains (eg, infrastructures and support mechanisms) that are important to safeguard children's and families' care during disasters. A self-assessment tool to assess these domains was distributed to 24 regional health care coalitions along with a 9-question usefulness survey. The self-assessment tool addressed 3 of the original domains, which have regional or national open-source databases and datapoints that health care coalitions can access for their responses. RESULTS: The survey received a 50% response rate. Approximately 40% of respondents indicated they were "somewhat likely" to make changes based on data gathered by the tool. The original self-assessment tool was revised to create an expanded web-based version. CONCLUSIONS: Health care coalitions and localities can use this tool to evaluate pediatric preparedness, identify needed improvements, and improve outcomes for children, families, and communities.

Women in Health and their Economic, Equity and Livelihood statuses during Emergency Preparedness and Response (WHEELER) protocol: a mixed methods study in Kenya.

INTRODUCTION: Kenya reported its first COVID-19 case on 13 March 2020. Pandemic-driven health system changes followed and unforeseen societal, economic and health effects reported. This protocol aims to describe the methods used to identify the gender equality and health equity gaps and possible disproportional health and socioeconomic impacts experienced by paid and unpaid (community health volunteer) female healthcare providers in Kilifi and Mombasa Counties, Kenya during the COVID-19 pandemic. METHODS AND ANALYSIS: Participatory mixed methods framed by gender analysis and human-centred design will be used. Research implementation will follow four of the five phases of the human-centred design approach. Community research advisory groups and local advisory boards will be established to ensure integration and the sustainability of participatory research design. ETHICS AND DISSEMINATION: Ethical approval was obtained from the Institutional Scientific and Ethics Review Committee at the Aga Khan University and the University of Manitoba.This study will generate evidence on root cultural, structural, socioeconomic and political factors that perpetuate gender inequities and female disadvantage in the paid and unpaid health sectors. It will also identify evidence-based policy options for future safeguarding of the unpaid and paid female health workforce during emergency preparedness, response and recovery periods.

The City of Penticton's comprehensive approach to wildfire risk reduction.

From 2017 to 2023, British Columbians experienced four record-breaking wildfire seasons, resulting in reduced air quality, mass evacuations and the destruction of homes, properties and livelihoods. Wildfire risk reduction is vital to breaking the sequence of disaster that has befallen such communities as Kelowna, BC in 2003, Ft. McMurray, AB in 2016, and Lytton, BC in 2021. As the City of Penticton ('the City') is located in a wildfire-prone environment, its Fire Department, FireSmart Team and Emergency Program have worked closely together to facilitate a proactive and comprehensive approach towards reducing the impacts of wildfire on Penticton's neighbourhoods, businesses and residents through a variety of wildfire mitigation initiatives. This paper discusses the City's efforts to achieve a holistic wildfire risk management plan through alignment with the seven disciplines of FireSmart and the four pillars of emergency management, namely: the use of education; land use planning and development considerations; vegetation management; emergency planning; and cross training and interagency cooperation. The paper describes the challenges the City has faced, as well its successes, and provides recommendations to help other local authorities reduce the risk of wildfire in their communities.

Pandemic Management: Health Data and Public Health Surveillance.

The inefficiency of the healthcare system in addressing pandemics is highlighted after COVID-19 which is mostly rooted in data availability and accuracy. As it is believed we might witness more pandemics in future, our research's main objective is to propose an integrated health system to support healthcare preparedness for future infectious outbreaks and pandemics. The system could support managers and authorities in healthcare and disaster management, and policymakers through data collection, sharing, and analysis.

Conceptualising multiple hazards and cascading effects on critical infrastructures.

Despite increased research on 'multiple hazards' and 'cascading effects', ambiguity remains concerning terminology. This paper reviews the literature to explore how these two concepts are defined in relation to critical infrastructures and their vital societal functions. Next, it investigates how the concepts are operationalised in Swedish disaster risk management. Findings indicate that regardless of a wealth of methodologies assessing multiple hazards and their cascading effects, these are rarely used by local planners, suggesting a gap between scientific approaches and practical implementation. Research mainly captures multiple hazards and cascading effects through technical parameters related to the severity of a hazard or the direct physical impacts on infrastructure. Less focus has been placed on the wider or knock-on effects across sectors and how these translate into societal risk. Future research should move beyond traditional understandings of social vulnerabilities as only pre-existing, to analyse how cascading effects on infrastructure and services can put new social groups at risk.

Community resilience across Australia towards natural hazards: an application of the Conjoint Community Resiliency Assessment Measurement.

Natural hazards can turn into disasters when not managed well. An important part of disaster risk reduction is to understand how well communities are prepared for natural hazards and how well they can cope with and recover from shocks in the long term. This research assesses self-reported community resilience and asks what makes a community resilient, using Australia as a case study. It reports on an Australian-wide online survey which included questions related to the Conjoint Community Resiliency Assessment Measurement, a subjective indicator, as well as questions about risk perception, well-being, and self-efficacy. Community resilience was found to be moderately high but scores for community leadership and preparedness were low. Perceived community resilience was positively correlated with age and those with high scores for self-efficacy and well-being. There was, as expected, an inverse relationship between reliance on external support during natural hazards and self-efficacy. The results complement previous studies which used different measures of community resilience.

Embedding Equity into the Hospital Incident Command System: A Narrative Review.

BACKGROUND: Disasters exacerbate health inequities, with historically marginalized populations experiencing unjust differences in health care access and outcomes. Health systems plan and respond to disasters using the Hospital Incident Command System (HICS), an organizational structure that centralizes communication and decision-making. The HICS does not have an equity role or considerations built into its standard structure. The authors conducted a narrative review to identify and summarize approaches to embedding equity into the HICS. METHODS: The peer-reviewed (PubMed, SCOPUS) and gray literature was searched for articles from high-income countries that referenced the HICS or Incident Command System (ICS) and equity, disparities, or populations that experience inequities in disasters. The primary focus of the search strategy was health care, but the research also included governmental and public health system articles. Two authors used inductive thematic analysis to assess commonalities and refined the themes based on feedback from all authors. RESULTS: The database search identified 479 unique abstracts; 76 articles underwent full-text review, and 11 were included in the final analysis. The authors found 5 articles through cited reference searching and 13 from the gray literature search, which included websites, organizations, and non-indexed journal articles. Three themes from the articles were identified: including equity specialists in the HICS, modifying systems to promote equity, and sensitivity to the local community. CONCLUSION: Several efforts to embed equity into the HICS and disaster preparedness and response were discovered. This review provides practical strategies health system leaders can include in their HICS and emergency preparedness plans to promote equity in their disaster response.

COVID-19 Response of the Journal Public Health Reports (PHR), March 2020-March 2023.

OBJECTIVE: Publication science is the scholarly study of various aspects of the academic publishing process. Its applications to COVID-19 literature have been limited. Here, we describe COVID-19 submissions to, and resulting articles published by, the journal Public Health Reports (PHR), an important resource for US public health practice. METHODS: We reviewed PHR's COVID-19 submissions and articles published between March 27, 2020, and March 27, 2023. We coded each article for article type, author affiliation, the categories listed in PHR's call for COVID-19 papers, and the public health emergency preparedness and response capabilities from the Centers for Disease Control and Prevention (CDC). RESULTS: During the study period, PHR received 1545 COVID-19 submissions and published 190 of those articles in a collection, COVID-19 Response. The COVID-19 Response collection included 102 research articles, 29 case study/practice articles, and 24 commentaries. The corresponding author of more than half (52.1%; n = 99) of the articles was affiliated with academia. By the categories listed in PHR's call for COVID-19 papers, 51 articles addressed health disparities, 38 addressed public health surveillance, and 34 addressed COVID-19 vaccination. By the CDC public health emergency preparedness and response capabilities, 87 articles addressed public health surveillance and epidemiologic investigation, 38 addressed community preparedness, and 32 addressed community recovery. The percentage of articles focused on policy/law was higher early in the pandemic (2020-2021) than later (2022-2023) (9.5% vs <3.0%). During the latter period, articles largely focused on vaccination (12.8%) and contact tracing (10.6%). CONCLUSIONS: Articles published in PHR's COVID-19 Response collection covered a broad range of topics and were authored by contributors from diverse organizations. Our characterization of the COVID-19 output of a representative US public health practice journal can help academic publishing better address informational needs of public health responders.