Components and entities of post-disaster damage and loss assessment program in healthcare sector: a scoping review.

BACKGROUND: Disasters can cause casualties and significant financial loss. In accordance with the Sendai Framework for Disaster Risk Reduction, areas affected by disasters must be built back better. Accurate post-disaster damage and loss assessments are critical for the success of recovery programs. This scoping review aimed to identify the components and entities of the healthcare sector's post-disaster damage and loss assessment program. METHODS: An comprehensive search for relevant literature was performed using several databases, including the Web of Science, PubMed, Scopus, ProQuest, and Magiran. The search was limited to papers published between 2010 and 2022. In addition, we searched the grey literature for resources related to post-disaster damage and loss assessments. Study selection and data extraction were evaluated by a third reviewer. The main themes were determined through a consensus process and agreement among team members. RESULTS: A total of 845 papers were identified, 41 of which were included in the review. The grey literature search yielded 1015 documents, 23 of which were associated with the study's purpose. The findings were classified into five main themes, 20 subthemes, and 876 codes. The main-themes include the following: Concepts and Definitions; Post-Disaster Damage and Loss Assessment Procedures; Healthcare sector procedures; Assessments Tools, and Methods; Intra-sectoral, Inter-sectoral, and cross-cutting issues. CONCLUSIONS: The existing corpus of literature on post-disaster damage and loss assessment programs within the healthcare sector offers only limited insights into the entities and components involved. It is of great importance that stakeholders have an extensive grasp of these pivotal concepts and principles, as they are fundamental in enabling effective responses to disasters, informed decision-making, and facilitating rehabilitation and reconstruction efforts. Consequently, there is a considerable scope for further investigation in this area. SCOPING REVIEW REGISTRATION NUMBER: https://osf.io/nj3fk .

Post-disaster damage and loss assessment in the Iranian healthcare sector: a qualitative interview study.

BACKGROUND: Accurate post-disaster damage and loss assessment is critical for the success of subsequent recovery programs. A comprehensive and systematic damage and loss assessment process involves evaluating the physical damage and financial impact of an event on individuals, communities, and assets. To ensure effective recovery, the various components and entities included in the program must be developed appropriately and efficiently. This study aimed to identify the components and entities of the Iranian healthcare sector's post-disaster damage and loss assessment program. METHODS: A qualitative study employing purposive sampling and semi-structured individual interviews was conducted with 18 participants between October 2022 and July 2023, with continuing until data saturation was achieved. Data collection involved semi-structured interviews and observational notes with experts, including representatives from the National Disaster Management Organization (NDMO), the Iranian Red Crescent Society, and the Disaster Risk Management Department of the Ministry of Health and Medical Sciences Universities. The interviews were conducted in the workplace of the participants. Thematic analysis, a conventional qualitative method, was employed for the analysis of the data. Following the transcription of the recorded interviews, the initial codes were extracted, reviewed for accuracy, and classified. RESULTS: The results of this study are based on the insights and experiences of a diverse group of qualified experts in their respective fields. The findings were analysed and classification into ten main themes, 29 sub-themes, and 1,058 codes. The main themes were key concepts and principles of assessment; assessment stages; health system measures in assessment; roles and responsibilities; team composition; information and communication; coordination and collaboration; data collection and analysis; assessment tools and methods; and reporting, documentation, and recommendations. CONCLUSION: An understanding of key concepts and principles enables stakeholders to respond effectively to disasters, make informed decisions, and facilitate recovery and reconstruction efforts.

Dimensions of hospital resilience emphasized during the COVID-19 pandemic response: A systematic review.

Objectives: Hospitals must maintain their effective operations during and after disasters. Due to the current increase in disasters, hospital resilience has drawn scholarly attention. This study aimed to review studies on the changes in the definition of hospital resilience after COVID-19, build a conceptual framework for careful measurement, and identify the main dimensions of hospital resilience emphasized during the COVID-19 pandemic. Design: The initial phase of this study was a systematic review of articles published before the COVID-19 pandemic to extract the hospital resilience-related dimensions for the second phase. The second phase involved text-mining articles published both before and after the emergence of COVID-19. Setting: In the systematic review phase, 12 databases were searched from 2006 to January 2020, including Scopus, Web of Science, MEDLINE through PubMed, Embase, ERIC, ProQuest, the Cochrane Library, Emerald, Springer, Science Direct/ELSEVIER, Google Scholar, and SID (for Persian language papers). Then, after COVID-19, articles published in these databases between January 2020 and May 2022 were evaluated using text mining. Result: During the systematic phase, 17 out of 1530 papers published before COVID-19 were synthesized to collect components of hospital disaster resilience. These identified components were the inputs for the text-mining phase. The text mining on pre-COVID papers resulted in six clusters, with the highest weight (0.65) belonging to general resilience and disaster preparedness, while in the post-COVID text mining phase, including 70 papers, 8 clusters have been identified, with the highest weight cluster (0.78) focusing on the mental and psychological aspects of resilience among healthcare workers. Conclusion: Following the COVID pandemic, scholarly attention has shifted to the more personal dimensions of hospital resilience, including psychological resiliency. It seems necessary for policymakers to focus more on the individual and psychological resilience of hospital staff.

Community-based education: An effective policy for earthquake preparedness in Iran: Empirical study.

BACKGROUND: As natural or man-made shocks, disasters are sudden events that require emergency and fundamental measures. The need to be prepared for disasters has become clearer than ever worldwide. This study aimed to investigate the effect of earthquake preparedness training using the face-to-face or cascade method in rural households living in Juybar County (Iran) in 2018. METHODS AND MATERIAL: Following an experimental design with a pretest and posttest, the study was performed on married women aged 10-49 living in Kurdkolay village of Juybar county (n = 372). Participants were randomly categorized into two groups of training (n = 95) and face-to-face cascade method (n = 95). Data were collected using the Disaster Preparedness Assessment Index, comprising demographic and education sections. Data were collected using the disaster preparedness assessment index and analyzed using SPSS version 24. RESULTS: The findings indicated improved preparedness in all five dimensions in both groups. There was a significant difference between the study groups immediately and one week after the intervention (P < 0.05); i.e. a higher impact for the face-to-face cascade method. Meanwhile, both groups presented a similar level of preparedness 90 days after receiving the intervention (P > 0.05). CONCLUSIONS: The face-to-face cascade method was more effective in the short term, while no difference was found in the long term. Crisis managers and policymakers should choose their preferred method based on available facilities, human resources, and context to increase preparedness against earthquakes. Mothers play a vital role in educating and nurturing their children. It is suggested to conduct educational programs at the community level using the most appropriate methods that are chosen based on the best evidence.

Developing a conceptual model of post-disaster damage and loss assessment program in the Iranian health sector: a qualitative study protocol.

INTRODUCTION: Annual natural and man-made disasters in Iran eventually lead to casualties and considerable financial loss. The success of a reconstruction programme depends on accurate postdisaster damage and loss assessment. Based on these assessments, the goals, priorities and approaches required for reconstruction are prepared and formulated. To effectively implement a reconstruction and rehabilitation programme in the country's health sector, it is necessary to prepare and compile a postdisaster damage and loss assessment programme. METHODS AND ANALYSIS: This qualitative study will be conducted to develop a conceptual model of a postdisaster damage and loss assessment programme in Iran's health sector. First, a scoping review method will be conducted to identify the entities and components of the postdisaster damage and loss assessment programme. Then, using semistructured interviews, the opinions of university professors and disaster damage and loss assessors in the health sector will be obtained. Next, by conducting a focus group discussion, the initial programme of disaster damage and loss assessment in the Iranian health sector will be developed and then, the modified Delphi method will be used to validate it. ETHICS AND DISSEMINATION: Ethical approval for this study was obtained from the research ethics committee of Isfahan University of Medical Sciences (IR.MUI.NUREMA.REC.1400.171). The study results will be disseminated to stakeholders, published in peer-reviewed journals and presented at conferences.

Driving Hazard Perception Tests: A Systematic Review.

Objective: The present study was conducted to evaluate previous studies on hazard perception among road users. Methods: A comprehensive search was conducted using electronic databases and search engines including Science Direct, PubMed, Scopus, Embase, Web of Science, Iranmedex, SID, Irandoc, and Google Scholar from January 2000 to September 2021. The search was performed using a combination of medical subject heading terms and keywords. Endnote software version 20.0 (Clarivate, Philadelphia, PA, USA) was used to organize the included articles. Thematic content analysis was used to analyze the findings. The entire review process was conducted by two authors, and unresolved challenges were discussed with other researchers. Results: Findings of the study show that all of the tests could discriminate between inexperienced and experienced drivers. The use of dynamic hazard perception tests was more common than static tests, and in some cases, simulators were used. Moreover, the results indicated a weak correlation between the results of dynamic and static tests. Therefore, it could be claimed that both dynamic and static methods measured certain dimensions of hazard perception. Conclusion: Regarding the importance of hazard perception, the findings of this study can provide further progress in designing hazard perception tests. The hazard perception tests can be sensitive to cultural or legal differences. It should also be noted that in developing tools for measuring drivers' hazard perception, different dimensions of hazard perception must be considered, so that the level of drivers' hazard perception can be reported accurately.

Disaster planning approaches in Iran's health system: A mixed-methods study.

BACKGROUND: Disaster planning and management pose a serious challenge to most countries. These challenges point to insufficient planning to deal with these events. Therefore, it is necessary to pay attention to the methods and characteristics of the decision-making approaches in these events. In this study, we tried to identify most appropriate approaches for the Iranian health system by studying disaster planning approaches. MATERIALS AND METHODS: This study was conducted using mixed methods in 2020-2021 in two phases: qualitative and quantitative. First, we reviewed at the research literature. Our goal was to identify studies that suggested approaches to disaster planning. The next step in this study was a qualitative study using semi-structured interviews. Participants in qualitative phase included managers and employees from different parts of the Iranian health system from the provinces of Golestan, Fars, Khuzestan, Lorestan, Kerman, Sistan, and Baluchestan. RESULTS: By combining approaches taken from literature reviews and qualitative study, four main approaches were identified. The results of our study have shown that disaster response planning approaches include function, risk assessment, capability, and futuristic base. CONCLUSION: This study provides complete overview of disaster planning approaches that enable health professionals to use them to develop response plans. Our findings indicate that in complex and large-scale events such as floods and pandemics, it is necessary to combine the introduced methods for operational planning.

Challenges of prehospital aerial operations in response to earthquake hazards: A qualitative study.

BACKGROUNDS: Due to the severity of the earthquake, it may need immediate treatment and transfer of the injured people to advanced medical centers, as well as dispatch of the expert team and specialized health equipment to the accident-affected area. Aerial emergency is an important responsibility of the health care system in this situation. The study aimed to extract the prehospital emergency challenges of Iran aerial operations emergency in response to the earthquake. MATERIALS AND METHODS: The study was qualitative content analysis with conventional approach. Sampling was done in a purposive method and data were collected through semi-structured interview. The panel involved consists of 26 health professionals in medical emergencies. Recorded interviews were transcribed into written and then conventional content analysis was used to derive coding categories directly from the text data. RESULTS: Content analysis is provided 97 initial codes, 20 subcategories and 4 main categories including challenges of "response assessment," "support," "pre-hospital staff-management," and "response operation," respectively. CONCLUSIONS: The results showed that the necessity to assess the affected area, staffing, and management actions, including integrated operations command and the development of a dedicated response plan, as well as the use of strategies inter-organizational coordination in the response phase to earthquake. This study also emphasized that providing standard equipment, support actions, and strengthening communication infrastructure, and updating the aerial emergency system should be considered as one of the priorities of the emergency organization of Iran to provide a desired response to the earthquake.

Analysis of the intellectual and social structure of health system response plan to earthquake studies adopting word co-occurrence and narrative approaches.

BACKGROUND AND AIM: Earthquake is a natural disaster severely affecting the societies' health, hygiene, and welfare as such the most effective method to respond to its damages is to develop a readiness plan. This study aimed to discover thematic patterns and co-author relationships extracted from relevant publications to plan an earthquake response. MATERIALS AND METHODS: This descriptive-analytical study adopted the scientometric approach and used word co-occurrence and social network analysis. The published articles indexed in PubMed were retrieved from 1970 to 2021 using a combination of keywords "earthquake and response." The data were analyzed in VOSviewer, UCINET, and NetDraw software. RESULTS: The following six thematic clusters with a social map were extracted: Initial response of the healthcare system, response to probabilistic risks after the hazard, response to mental health and community resilience, response to public health, response to post-traumatic stress disorders, and staff's response to the needs assessment and continuity of diagnostic treatment services. Moreover, social network analysis revealed the great impact of Japanese and Chinese authors and institutes. CONCLUSION: The present study detected many gaps in the literature on earthquake response, which can contribute to developing a general framework to prepare integrated healthcare earthquake response plans to promote the performance of this system.

Information Needs of Pregnant Women in the COVID-19 Pandemic from Experts' Point of View: A Qualitative Study.

BACKGROUND: As pregnant women are among vulnerable groups susceptible to respiratory infections, healthcare systems in most countries would pay more attention to providing the services required in the COVID-19 pandemic. The present study aims to identify the information needs of pregnant women during the COVID-19 pandemic. METHODS: The research team conducted a qualitative conventional content analysis with an inductive approach to identify the views of 19 experts when working in the field of providing obstetric and midwifery services in Isfahan from April to June 2020. The semi-structured interviews were analyzed using MAXQDA v18. RESULTS: The results showed that the information needs of pregnant women during the Covid-19 epidemic should be set in four areas, including 1) Self-efficacy of pregnant women, 2) Information that provokes sensitivity to the preventive measures, 3) Awareness of the perceived threat, and 4) Awareness of the health system functions in COVID-19 pandemic. CONCLUSION: The study shows that the self-efficacy of pregnant women depends deeply on being informed of the general and specific self-care principles. Besides, sensitivity could be achieved through the increased risk perception and knowledge on the pandemic. However, pregnant mothers should know the potential threats that could pose them at risk of vulnerability. Finally, awareness of the health system functions regarding access to reliable information resources along with provided services at Medical University websites is also recommended.

Information challenges of COVID-19: A qualitative research.

BACKGROUND: At the beginning of the COVID-19 pandemic, the Iranian Ministry of Health and Medical Education set up a 24-h call center, i.e., Center 4030, to mitigate people's worries and anxieties, create composure, increase people's trust, and answer their questions. This qualitative study aimed to identify the challenges of COVID-19-related-information among people in point of experts' views. MATERIALS AND METHODS: This qualitative study was conducted to collect the opinions of experts on the identification of the Information challenges of COVID-19 during March-June 2020. The research population included all health professionals and experts. The sampling method was initially purposive and continued to saturate the data as snowball technique. In this study, 19 participants were interviewed. The data were collected using a semi-structured interview. After collecting the data, the audio files of the interviews were written down to extract their external and internal elements. MAXQDA version 12 software was used to organize qualitative analysis and coding data. RESULTS: The results of this study involved eight themes, i.e., lack of planning, lack of social trust in government, lack of COVID-19-integrated scientific authority in the country, conflicts of interest, lack of integrated information sources, distracting public attention, infodemic, and poor information quality, classified into 16 categories. CONCLUSIONS: The main information challenges that people in Iran faced included the lack of a scientific reference source to access accurate information, the existence of a large volume of information in virtual networks, and a huge volume of statistics from various information channels that caused confusion among people.

ARE MACRO AND MICRO ENVIRONMENT AFFECTING MANAGEMENT OF FRESH WATER RESOURCES? A CASE FROM IRAN WITH PESTLE ANALYSIS.

INTRODUCTION: Oil spill in fresh water can affect ecological processes and accordingly it can influence human health. Iran, due to having 58.8 % of the world oil reserves, is highly vulnerable to water contamination by oil products. AIM: The aim of this study was to determine environmental factors affecting the management of the oil spill into one of the river in Iran using the PESTLE analysis. MATERIAL AND METHODS: This was a qualitative case study conducted in 2015 on an oil spill incident in Iran and its roots from a disaster management approach. Semi-structured interviews were conducted for data collection. Seventy managers and staffs with those responsible or involved in oil spill incident management were recruited to the study. Qualitative content analysis approach was employed for the data analysis. Document analysis was used to collect additional information. RESULTS: Findings of the present study indicated that different factors affected the management of the event of oil spill onto one of the central river and consequently the management of drink water resources. Using this analysis, managers can plan for such events and develop scenarios for them to have better performance for the future events.

Clinical risk assessment in intensive care unit.

BACKGROUND: Clinical risk management focuses on improving the quality and safety of health care services by identifying the circumstances and opportunities that put patients at risk of harm and acting to prevent or control those risks. The goal of this study is to identify and assess the failure modes in the ICU of Qazvin's Social Security Hospital (Razi Hospital) through Failure Mode and Effect Analysis (FMEA). METHODS: This was a qualitative-quantitative research by Focus Discussion Group (FDG) performed in Qazvin Province, Iran during 2011. The study population included all individuals and owners who are familiar with the process in ICU. Sampling method was purposeful and the FDG group members were selected by the researcher. The research instrument was standard worksheet that has been used by several researchers. Data was analyzed by FMEA technique. RESULTS: Forty eight clinical errors and failure modes identified, results showed that the highest risk probability number (RPN) was in respiratory care "Ventilator's alarm malfunction (no alarm)" with the score 288, and the lowest was in gastrointestinal "not washing the NG-Tube" with the score 8. CONCLUSIONS: Many of the identified errors can be prevented by group members. Clinical risk assessment and management is the key to delivery of effective health care.

Electronic health indicators in the selected countries: Are these indicators the best?

BACKGROUND: Many changes have been made in different sciences by developing and advancing information and communication technology in last two decades. E-health is a very broad term that includes many different activities related to the use of electronic devices, software as well as hardware in health organizations. AIMS: The aim of this study is comparing electronic health indicators in the selected countries and discussion on the best indicators. SETTINGS AND DESIGN: This study has chosen 12 countries randomly based on the regional division of the WHO. The relevant numbers of health indicators and general indicators and information technology indicators are extracted of these countries. We use data from the Bitarf's comparative study, which is conducted by the Iranian Supreme Council of Information Technology in 2007. MATERIALS AND METHODS: By using Pearson correlation test, the relations between health general indicators and IT indicators are studied. STATISTICAL ANALYSIS USED: Data was analyzed based on the research objectives using SPSS software and in accordance with research questions Pearson correlation test were used. RESULTS: The findings show that there is a positive relation between indicators related to IT and "Total per capita health, healthy life expectancy, percent literacy". Furthermore, there is a mutual relation between IT indicators and "mortality indicator". CONCLUSION: This study showed differences between selective indicators among different countries. The modern world, with its technological advances, is not powerless in the face of these geographic and health disparity challenges. Researchers must not rely on the available indicators. They must consider indicators like e-business companies, electronic data internet, medical supplies, health electronic record, health information system, etc., In future, continuous studies in this field, to provide the exact and regular reports of amount of using of these indicators through different countries must be necessary.

Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS).

BACKGROUND: Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS) is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS). METHODS: This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research instrument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. RESULTS: Findings of study were categorized into three general categories including requirements (organizational and sub-organizational), barriers (internal and external) of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. CONCLUSIONS: Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authorities in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable framework and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.