Development of key indicators of hospital resilience: a modified Delphi study

Abstract

Objectives Hospital resilience is an emerging concept, which can be defined as ‘a hospital’s ability to resist, absorb, and respond to the shock of disasters while maintaining its critical health care functions, and then recover to its original state or adapt to a new one’. Our aim was to develop a comprehensive framework of key indicators of hospital resilience. Methods A panel of 33 Chinese experts was invited to participate in a three-round, modified Delphi study to develop a set of potential measures previously derived from a literature review. In the first round, these potential measures were modified to cover the comprehensive domains of hospital resilience. The importance of proposed measures was scored by experts on a five-point Likert scale. Subsequently, the experts reconsidered their voting in light of the previous aggregated results. Agreement on measures was defined as at least 70% of the responders agreeing or strongly agreeing to the inclusion of a measure. Results A large proportion of preliminary measures (89.5%) were identified as having good potential for assessing hospital resilience. These measures were categorized into eight domains, 17 subdomains, and 43 indicators. The highest rated indicators (mean score) were: equipment for on-site rescue (4.7), plan initiation (4.6), equipment for referral of patients with complex care needs (4.5), the plan execution (4.4), medication management strategies (4.4), emergency medical treatment conditions (4.4), disaster committee (4.4), stock types and quantities for essential medications (4.4), surge capacity of emergency beds (4.4), and mass-casualty triage protocols (4.4). Conclusions This framework identifies a comprehensive set of indicators of hospital resilience. It can be used for hospital assessment, as well as informing priority practices to address future disasters better.

Developing a tool to measure the organizational resilience of Tanzania's water supply systems

“…Each attribute was scored on a five‐point Likert scale (1 = strongly disagree, 2 = disagree, 3 = neither agree nor disagree, 4 = agree, and 5 = strongly agree). Consensus on a particular indicator was considered to have been reached when at least 70% of the experts, on average, had agreed or strongly agreed to its inclusion, and standard deviation was less than 0.998 (Zhong, Clark, Hou, Zang, & FitzGerald, ).…”

Developments in Surge Research Priorities: A Systematic Review of the Literature Following the Academic Emergency Medicine Consensus Conference, 2007–2015

“…Following abstract and article review for relevance, a total of 313 articles addressing surge and surge capacity remained. Following detailed text review, 50 quantitative and 11 concept papers (consensus conference recommendations) met all inclusion criteria (Tables A–E and Data Supplement S1, available as supporting information in the online version of this paper). Of the quantitative articles judged relevant, 31 articles focused on criteria and methods for decision‐making for scarce resource allocation, 16 were related to effective triage protocols, nine concerned key decision makers for surge‐capacity planning and evaluating response efficacy, seven addressed meeting workforce needs, and seven were related to developing communication and information‐sharing strategies.…”

Towards Developing a Model for the Evaluation of Hospital Disaster Resilience: A Systematic Review

“…One of the advantages of this tool is that the non-structural section is wide and consists of many sub-categories. The disaster management category in HSI has emphasized on preparedness of Zhong suggested a framework including four domains and 12 subdomains for assessing hospital resilience assessment in China (32)(33)(34). This framework highlights managerial aspect of hospitals more than the structural and non-structural systems at the time of danger.…”

“…This tool not only helps to assess safety status, but also helps to evaluate the response capacity of the hospitals (22)(23)(24)(25)(26)(27).Moreover, there are some studies that mentioned instruments for assessing Hospital Disaster Resilience (HDR). In some of them the authors focused on operational characteristics of hospitals; however, the structural and non-structural aspects of hospital resilience were not mentioned in details (28)(29)(30)(31)(32)(33).For instance, Zhong proposed multiple concepts for assessing hospitals resilience in response to disasters in China. The variables used in this study included hospital safety, emergency services, surge capacity, command, disaster plan, logistics, staff ability, disaster training, communication and cooperation systems, recovery, and adaptation (34).…”

“…The remained article was a narrative study. Additional file 3 shows the characteristics of the full sources included in the study(4,8,25, 27,29,(31)(32)(33).…”