Ali Nasiri1, Aidin Aryankhesal2,3, Hamidreza Khankeh4,5. 1. Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. 2. Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran. 3. Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. 4. Research Center in Emergency and Disaster Health, University of Social Welfare and Rehabilitation Science (USWR), Tehran, Iran. 5. Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
Abstract
OBJECTIVE: Iran, as one of the most disaster-prone countries in the world, is exposed to a wide range of hazards. Hence, the health sector should be prepared to deal with the consequences of emergencies. This study aimed to explore Iranian disaster management status and to identify the necessary characteristics of successful incident commanders in this field. METHODS: A qualitative content analysis was designed using in-depth semi-structured interviews with 30 commanders and experts, selected by purposeful sampling, who had first-hand experiences in managing health disasters. Field notes, formal institutional reports, and photos were employed as well. Verbatim transcribed interviews and other data sources were analyzed using constant comparison method. Ethical issues were considered carefully throughout the study process. RESULTS: Two main themes were developed: The first theme, "limbo situation," as expression of the problem describes inadequacies and complexities of disaster management in Iranian health sector, including seven categories. The second theme was "effective disaster leadership" consisting of "commanders' traits" and "commanders' competencies" as subthemes. CONCLUSIONS: The study demonstrated the chaotic feature of disaster management in Iran and probably some other developing countries, with crucial and unclear role of field commanders. Working under stress, time pressure, uncertainty, and management of paradoxes needs timely and on-field decision making. This study revealed that Iranian health sector incident commanders should be transformational leaders with the ability of influencing subordinate staff and have Janusian thinking skills for overcoming the existing limbo situation.
OBJECTIVE: Iran, as one of the most disaster-prone countries in the world, is exposed to a wide range of hazards. Hence, the health sector should be prepared to deal with the consequences of emergencies. This study aimed to explore Iranian disaster management status and to identify the necessary characteristics of successful incident commanders in this field. METHODS: A qualitative content analysis was designed using in-depth semi-structured interviews with 30 commanders and experts, selected by purposeful sampling, who had first-hand experiences in managing health disasters. Field notes, formal institutional reports, and photos were employed as well. Verbatim transcribed interviews and other data sources were analyzed using constant comparison method. Ethical issues were considered carefully throughout the study process. RESULTS: Two main themes were developed: The first theme, "limbo situation," as expression of the problem describes inadequacies and complexities of disaster management in Iranian health sector, including seven categories. The second theme was "effective disaster leadership" consisting of "commanders' traits" and "commanders' competencies" as subthemes. CONCLUSIONS: The study demonstrated the chaotic feature of disaster management in Iran and probably some other developing countries, with crucial and unclear role of field commanders. Working under stress, time pressure, uncertainty, and management of paradoxes needs timely and on-field decision making. This study revealed that Iranian health sector incident commanders should be transformational leaders with the ability of influencing subordinate staff and have Janusian thinking skills for overcoming the existing limbo situation.
Authors: Heeyoung Han; Amy Clithero-Eridon; Manuel João Costa; Caitriona A Dennis; J Kevin Dorsey; Kulsoom Ghias; Alex Hopkins; Kauser Jabeen; Debra Klamen; Sophia Matos; John D Mellinger; Harm Peters; Suzanne Pitama; C Leslie Smith; Susan F Smith; Boyung Suh; Sookyung Suh; Marko Zdravković Journal: Korean J Med Educ Date: 2021-11-30