Maria Moitinho de Almeida1, Joris Adriaan Frank van Loenhout1, Sunil Singh Thapa2, K C Kumar3, Deepak Prakash Mahara2, Debarati Guha-Sapir1, Isabelle Aujoulat4. 1. Centre for Research on the Epidemiology of Disasters, Institute of Health and Society, Université Catholique de Louvain (UCLouvain), Brussels, Belgium. 2. Department of Orthopedics, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. 3. Tribhuvan University Teaching Hospital, Kathmandu, Nepal. 4. Institute of Health and Society, Université Catholique de Louvain (UCLouvain), Brussels, Belgium.
Abstract
Background: Resilient hospitals are increasingly recognized as a cornerstone of disaster reduction in global policies such as the Sendai Framework for Action. However, current hospital resilience frameworks emerged from pre-disaster conceptualizations, and have not been verified in real-life disaster contexts nor in the frontlines. Our aim was to study a tertiary hospital's resilience after the 2015 earthquake in Nepal, as experienced by its staff. Methods: We undertook a qualitative study in the Tribhuvan University Teaching Hospital (TUTH), where we conducted 18 semi-structured interviews with hospital staff. We inductively created themes to describe the earthquake burden to the hospital, and to analyze individual resilience of hospital staff. In addition, we deductively documented the resilience of the hospital as a system, according to the system resilience dimensions: means of resilience (redundancy and resourcefulness), and ends of resilience (robustness and rapidity). Results: In terms of robustness, TUTH increased its capacity for earthquake victims as elective activities were temporarily interrupted and quality of care was not a priority. Three stages of rapidity were identified: critical rapidity to address immediate needs, stabilizing rapidity until the hospital re-started routine activities, and recovery rapidity. In addition to the disaster plan, emerging adaptations played a major role in redundancy and resourcefulness. We found that individual resilience depended on three determinants: safety, meaningfulness, and sense of belonging. Conclusions: Hospital resilience results from a complexity of emerging and planned adaptations, as well as from interdependencies with individual resilience. Frameworks and plans to improve hospital resilience must reflect flexibility of response, and a concern for well-being of hospital staff is central for sustainable disaster response and improved resilience.
Background: Resilient hospitals are increasingly recognized as a cornerstone of disaster reduction in global policies such as the Sendai Framework for Action. However, current hospital resilience frameworks emerged from pre-disaster conceptualizations, and have not been verified in real-life disaster contexts nor in the frontlines. Our aim was to study a tertiary hospital's resilience after the 2015 earthquake in Nepal, as experienced by its staff. Methods: We undertook a qualitative study in the Tribhuvan University Teaching Hospital (TUTH), where we conducted 18 semi-structured interviews with hospital staff. We inductively created themes to describe the earthquake burden to the hospital, and to analyze individual resilience of hospital staff. In addition, we deductively documented the resilience of the hospital as a system, according to the system resilience dimensions: means of resilience (redundancy and resourcefulness), and ends of resilience (robustness and rapidity). Results: In terms of robustness, TUTH increased its capacity for earthquake victims as elective activities were temporarily interrupted and quality of care was not a priority. Three stages of rapidity were identified: critical rapidity to address immediate needs, stabilizing rapidity until the hospital re-started routine activities, and recovery rapidity. In addition to the disaster plan, emerging adaptations played a major role in redundancy and resourcefulness. We found that individual resilience depended on three determinants: safety, meaningfulness, and sense of belonging. Conclusions: Hospital resilience results from a complexity of emerging and planned adaptations, as well as from interdependencies with individual resilience. Frameworks and plans to improve hospital resilience must reflect flexibility of response, and a concern for well-being of hospital staff is central for sustainable disaster response and improved resilience.
Authors: Eric D Vugrin; Stephen J Verzi; Patrick D Finley; Mark A Turnquist; Anne R Griffin; Karen A Ricci; Tamar Wyte-Lake Journal: J Healthc Eng Date: 2015 Impact factor: 2.682
Authors: Julita Gil Cuesta; Joris A F van Loenhout; Maria L de Lara-Banquesio; Juan M Isiderio; Isabelle Aujoulat; Debarati Guha-Sapir Journal: Front Public Health Date: 2018-08-31
Authors: Maria Moitinho de Almeida; Joris Adriaan Frank van Loenhout; Sunil Singh Thapa; K C Kumar; Benjamin-Samuel Schlüter; Ravikant Singh; Xavier Banse; Dan Putineanu; Deepak Prakash Mahara; Debarati Guha-Sapir Journal: PLoS One Date: 2019-07-18 Impact factor: 3.240
Authors: Saeed Fallah-Aliabadi; Abbas Ostadtaghizadeh; Ali Ardalan; Farin Fatemi; Bijan Khazai; Mohammad Reza Mirjalili Journal: BMC Health Serv Res Date: 2020-01-29 Impact factor: 2.655