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Objective: This study aims to explore a public volunteer’s hospital response model in natural disasters in Iran. Methods: This study employed grounded theory using the Strauss and Corbin 2008 method and data analysis was carried out in three steps, namely open, axial, and selective coding. The present qualitative study was done using semi-structured interviews with 36 participants who were on two levels and with different experiences in responding to emergencies and disasters as “public volunteers” and “experts”. National and local experts were comprised of professors in the field of disaster management, hospital managers, Red Crescent experts, staff and managers of Iran Ministry of Health and Medical Education. Results: The main concept of the paradigm model was “policy gap and inefficiency” in the management of public volunteers, which was rooted in political factions, ethnicity, regulations, and elites. The policy gap and inefficiency led to chaos and “crises over crises.” Overcoming the policy gap will result in hospital disaster resilience. Meanwhile, the model covered the causal, contextual, and intervening conditions, strategies, and consequences in relation to the public volunteers’ hospital response phase. Conclusions: The current public volunteers’ hospital in Iran suffered from the lack of a coherent, comprehensive, and forward-looking plan for their response. The most important beneficiaries of this paradigm model will be for health policy-makers, to clarify the main culprits of creating policy gap and inefficiency in Iran and other countries with a similar context. It can guide the decision-makings in upstream documents on the public volunteers. Further research should carried out to improve the understanding of the supportive legal framework, building the culture of volunteering, and enhancing volunteers’ retention rate.

Introduction: One of the most important topics in crises management is managing volunteers. In this respect, providing proper informing society and incentive mechanisms and maintaining volunteers is very crucial. The purpose of this study is determining methods of informing and attracting public cooperation in volunteer activities in hospitals of Tehran city. Methods: The study is a descriptive research. The sample includes 180 managers and experts in search and rescue and emergency doctors and nurses that were selected using stratified random sampling. Data was collected by "Volunteer Management" questionnaire. Validity is confirmed by 10 experts, and reliability was calculated using Cronbach's alpha based on the 30 preliminary questionnaires. Data is analyzed using SPSS/20. Results: The informing methods are appropriate and significant (P ≤ 0.05). Average scores for the visual media, public call and SMS are 5.94, 5.82 and 5.63 respectively. In addition, among attracting volunteers' cooperation mechanisms, the monthly payment (4.59) volunteer authentic card (4.43) were determined as appropriate methods (P ≤ 0.05). Conclusions: This study showed that visual media (television), public call in the city and SMS play an important role in public informing. Providing monthly salary and volunteer authentic card are effective approaches to attract volunteers. Thus, it is suggested that television programs and municipality advertises incentives such as salaries and valid cards to attract volunteers.

In recent years, volunteers as auxiliary forces for human resources have been playing a vital and effective role to mitigate the effects of disasters (1). Volunteers need to be recognized, guided, and prepared by the relevant agencies and organizations. Volunteers are considered a valuable resource for the community, especially when they are trained and given missions properly under the existing management system (2). According to comprehensive theory of volunteers, volunteerism is productive and profitable. Undoubtedly, among the multiple institutions and organizations related to disaster and rescue management, healthcare systems, particularly hospitals, are the main unit of providing services in disasters (3). Hospitals are faced with shortages of nursing and rescue forces in disasters (4). Also, there is the possibility of damage to the hospital and the staff during unexpected events. In such situations, the existence of volunteers' management in hospital is essential for improving the performance of healthcare systems. Previous studies have investigated the volunteers in the red crescent in Iran; however, the innovation of this study is to discuss the activities of the volunteers in hospitals. The weakness in the volunteers' preparation by the healthcare systems causes irreparable damages after the disasters. Hospitals require programs and plans to prepare the volunteers in three phases of the disasters (before, during, and after). For this purpose, it is necessary to identify and prioritize the measures and the activities at each stage. The aim of this study was to examine the preparation measures of the local volunteers in hospitals (before, during, and after) disasters.This was a cross sectional study in which a researchermade questionnaire was used to collect the data in September 2014 to May 2015. The population was composed of all relief and rescue managers, emergency nurses, and emergency doctors in the hospitals of Tehran University of Medical Sciences (governmental hospitals). A total number of 180 participants were selected by random sampling method. The questionnaire consisted of 30 items in 3 domains as it follows: 1) before disaster (9 items); 2) during disaster (10 items); and 3) after disaster (11 items). The items were rated according to a 5-point scale from 1 to 5. Cronbach's alpha was used to assess the reliability. Cronbach's alpha was calculated for the three sections of the questionnaire (0.75, 0.81 and 0.79). Calculated Cronbach's alpha indicated that the questionnaire had acceptable reliability.The data have been analyzed using mean ± SD, one-sample t-test, and Friedman test. One-sample t-test was used to analyze the significance of the volunteers' preparation measures. Friedman test was used to prioritize the preparation measures.The results of the t-test showed that all the preparation measures in the three phases of the disasters were significant (P ≤ 0.05). The priority of the preparation measures before disaster included maneuver (mean rank = 6.61), holding practical tests (6.05),...