Hospital Preparedness and Resilience in Public Health Emergencies at District Hospitals and Community Health Centres

Abstract

Background: Public health emergencies (PHE) caused by natural hazards spread from one particular locality to adjacent geographic areas and then encompass the entire planet in today’s fast global connectivity mode. Each country, including India, has its own set of potential disasters based on the hazards present as well as the unique vulnerabilities of the community and community’s preparedness to respond to particular disasters. Currently, human history is observing a very critical time fighting an invisible enemy—COVID-19. Therefore, in this study, we seek to understand the standardised measures of public hospital preparedness and resilience at times of health emergencies, including a pandemic, the most current one being COVID-19. Methods: We conducted a descriptive, cross-sectional study among health officials of district hospitals (DHs) and community health centres (CHCs) of Rajasthan using a semi-structured online questionnaire, with COVID-19 in mind, and sending it to those who had attended a training programme on disaster preparedness in hospitals. Results: In all, questionnaires were sent to 80 health officials of DHs and CHCs, of which 58 responded, with a response rate of 72.5 per cent. We collected responses on public health emergency preparedness, training-related issues, the capacity to deal with emergencies and prior experience in managing an emergency. Conclusion: The resilience and preparedness of DHs and CHCs in Rajasthan appear to be limited. From the studies it has been revealed that proper training and education on disasters like the current COVID-19, which is of significant importance for healthcare workers, is limited to only 37.9 per cent of healthcare workers. It also emerges that the staff members whenever required could mark and perform in the triage area, but the Isolation room haven’t got the request facilities and equipped to stabilise a critical patient despite availability of emergency stock of medicine. The stated functional status of DHs and CHCs reveals that the level of emergency preparedness is between low and medium and also varies from hospital to hospital and from CHC to CHC. Hence, it is time to reassess and upgrade emergency preparedness plans, which include mitigation, preparedness, response and recovery. Federal-, state- and local-level emergency management agencies’ functioning has to be effective and well-coordinated with the local level of operation.

What is “hospital resilience”? A scoping review on conceptualization, operationalization, and evaluation

“…Strengthening the managerial competencies of hospital leaders in the face of outbreaks such as COVID-19 is found to be among the most critical lessons learned from the pandemic (59). This is similar to studies from Iran, India and the Philippines, where strong leadership enabled hospital preparedness and resilience (34,46,60). In addition to this, the pandemic further highlighted the importance of coordination with other hospitals, local authorities, and disaster management agencies, functional information systems (which adapt new technologies), and internal and external communication with the community, media, civic organizations, and local authority, particularly for risk communication and community engagement (3,15).…”

“…Across the literature, hospital preparedness is highlighted as the most essential stage of the DRM cycle (19,22,34,35,41,46,52,60). One systematic review on hospital resilience found that more than half of included studies mentioned hospital planning and preparedness, indicating the bias the literature toward preparedness as a stepping-stone to resilience (22).…”

Role of hospitals in recovery from COVID-19: Reflections from hospital managers and frontliners in the Eastern Mediterranean Region on strengthening hospital resilience

“…Frontliners aptly noted the hospital's role in fulfilling their primary functions in service delivery but also additional functions in health promotion, community engagement, and risk mitigation. This is consistent with global literature on hospitals during health emergencies where the primary objective of resilient hospitals is to "maintain their function, which occurs when they provide quality (safe, effective, patient-centered, timely, efficient, equitable) and continuous critical and essential services, amidst the crises, while leaving no one behind" (2,(21)(22)(23)(24). Whereas historically public health functions have been associated with primary care; recent evidence on building resilient health systems to achieve UHC and health security highlights the contributions of all health systems actors (including hospitals) in fulfilling EPHF (13).…”

Gray Measure and Spatial Distribution Exploration of Local Emergency Resilience on Compound Disasters

“…Disaster preparedness [ 27 ] and preparedness education [ 29 , 32 ] are national priorities [ 29 ], for which the policy is usually implemented by local departments [ 34 , 35 ]. Infrastructure [ 30 , 40 ], resources [ 33 , 36 , 41 ], as well as planning and warning communication [ 33 , 35 ] are indispensable elements of community resilience in disasters. For cross-regional disaster prevention, neighbors might function as resources for disaster preparedness [ 39 ], and cross-regional organizational relations could enhance resilience in each hierarchical and horizontal emergency management network [ 42 ].…”