Resilience Assessment of healthcare facilities within urban context: Learning from a non-profit hospital in Tehran, Iran

Rahmani, Mehrdad; Lotfata, Aynaz; Khoshnevis, Sarasadat; Javanmardi, Komar

doi:10.1101/2021.09.13.21263435

Cited by 4 publications

(5 citation statements)

References 32 publications

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“…Most proposed measures for robustness are related to hospital safety using the HSI or modified versions (21). One study utilized a customized five-dimensional City Resilience Profiling Tool (63), while another evaluated the hospital'sbuilt environment and plans (38) to measure hospital resilience within its environment. Other studies related to natural hazards measured environmental characteristics (e.g., seismic, climaterelated exposures) (10, 40), infrastructural planning and design (47,49,50,63), and modeling to measure hospital's loss of function (39,44).…”

Section: Discussionmentioning

confidence: 99%

“…Resilient hospitals contribute to building stronger health systems, healthy communities, and sustainable development. Hospital, health systems, and community resilience are interdependent on one another (9,10,13,15,19,52,63).…”

Section: Componentsmentioning

confidence: 99%

“…Systematic, collaborative, and coordinated approaches are essential to hospitals' resilience, especially in the recovery stage (15,18). Continuous training, teamwork, institutional learning, and adapting new technologies are key enabling factors to sustainable and effective response and recovery and, ultimately, hospitals' resilience (8,18,25,32,57,63). Another study found that the most common adaptive strategies included empowering local leaders, increasing community awareness through communication and engagement, and enhancing community engagement (75).…”

Section: Recoverymentioning

confidence: 99%

“…In responding to natural, technological, societal hazards, hospitals should be prepared to mobilize large investments for repairs, rehabilitation, retrofitting, and reconstruction to mitigate structural and non-structural failures (21). Studies highlight the importance of constructive resilience, especially in the recovery, noting that most damages are related to inappropriate site selection for the building, lack of proper design or insufficient maintenance (21,63). Following natural hazards such as earthquakes, the damages caused to utility networks and non-structural components had the most significant effect on hospitals' functionality and, therefore, resilience; these were also the costliest to repair and required prioritization in the recovery (21,40,44,45).…”

Section: Recoverymentioning

confidence: 99%

“…Moreso, in FCRS, hospital resilience and services continuity often depended on flexible financing to ensure swift procurement, equitable distribution, and efficient use of resources (3,15,16,22,24,25,28,34,(49)(50)(51)(52). Further to this, strengthening hospital's resilience requires improving health systems and community resilience; and the reverse is symbiotic (9,10,13,15,19,52,63). Without resilient hospitals, health system cannot be resilient; furthermore, multi-sectoral interventions, using whole of government and whole of society approaches, are needed to strengthen resilience at the national level to mitigate the impacts of shocks on hospitals' (5,7,9,23,26,34,52).…”

Section: Implications and Challengesmentioning

confidence: 99%

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

Khalil

Ravaghi

Samhouri

et al. 2022

Front. Public Health

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BackgroundCOVID-19 underscored the importance of building resilient health systems and hospitals. Nevertheless, evidence on hospital resilience is limited without consensus on the concept, its application, or measurement, with practical guidance needed for action at the facility-level.AimThis study establishes a baseline for understanding hospital resilience, exploring its 1) conceptualization, 2) operationalization, and 3) evaluation in the empirical literature.MethodsFollowing Arksey and O'Malley's model, a scoping review was conducted, and a total of 38 articles were included for final extraction.Findings and discussionIn this review, hospital resilience is conceptualized by its components, capacities, and outcomes. The interdependence of six components (1) space, 2) stuff, 3) staff, 4) systems, 5) strategies, and 6) services) influences hospital resilience. Resilient hospitals must absorb, adapt, transform, and learn, utilizing all these capacities, sometimes simultaneously, through prevention, preparedness, response, and recovery, within a risk-informed and all-hazard approach. These capacities are not static but rather are dynamic and should improve continuously occur over time. Strengthening hospital resilience requires both hard and soft resilience. Hard resilience encompasses the structural (or constructive) and non-structural (infrastructural) aspects, along with agility to rearrange the space while hospital's soft resilience requires resilient staff, finance, logistics, and supply chains (stuff), strategies and systems (leadership and coordination, community engagement, along with communication, information, and learning systems). This ultimately results in hospitals maintaining their function and providing quality and continuous critical, life-saving, and essential services, amidst crises, while leaving no one behind. Strengthening hospital resilience is interlinked with improving health systems and community resilience, and ultimately contributes to advancing universal health coverage, health equity, and global health security. The nuances and divergences in conceptualization impact how hospital resilience is applied and measured. Operationalization and evaluation strategies and frameworks must factor hospitals' evolving capacities and varying risks during both routine and emergency times, especially in resource-restrained and emergency-prone settings.ConclusionStrengthening hospital resilience requires consensus regarding its conceptualization to inform a roadmap for operationalization and evaluation and guide meaningful and effective action at facility and country level. Further qualitative and quantitative research is needed for the operationalization and evaluation of hospital resilience comprehensively and pragmatically, especially in fragile and resource-restrained contexts.

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