Emergency and Disaster Management: An Investigation of Hospitals Disaster Preparedness in the Eastern Province of Saudi Arabia

Abstract

<p>Background</p> <p>Disasters are emergency events that overwhelm the resources of the region or location in which it occurs, resulting in substantial human suffering, loss of life, and severe economic harm. Disaster preparedness and management refer to the measures taken before a disaster, aiming to minimise life loss, critical services disruption, and damage when the disaster occurs. Disasters occur rarely but have significant adverse consequences when they do. Recent statistics suggest that 1.23 million lives and 2.97 trillion dollars have been lost in the last two decades due to disaster events globally. Hospitals provide essential primary emergency healthcare to the victims of disasters to ensure their recovery. It is crucial that hospitals are well prepared for disasters to minimise their effects.</p> <p>Aim</p> <p>The primary aim of the study was to investigate disaster preparedness among hospitals in the Eastern Region of the Kingdom of Saudi Arabia. The specific objectives are: to assess disaster preparedness of hospitals in the Eastern region of Saudi Arabia" to compare the disaster preparedness between private and government hospitals in the Eastern Region of Saudi Arabia" and to determine factors influencing the preparedness for disasters among hospitals in the Eastern Region of the Kingdom of Saudi Arabia (KSA).</p> <p>Methods</p> <p>A descriptive cross-sectional study of all hospitals in the Eastern Region of KSA was conducted between July 2017 and July 2018. The included hospitals were selected using convenience sampling. The survey was adapted according to World Health Organization (WHO) National Health Sector Emergency Preparedness and Response Tool and Hospital Emergency response checklist. It was distributed together with an official letter providing information about the aim and objectives of the study as well as ethical issues guiding their participation in the exercise. Out of 72 hospitals in the region, 63 responded to the survey and were included in the analysis. Before data collection, ethical approval was obtained from the Human Research Ethics Committee at the University of New England (HE17-155) and the Ministry of Health, Saudi Arabia (IRB00010471).</p> <p>Results</p> <p>All 63 participating hospitals had disaster plans and reported to have multidisciplinary planning committees. About 70% of the included hospitals established an educational program on disaster preparedness once per year. Assessment of hospital disaster preparedness was mostly conducted using disaster drills. However, only 9.5% of the hospitals had post-disaster recovery assistance programs like counseling and support services. In all responding hospitals, the level of disaster preparedness was acceptable in most indicators of preparedness, however, some hospitals to some extent fell short of preparedness in surge capacity, equipment and logistic services, and post-disaster recovery. Government and privately-owned hospitals were generally comparable in disaster preparedness. However, government hospitals were more likely to have hospital disaster preparedness (HDP) plans that cover World Health Organization (WHO)'s "all-hazard" approach (<i>p</i> = 0.01), both internal and external disasters (<i>p</i> = 0.002), compared to private hospitals. Also, a three-factor structure was identified as key predicators of hospital disaster preparedness capacity. The first factor was the most highly weighted factor which includes: education and training (0.849)" monitoring and assessing HDP (0.723)" disaster planning (0.721)" and, command and control (0.713). The second factor included surge capacity (0.708)" triage system (0.844)" post-disaster recovery (0.809)" and, communication (0.678). The third factor represented safety and security (0.638)" and, logistics, equipment and supplies (0.766).</p> <p>Conclusion</p> <p>Hospital disaster preparedness in ther Eastern province of KSA was generally acceptable, however preparedness in surge capacity, equipment and logistic services and post-disaster recovery fell short. Government and private hospitals were comparable in preparedness with regards to all indicators except surge capacity, post-disaster recovery and availability of some equipment. Some recommendations to improve hospitals' disaster preparedness should be proposed, including improved staff training and testing, better communications and safety procedures, and adoption of a holistic approach for disaster management. The identified threefactor structure provides an innovative approach to assist the operationalization of the concept of disaster preparedness capacity building and service improvement as well as serving as a groundwork to further develop instrument for assessing hospital disaster preparedness in future studies.</p>