Validation of a framework for measuring hospital disaster resilience using factor analysis

Hospital disaster resilience can be defined as “the ability of hospitals to resist, absorb, and respond to the shock of disasters while maintaining and surging essential health services, and then to recover to its original state or adapt to a new one.” This article aims to provide a framework which can be used to comprehensively measure hospital disaster resilience. An evaluation framework for assessing hospital resilience was initially proposed through a systematic literature review and Modified-Delphi consultation. Eight key domains were identified: hospital safety, command, communication and cooperation system, disaster plan, resource stockpile, staff capability, disaster training and drills, emergency services and surge capability, and recovery and adaptation. The data for this study were collected from 41 tertiary hospitals in Shandong Province in China, using a specially designed questionnaire. Factor analysis was conducted to determine the underpinning structure of the framework. It identified a four-factor structure of hospital resilience, namely, emergency medical response capability (F1), disaster management mechanisms (F2), hospital infrastructural safety (F3), and disaster resources (F4). These factors displayed good internal consistency. The overall level of hospital disaster resilience (F) was calculated using the scoring model: F = 0.615F1 + 0.202F2 + 0.103F3 + 0.080F4. This validated framework provides a new way to operationalise the concept of hospital resilience, and it is also a foundation for the further development of the measurement instrument in future studies.

Disaster resilience in tertiary hospitals : a cross-sectional survey in Shandong Province, China

Background: Hospital disaster resilience can be defined as a hospital’s ability to resist, absorb, and respond to the shock of disasters while maintaining critical functions, and then to recover to its original state or adapt to a new one. This study aims to explore the status of resilience among tertiary hospitals in Shandong Province, China. Methods: A stratified random sample (n = 50) was derived from tertiary A, tertiary B, and tertiary C hospitals in Shandong Province, and was surveyed by questionnaire. Data on hospital characteristics and 8 key domains of hospital resilience were collected and analysed. Variables were binary, and analysed using descriptive statistics such as frequencies. Results: A response rate of 82% (n = 41) was attained. Factor analysis identified four key factors from eight domains which appear to reflect the overall level of disaster resilience. These were hospital safety, disaster management mechanisms, disaster resources and disaster medical care capability. The survey demonstrated that in regard to hospital safety, 93% had syndromic surveillance systems for infectious diseases and 68% had evaluated their safety standards. In regard to disaster management mechanisms, all had general plans, while only 20% had specific plans for individual hazards. 49% had a public communication protocol and 43.9% attended the local coordination meetings. In regard to disaster resources, 75.6% and 87.5% stockpiled emergency drugs and materials respectively, while less than a third (30%) had a signed Memorandum of Understanding with other hospitals to share these resources. Finally in regard to medical care, 66% could dispatch an on-site medical rescue team, but only 5% had a ‘portable hospital’ function and 36.6% and 12% of the hospitals could surge their beds and staff capacity respectively. The average beds surge capacity within 1 day was 13%. Conclusions: This study validated the broad utility of a framework for understanding and measuring the level of hospital resilience. The survey demonstrated considerable variability in disaster resilience arrangements of tertiary hospitals in Shandong province, and the difference between tertiary A hospitals and tertiary B hospitals was also identified in essential areas.

Duty in the time of epidemics : what China and Zimbabwe teach us

In November 2002, a man with ‘atypical pneumonia’ treated in Foshan hospital, Guangdong Province, in the People's Republic of China, was the first known case of Severe Acute Respiratory Syndrome (SARS). However, it was not until April 2003 that the Chinese government admitted to the full scale of ‘atypical pneumonia’ cases infected with SARS, two months after the disease had rapidly spread across the world with initial infections in Hong Kong and Vietnam sourced to Guangdong. In 2008, Zimbabwe experienced one of the biggest outbreaks of cholera ever recorded. By February 2009, the disease had spread across all of Zimbabwe's 10 provinces and to neighbouring countries—Botswana, South Africa, Zambia and Mozambique—causing thousands of infections amongst their populations. This article seeks to examine what duties the Chinese and Zimbabwe states had to protect their citizens and the international community from these outbreaks. The article refers to the findings of the International Law Commission's study into the role of states and international organisations in protecting persons in the event of a disaster to consider whether there is an international duty to protect persons from epidemics. The article concludes that both cases reveal a growing concept of protection that entails an international duty to assist individuals when an affected state proves unwilling or unable to assist its own population in the event of a disease outbreak.

Institutional response and Indigenous experiences of Cyclone Tracy

Early on Christmas morning 1974 Tropical Cyclone Tracy, a Category 4 storm, devastated the Northern Territory city of Darwin leaving only 6% of the city’s housing habitable. The extent of the disaster was largely the result of unregulated and poorly constructed buildings, predominantly housing. While the engineering and reconstruction process demonstrated a very successful response and adaptation to an existing and future risk, the impact of the cyclone of the local community and its Indigenous population in particular, had not been well recorded. NCCARF therefore commissioned a report on the Indigenous experience of Cyclone Tracy to document how Indigenous people were impacted by, responded to, and recovered from Cyclone Tracy in comparison to non-Indigenous groups. The report also considers the research literature on disasters and Indigenous people in the Northern Territory, with a specific focus on cyclones, and considers the socio-political context of Indigenous communities in Darwin prior to Cyclone Tracy.

Adaptation lessons from cyclone Tracy

This case study will review the impact of Tropical Cyclone Tracy on the city and people of Darwin, the Australian engineering and institutional responses that it invoked and the relevance of these lessons to a world threatened by global climate change. At Christmas, 1974, Tropical Cyclone Tracy laid waste the city of Darwin, an iconic episode in the history of Australian natural disasters. It provides one of the clearest and most successful examples worldwide of adaptation to a catastrophe. Following large losses in Townsville from Tropical Cyclone Althea in 1971, the level of destruction in Darwin was such that it led to new regulations mandating the use of the wind code for reconstruction, and eventually to similar regulations for new construction in other cyclone-prone areas of Australia.

Cyclone Tracy and the road to improving wind-resistant design

Early on Christmas morning 1974, tropical cyclone Tracy devastated the city of Darwin leaving only 6 per cent of the city’s housing habitable and instigating the evacuation of 75 per cent of its population. The systematic failure of so much of Darwin’s building stock led to a humanitarian disaster that proved the impetus for an upheaval of building regulatory and construction practices throughout Australia. Indeed, some of the most enduring legacies of Tracy have been the engineering and regulatory steps taken to ensure the extent of damage would not be repeated. This chapter explores these steps and highlights lessons that have led to a national building framework and practice at the fore of wind-resistant design internationally.

Do airlines always suffer from crashes?

We examine the impact of aviation disasters on the stock prices of the crash airlines and their rival airlines. Results show that the crash airlines experience deeper negative abnormal returns as the degree of fatality increases. The stock prices of the rival airlines also suffer in large-scale disasters but benefit from the disasters when the fatality is minor.

Models of social media adoption in emergency management organisations

Recent natural disasters such as the Haitian earthquake 2011, the South East Queensland floods 2011, the Japanese earthquake and tsunami 2011 and Hurricane Sandy in the United States of America in 2012, have seen social media platforms changing the face of emergency management communications, not only in times of crisis and also during business-as-usual operations. With social media being such an important and powerful communication tool, especially for emergency management organisations, the question arises as to whether the use of social media in these organisations emerged by considered strategic design or more as a reactive response to a new and popular communication channel. This paper provides insight into how the social media function has been positioned, staffed and managed in organisations throughout the world, with a particular focus on how these factors influence the style of communication used on social media platforms. This study has identified that the social media function falls on a continuum between two polarised models, namely the authoritative one-way communication approach and the more interactive approach that seeks to network and engage with the community through multi-way communication. Factors such the size of the organisation; dedicated resourcing of the social media function; organisational culture and mission statement; the presence of a social media champion within the organisation; management style and knowledge about social media play a key role in determining where on the continuum organisations sit in relation to their social media capability. This review, together with a forthcoming survey of Australian emergency management organisations and local governments, will fill a gap in the current body of knowledge about the evolution, positioning and usage of social media in organisations working in the emergency management field in Australia. These findings will be fed back to Industry for potential inclusion in future strategies and practices.

Helpline Discourse

Helplines are services where callers can request help, advice, information, or support. While such help is usually offered through telephone helplines, web chat and email helplines are becoming increasingly available to members of the public. Helplines tend to offer specialized services, such as responding to computer software queries, or medical and health issues, or seeking information about natural disasters. Further, they may be aimed at particular populations such as children and young people. The earliest research investigating discourse in calls to helplines in social interactional research began in the 1960s with Sacks’ early work on calls to a suicide prevention center. Since then interactional research has produced a wealth of understandings into the mundane and institutional interactional practices through which help is sought and delivered. In addition to discussing the breadth of research into helplines, this entry explores the relationship between philosophies and interactional practices of helpline services.

Developing an evaluation framework for hospital disaster resilience : tertiary hospitals of Shandong Province, China

This thesis provided a definition and conceptual framework for hospital disaster resilience; it used a mixed-method, including an empirical study in tertiary hospitals of Shandong Province in China, to devise an assessment instrument for measuring hospital resilience. The instrument is the first of its type and will allow hospitals to measure their resilience levels. The concept of disaster resilience has gained prominence in the light of the increased impact of various disasters. The notion of resilience encompasses the qualities that enable the organisation or community to resist, respond to, and recover from the impact of disasters. Hospital resilience is essential as it provides 'lifeline' services which minimize disaster impact. This thesis has provided a framework and instrument to evaluate the level of hospital resilience. Such an instrument could be used to better understand hospital resilience, and also as a decision-support tool for its promoting strategies and policies.

Progress and challenges of disaster health management in China : a scoping review

Background Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries. Objective This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity. Design A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims. Results The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue. Conclusions One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level).

Collaboration to improve evacuation centre operations in disaster-affected communities

Emergency sheltering is a temporary source of safety and support for people affected by disasters. People access emergency sheltering just prior to or soon after a disaster; therefore they are often scared, stressed, and/or experiencing loss/grief. The gathering of people in shelters also increases several environmental health risks. Therefore ensuring emergency shelters contain adequate facilities (permanent or temporary) and are well managed is essential in providing immediate support to disaster-affected communities and providing a level of assurance that the agencies involved are capable of supporting them through the recovery process. This paper will be presented by representatives of Australian Red Cross and Environmental Health Australia (Queensland), which both have an interest in emergency sheltering in Queensland. The paper will cover the development, content and application of the ‘Preferred Sheltering Practices for Emergency Sheltering in Australia’ and the roles of various organisations in relation to emergency sheltering. The importance of or- ganisational collaboration will also be discussed, with a focus on the experience of the two organisations fol- lowing the 2011 floods in Queensland and how they are collaborating to improve future operations in evacu- ation centres, which are a common form of emergency sheltering in Queensland. The organisations are con- tinuing to work together with the ultimate goal of improving services to disaster-affected communities and supporting such communities to start the recovery process.

Amanda Gearing Queensland Flood Collection 2011-2012

A collection of oral history recordings, photographs, hand drawn maps, videos and speech notes relating to the 2011 Queensland floods and the major flood event that occurred in Toowoomba and the Lockyer Valley region on 10 January 2011: a flash flood (described as an 'inland tsunami') which devastatingly took 21 human lives. The collection, amassed by Toowoomba-based journalist Amanda Gearing for her Master of Arts degree, includes 86 oral history recordings of flood survivors and rescuers in Spring Bluff, Murphys Creek, Toowoomba, Withcott, Postmans Ridge, Helidon, Carpendale and Grantham as well as digital photographs and videos taken by a number of those interviewed including those taken by Amanda Gearing and other locals. The interviews are very personal and powerful recollections of the experience of the flood event. Some recall feelings of fear and despair and tell of trauma and loss which continues well after the flood event. All are stories of resilience and hope, of rebuilding lives, of lessons learnt, and recommendations in order to avoid the same devastating results in future disasters.

Queensland floods anniversary : Brian Willmett

"In today's story we hear from Postmans Ridge helicopter pilot, Brian Willmett, and how he and his neighbours worked together to rescue four people, including Kevin and Eileen Lees, from the inland tsunami which swept down the Lockyer Valley during last year's Queensland floods. It was a ten metre high wave that swept through Postmans Ridge that day, ripping houses from their foundations and sweeping two people to their deaths. Brian Willmett was at home when he suddenly ran to rescue neighbours who were in danger. To mark the anniversary of the floods in Queensland, ABC Open has compiled Aftermath, an extensive look at the Queensland floods as well as floods in NSW, Victoria and remote Western Australia, Cyclone Yasi and the 2009 Victorian 'Black Saturday' bushfires. Australia certainly has been hit by a few disasters in the past two or so years. The site has a timeline showing content from these six disasters, with links to about 40 people effected by these disasters. If you go to that site you will be able to choose a person to watch videos about them."

Queensland floods anniversary : Angela Emmerson

"We're marking the anniversary of the destructive floods that hit Queensland a year ago this week with our series of interviews from survivors. Today's story is from Helidon teenager and university student Angela Emmerson, who tells Amanda Gearing how she and her sister scrambled to the roof to escape the dangerous flash flood which suddenly engulfed their house on the 10th of January last year. Tomorrow we'll hear from Grantham resident Rob Wilkin who rescued 31 local people using his car and boat. He helped them escape to safety as 138 houses in the town were destroyed. To mark the anniversary of the floods in Queensland, ABC Open has compiled Aftermath, an extensive look at the Queensland floods as well as floods in NSW, Victoria and remote Western Australia; Cyclone Yasi and the 2009 Victorian 'Black Saturday' bushfires. Australia certainly has been hit by a few disasters in the past two or so years. The site has a timeline showing content from these six disasters, with links to about 40 people effected by these disasters. If you go to that site you will be able to choose a person to watch videos about them."