Investigating the level of functional preparedness of selected Tehran hospitals in the face of biological events: a focus on COVID-19

Purpose This study aims to evaluate the functional readiness of selected hospitals in Tehran in the face of biological events focusing on the Coronavirus. Design/methodology/approach The current study is a cross-sectional, descriptive-analytical study, with the research population consisting of four hospitals in Tehran (Ministry of Health, Social Security, Azad and Military University). This study used data collection tools, standardized functional preparedness tools for hospitals using a biological approach and a standardized checklist of biological event preparations for the American Hospital Association. Interviews with the incident and disaster committee director and observation of each hospital’s existing documents, were used to collect data, which was then analyzed using SPSS-16 software. Findings According to the results, the average percentage of total hospital preparedness in biological events is 36.9%. With 53.3%, the selected military hospital has the most preparation, whereas the Ministry of Health has the lowest preparation with 28.3%. Surge capacity management and communication had the most remarkable preparedness rate of 68.75% (adequate preparedness), biological consultants, meeting management and post-disaster recovery had the lowest preparedness rate of 0% (extremely weak preparedness). Practical implications The average functional preparedness of selected hospitals in Tehran was assessed at an insufficient level in this study. Given the recurrence of disease waves, these results are helpful in increasing hospital preparedness for impending events. Improving preparedness in most areas, especially in post-disaster recovery seems necessary. Originality/value Given the COVID-19 pandemic, it is important to assess hospitals’ readiness to increase capacity and respond to this scourge. Few studies have been done in this field in the world. This study investigates this issue in the capital of Iran. The finding of this study suggest authorities’ attention to this issue and the creation of severe and prompt solutions and measures and the use of military hospital experiences to improve biological threat preparedness.

National hospital readiness for COVID-19 in Lesotho: evidence for oxygen ecosystem strengthening

SETTING:Sub-Saharan African country, Lesotho, during the SARS-CoV-2 COVID-19 pandemic.OBJECTIVE: To evaluate COVID-19 hospital capacity in Lesotho.DESIGN: We conducted a pragmatic assessment of all public hospitals in Lesotho using a WHO COVID-19 hospital assessment tool during July 2020 (baseline), with targeted follow-up in December 2020. We adapted the WHO tool into a questionnaire with a focus on hospital services and included oxygen ecosystem elements (pulse oximeters, oxygen, and advanced respiratory care). We converted qualitative questionnaire answers into quantitative ordinal variables and used standard statistics for analysis.RESULTS: At baseline, we found all 12 questionnaire domains demonstrate both hospital preparedness and weakness in infection prevention and control. Key baseline gaps were lack of a dedicated team, and insufficient personal protective equipment and space for donning and doffing. Substantial limitations were noted in hypoxemia diagnosis and treatment; information management and care coordination pathways were also suboptimal. Targeted follow-up after 5 months revealed improvement in the availability of pulse oximetry, oxygen capacity, and heated high-flow nasal cannula devices.CONCLUSION: Our baseline findings may reflect uneven early pandemic care quality; targeted follow-up suggests strengthening of the oxygen ecosystem.

An armed assailant in our hospital: Are we prepared?

ABSTRACT While armed assailant attacks are rare in the hospital setting, they pose a potential risk to healthcare staff, patients, visitors and the infrastructure. Singapore hospitals have well-developed disaster plans to respond to a mass casualty incident occurring outside the hospital. However, lack of an armed assailant incident response plan can significantly reduce the hospital’s ability to appropriately respond to such an incident. The authors describe various strategies that can be adopted in the development of an armed assailant incident response plan. Regular staff training will increase staff resilience and capability to respond to a potential threat in the future. The aim of this article is to highlight the need for the emergency preparedness units of all hospitals to work together with various stakeholders to develop an armed assailant incident response plan. This will be of great benefit for keeping healthcare facilities safe, both for staff as well as for the community. Keywords: Armed assailant, hospital, preparedness, response, strategies

A national survey of hospital readiness during the COVID-19 pandemic in Nigeria

Introduction The COVID-19 pandemic continues to overwhelm health systems across the globe. We aimed to assess the readiness of hospitals in Nigeria to respond to the COVID-19 outbreak. Method Between April and October 2020, hospital representatives completed a modified World Health Organisation (WHO) COVID-19 hospital readiness checklist consisting of 13 components and 124 indicators. Readiness scores were classified as adequate (score ≥80%), moderate (score 50–79.9%) and not ready (score <50%). Results Among 20 (17 tertiary and three secondary) hospitals from all six geopolitical zones of Nigeria, readiness score ranged from 28.2% to 88.7% (median 68.4%), and only three (15%) hospitals had adequate readiness. There was a median of 15 isolation beds, four ICU beds and four ventilators per hospital, but over 45% of hospitals established isolation facilities and procured ventilators after the onset of COVID-19. Of the 13 readiness components, the lowest readiness scores were reported for surge capacity (61.1%), human resources (59.1%), staff welfare (50%) and availability of critical items (47.7%). Conclusion Most hospitals in Nigeria were not adequately prepared to respond to the COVID-19 outbreak. Current efforts to strengthen hospital preparedness should prioritize challenges related to surge capacity, critical care for COVID-19 patients, and staff welfare and protection.

COSMIN Checklist for Systematic Reviews of the Hospital Preparedness Instruments in Biological Events

Background and PurposeThe purpose of this research was to evaluate the psychometric properties of hospital preparedness instruments in biological events. The Consensus-based Standards for the selection of health Measurements Instruments (COSMIN) checklist has been used to design the appropriate hospital preparedness instruments in these events.MethodsA systematic search was performed in PubMed, Scopus, Web of Science and ProQuest, Google Scholar for relevant literature until December 31, 2018, and the data were extracted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the identified studies was assessed per measurement property according to the COSMIN checklist. Twenty studies that met the inclusion criteria were included.ResultsThe result showed that none of the evaluated checklists and instruments included all dimensions required for an appropriate hospital preparedness evaluation. The results revealed that none of the included studies reported adequate information on all the measurement properties of the instruments studied as per the COSMIN criteria.ConclusionsThe information on their measurement properties was lacking. Thus, there was a need for evaluating measurement. However, a vital necessity is felt for developing an instrument with acceptable psychometric properties for measuring hospital preparedness in biological events. The present study provided improved clarity about the quality of currently available hospital preparedness instruments in the biological event and the results of this systematic review could be used to prepare a standardized instrument to evaluate hospital preparedness in biological disaster.

Hospital Preparedness and Response Framework during infection pandemic.

Coronavirus disease 2019 (COVID-19) has put an unprecedented burden to world health, economy and social life with possible long-term consequences. The velocity and mass of this infection pandemic had already overwhelmed every robust health care system in the world. The evidence pertaining to this novel infection pandemic is evolving, so are the challenges in terms of adequate preparedness and response. In this review, we enumerate the strategic and operational domains and build a functional framework for the management of hospital mass infection incidents due to COVID-19 and similar future pandemics. This functional framework could assist health policy maker and health care worker to implement, innovate, and translate preparedness and response to save valuable life and resources.

COVID-19 Pandemic—Frontline Experiences and Lessons Learned From a Tertiary Care Teaching Hospital at a Suburban Location of Southeastern India

The key challenges to any health care setup during emergency situations, such as that of the COVID-19 pandemic would be to rapidly address hospital preparedness and response tailored to the local population, societal influences, political factors within the existing infrastructure, and workforce. Second, to adopt and moderate policies, standard operating procedures (SOPs) and guidelines issued by national and international agencies, such as WHO, CDC, and the Indian Council for Medical Research (ICMR) were tailor-made to the local conditions of the hospital and community. In this publication, we have discussed the challenges and experiences in preparation and responses to the ongoing COVID-19 pandemic at a tertiary teaching hospital situated at a suburban locale in a small union territory. Puducherry is located in the South Eastern Coromandel Coast of India. The core processes, such as hospital preparedness, adoption, and amendments to SOPs based on dynamic changes in guidelines released by the central and local government, training given to health care workers, setting up the in-house diagnostic facility, surge capacity, management of supplies during the lockdown, infection prevention, and control and patient care are discussed. We have also reinforced our experiences in translating COVID-related opportunities for research and innovation in the form of awards and research proposals for the faculty and students of our institute. The lessons learned in terms of strength and limitations on the ground level of public health during this process is worth sharing as it would provide guidance in preparing the health care setups for pre- and post-pandemic.