Hospital Incident Command System (HICS) performance in Iran; decision making during disasters

Area of Science:

• Healthcare Management
• Disaster Preparedness
• Public Health

Background:

• Hospitals are critical community health infrastructure requiring robust disaster response capabilities.
• The Hospital Incident Command System (HICS) provides a framework for hospital emergency operations.
• Pre-disaster assessment of management system strengths and vulnerabilities is often lacking.

Purpose of the Study:

• To evaluate decision-making performance within Iranian hospitals using HICS job action sheets.
• To assess hospital preparedness for disaster scenarios through tabletop exercises.

Main Methods:

• An observational study involving 23 Iranian hospitals from May 2008 to August 2009.
• Tabletop exercises were designed based on each hospital's highest probable risk.
• HICS job action sheets served as performance metrics, with scores categorized as fair, intermediate, or high.

Main Results:

• No participating hospital possessed a comprehensive hospital disaster management plan.
• 83% of hospitals demonstrated intermediate HICS performance; none achieved high performance.
• Logistics and finance sections showed higher performance than other areas; public hospitals outperformed university hospitals.

Conclusions:

• Iranian hospital decision-making performance during simulated disasters, assessed via HICS, was intermediate to poor.
• HICS job action sheets are effective tools for evaluating hospital emergency response.
• Simulations are valuable for preparedness assessment, though outcome correlation requires further study.