Safer Hospital Infrastructure Assessments for Socio-Natural Disaster - A Scoping Review

The aim of this review was to explore hospital socio-natural disaster resilience by identifying: studies assessing structural and non-structural aspects of building resilience; components required to maintain a safe and functional health facility; and if the checklists used were comprehensive and easily performed.

A review systemic approach using PRISMA was taken to search the literature. The search focused on articles that discuss hospital disaster resilience. This includes assessments and checklists for facility structural and non-structural components.

This review identified 22 articles describing hospital assessments using checklists containing structural and non-structural elements of resilience. These studies identified assessments undertaken in ten countries, with eight occurring across Iran. A total of seven differing checklists were identified as containing aspects of structural or non-structural aspects of building resilience. The World Health Organization (WHO) has authored three checklists and four others were developed independently.The structural resilience domain includes building integrity, building materials, design standards, and previous event damages as important elements to determine resilience. Within the internal safety and resilience domains, 11 differing elements were identified as important to non-structural or internal infrastructure resilience. These included the safety of power, water, telecommunication, medical gas supply, and medical equipment resupply systems.Independent evaluation methods were reported in the majority of articles, with a small number highlighting the benefits of both self-evaluation and independent review processes. Implementation of training programs to evaluators was mentioned in three papers with the assessor's knowledge and understanding of all checklist elements being highlighted as important to the validity of the evaluation.

The review identified the assessment of hospital resilience as important for management to determine areas of vulnerability within the hospital's infrastructure and to inform improvement strategies. Assessment criteria must be comprehensive, highlighting structural and non-structural aspects of facility infrastructure. These assessments are best done as a multi-disciplinary collective of experts, involving hospital employees in the journey. This collaborative approach provides a key educational tool for developing disaster capacity, engaging ownership of the process, and the resulting improvements.The on-going development of health facility and wider health system resilience must remain a key strategic focus of national governments and health authorities. The development of standardized procedures and guidelines must be embedded into daily practice.