Development and Psychometric Properties of an Effective Evacuation Preparedness Checklist for Hospitals in Disasters:...

Disasters such as earthquakes can severely disrupt hospital operations and endanger patient safety. Rapid evacuation of critically ill patients and medical equipment under pressure presents serious challenges. Strengthening preparedness through comprehensive training and systematic evaluation is essential. This study aimed to develop and validate a hospital evacuation preparedness checklist based on international standards to enhance hospital readiness and patient safety.

A comprehensive review of international evacuation standards was conducted, focusing on guidelines from OSHA, ISO, and NFPA. These frameworks informed the development of a localized checklist aligned with Iran's regulatory context. The tool's content validity was evaluated by expert panels, and its reliability was confirmed through statistical analyses, ensuring its applicability for improving hospital evacuation preparedness in Iran.

The evaluation of the emergency evacuation checklist, structured across six stages, Preparedness, Decision, Warning, Withdrawal, Shelter, and Return, showed strong validity and reliability. The checklist achieved a face validity score of 4.56/5, confirming expert agreement on its relevance. It recorded a Content Validity Ratio of 0.90 and a Content Validity Index of 0.94, supporting comprehensive domain coverage. Test-retest reliability (r = 0.87, p < 0.001) indicated good temporal stability, while the intraclass correlation coefficient (ICC = 0.89) reflected excellent inter-rater consistency. Construct validity, assessed through expert consultation and exploratory factor analysis, confirmed that the checklist accurately represents the six key phases of hospital evacuation preparedness. These results underscore its robustness as a practical tool for hospital emergency management.

The developed checklist demonstrates strong psychometric properties, proving effective for enhancing hospital emergency preparedness. High face and content validity, together with consistent test-retest and ICC results, confirm its reliability and usability. Continuous evaluation and adaptation of such tools remain vital for strengthening hospital safety and operational readiness.