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  • 1.
    Djalali, Ahmadreza
    et al.
    Center for Research and Education in Emergency and Disaster Medicine, Università Del Piemonte Orientale, Novara, Italy; Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Ardalan, Ali
    Department of Disaster and Emergency Health, National Institute of Health Research, Tehran, iran; University of Medical Sciences, Tehran, Iran; Harvard Humanitarian Initiative, Department of Global Health and Population, Harvard School of Public Health, Cambridge MA, United States.
    Ohlen, Gunnar
    Intervention and Technology, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Ingrassia, Pier Luigi
    Center for Research and Education in Emergency and Disaster Medicine, Università Del Piemonte Orientale, Novara, Italy.
    Corte, Francesco Della
    Center for Research and Education in Emergency and Disaster Medicine, Università Del Piemonte Orientale, Novara, Italy.
    Castren, Maaret
    Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Section of Emergency Medicine, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Kurland, Lisa
    Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Section of Emergency Medicine, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Nonstructural Safety of Hospitals for Disasters: A Comparison Between Two Capital Cities2014In: Disaster Medicine and Public Health Preparedness, ISSN 1935-7893, E-ISSN 1938-744X, Vol. 8, no 2, p. 179-184Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Hospitals are expected to function as a safe environment during disasters, but many become unusable because of nonstructural damage. This study compares the nonstructural safety of hospitals to disasters in Tehran and Stockholm.

    METHODS: Hospital safety in Tehran and Stockholm was assessed between September 24, 2012, and April 5, 2013, with use of the nonstructural module of the hospital safety index from the World Health Organization. Hospital safety was categorized as safe, at risk, or inadequate.

    RESULTS: All 4 hospitals in Stockholm were classified as safe, while 2 hospitals in Tehran were at risk and 3 were safe. The mean nonstructural safety index was 90% ± 2.4 SD for the hospitals in Stockholm and 64% ± 17.4 SD for those in Tehran (P = .014).

    CONCLUSIONS: The level of hospital safety, with respect to disasters, was not related to local vulnerability. Future studies on hospital safety should assess other factors such as legal and financial issues. (Disaster Med Public Health Preparedness. 2014;0:1-6).

  • 2.
    Hugelius, Karin
    et al.
    Örebro University, School of Health Sciences.
    Semrau, Maya
    Brighton and Sussex Medical School, Brighton, United Kingdom.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Use of the HESPER Web to assess perceived needs immediately after multiple disaster events in Fiji2023In: Disaster Medicine and Public Health Preparedness, ISSN 1935-7893, E-ISSN 1938-744X, Vol. 17, article id e385; PII S1935789323000472Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: In January 2022, Fiji was hit by multiple natural disasters including a cyclone causing flooding, an underwater volcanic eruption and tsunami. This study aimed to investigate perceived needs among the disaster-affected people in Fiji and to evaluate the feasibility of the Humanitarian Emergency Settings Perceived Needs Scale (HESPER Web) during the early stage after multiple natural disasters.

    METHODS: A cross-sectional study using a self-selected, non-representative study sample was conducted. The HESPER Web was used to collect data.

    RESULTS: In all, 242 people participated. The number of perceived serious needs ranged between 2 and 14 (out of a possible 26), with a mean of 6 (SD 3). The top three most reported needs were access to toilets (60%), care for people in the community who are on their own (55%), and distress (51%). Volunteers reported fewer needs than the general public.

    CONCLUSIONS: The top three needs reported were related to water and sanitation and psychosocial needs. Such needs should not be underestimated in the emergency phase after natural disasters, and may require more attention from responding actors. The HESPER Web was be considered as a usable tool for needs assessment in a sudden onset disaster.

  • 3.
    Nekoie-Moghadam, Mahmood
    et al.
    Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
    Kurland, Lisa
    Department of Clinical Sciences and Education, Karolinska Institutet, Stockholm, Sweden; Department of Emergency Medicine, Södersjukhuset, Stockholm, Sweden.
    Moosazadeh, Mahmood
    Health Sciences Research Center, School of Health, Mazandaran University of Medical Sciences, Sari, Iran.
    Ingrassia, Pier Luigi
    Center for Research and Education in Emergency and Disaster Medicine - CRIMEDIM, University degli Studi del Piemonte Orientale "A. Avogadro", Novara, Italy.
    Della Corte, Francesco
    Center for Research and Education in Emergency and Disaster Medicine - CRIMEDIM, University degli Studi del Piemonte Orientale "A. Avogadro", Novara, Italy.
    Djalali, Ahmadreza
    Center for Research and Education in Emergency and Disaster Medicine - CRIMEDIM, University degli Studi del Piemonte Orientale "A. Avogadro", Novara, Italy.
    Tools and Checklists Used for the Evaluation of Hospital Disaster Preparedness: A Systematic Review2016In: Disaster Medicine and Public Health Preparedness, ISSN 1935-7893, E-ISSN 1938-744X, Vol. 10, no 5, p. 781-788Article, review/survey (Refereed)
    Abstract [en]

    Hospitals need to be fully operative during disasters. It is therefore essential to be able to evaluate hospital preparedness. However, there is no consensus of a standardized, comprehensive and reliable tool with which to measure hospital preparedness. The aim of the current study was to perform a systematic review of evaluation tools for hospital disaster preparedness. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The key words "crisis," "disaster," "disaster medicine," "emergency," "mass casualty," "hospital preparedness," "hospital readiness," "hospital assessment," "hospital evaluation," "hospital appraisal," "planning," "checklist," and "medical facility" were used in combination with the Boolean operators "OR" and "AND." PubMed (National Library of Medicine, Bethesda, MD), ISI Web of Science (Thomson Reuters, New York, NY), and Scopus (Elsevier, New York, NY) were searched. A total of 51,809 publications were screened. The following themes were required for relevance: logistics, planning, human resources, triage, communication, command and control, structural and nonstructural preparedness, training, evacuation, recovery after disaster, coordination, transportation, surge capacity, and safety. The results from 15 publications are presented. Fifteen articles fulfilled the criteria of relevance and considered at least 1 of the 14 predetermined themes. None of the evaluated checklists and tools included all dimensions required for an appropriate hospital preparedness evaluation. The results of the current systematic review could be used as a basis for designing an evaluation tool for hospital disaster preparedness.

  • 4.
    Rüter, Andres
    et al.
    Sophiahemmet University, Stockholm, Sweden; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Kurland, Lisa
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Gryth, Dan
    Department of Physiology and Pharmacology, Section of Anaesthesiology and Intensive Care, Karolinska Institutet, Stockholm, Sweden.
    Murphy, Jason
    Sophiahemmet University, Stockholm, Sweden; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Rådestad, Monica
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Djalali, Ahmadreza
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Center for Research and Education in Emergency and Disaster Medicine, Novara, Italy.
    Evaluation of Disaster Preparedness Based on Simulation Exercises: A Comparison of Two Models2016In: Disaster Medicine and Public Health Preparedness, ISSN 1935-7893, E-ISSN 1938-744X, Vol. 10, no 4, p. 544-548Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The objective of this study was to highlight 2 models, the Hospital Incident Command System (HICS) and the Disaster Management Indicator model (DiMI), for evaluating the in-hospital management of a disaster situation through simulation exercises.

    METHODS: Two disaster exercises, A and B, with similar scenarios were performed. Both exercises were evaluated with regard to actions, processes, and structures. After the exercises, the results were calculated and compared.

    RESULTS: In exercise A the HICS model indicated that 32% of the required positions for the immediate phase were taken under consideration with an average performance of 70%. For exercise B, the corresponding scores were 42% and 68%, respectively. According to the DiMI model, the results for exercise A were a score of 68% for management processes and 63% for management structure (staff skills). In B the results were 77% and 86%, respectively.

    CONCLUSIONS: Both models demonstrated acceptable results in relation to previous studies. More research in this area is needed to validate which of these methods best evaluates disaster preparedness based on simulation exercises or whether the methods are complementary and should therefore be used together. (Disaster Med Public Health Preparedness. 2016;10:544-548).

  • 5.
    Westman, Anja
    et al.
    Örebro University, School of Medical Sciences. Emergency Department, Örebro University Hospital, Örebro, Sweden.
    Hugelius, Karin
    Örebro University, School of Health Sciences. CRIMEDIM, Novara, Italy.
    Weinstein, Eric
    CRIMEDIM, Novara, Italy.
    Kurland, Lisa
    Örebro University, School of Medical Sciences.
    Facilitators and barriers for effective staff work in Swedish National governmental crisis response to the COVID-19 pandemic2022In: Disaster Medicine and Public Health Preparedness, ISSN 1935-7893, E-ISSN 1938-744X, Vol. 17, article id E191Article in journal (Refereed)
    Abstract [en]

    Objectives: The coronavirus disease (COVID-19) crisis response in Sweden was managed foremost by a collaboration of several national agencies. Normally, their strategical and operational collaboration is limited, but the pandemic required new and unfamiliar collaborations. This study aimed to clarify the facilitators and barriers of perceived effective staff work within and between 4 national agencies.

    Methods: A qualitative study of 10 participants with leading roles within the 4 national agencies' crisis organization was conducted via snowball sampling. The participant interviews were conducted between August and November 2020 and analyzed using content analysis.

    Results: Four categories emerged from the analysis: individual characteristics, intra-agency organization, interorganizational collaboration, and governmental directives. Subcategories crystallized from the data were analyzed and divided into factors for facilitating or to function as barriers for effective staff work.

    Conclusion: Individual factors such as attitude and approach were important for perceived effective staff work as well as clear mandates and structure of the organization. Barriers for perceived effective staff work include lack of network, the complexity of the mission and organizational structures, as well as lack of preparations and unclear mandates. Although flexibility and adaptability are necessary, they cannot always be planned, but can be incorporated indirectly by selecting suitable individuals and optimizing organizational planning.

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