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      Audit of the functional preparedness of the selected military hospital in response to incidents and disasters: participatory action research

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          Abstract

          Introduction

          Since hospitals play an important role in dealing with disaster victims, this study was conducted to audit the functional preparedness of the selected military hospital in response to incidents and disasters.

          Materials and methods

          This applied action research was conducted in all wards of a military hospital from September 2020 to September 2021. The functional preparedness of the hospital was assessed using a functional preparedness checklist containing 17 domains and the weaknesses of the hospital were identified. Then, during the hospital audit cycle, a plan was developed to improve work processes and the functional preparedness of different wards of the hospital in response to incidents and disasters using the FOCUS-PDCA model. The functional preparedness of the hospital was compared before and after the intervention and analyzed using SPSS22.

          Results

          The relative mean score of hospital preparedness in response to disasters was 508 out of 900 (56.44%) before the intervention, which was moderate. The relative mean score of the hospital preparedness in response to disasters was 561 (63.63%) after the intervention, which was good. The highest preparedness was related to risk assessment (85%) and the lowest preparedness was related to victims’ dead bodies (44%).

          Conclusion

          Considering the effect of action research on improving the hospital’s functional preparedness in response to disasters, other healthcare facilities are encouraged to incorporate auditing into their work plans.

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          Most cited references26

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          Patient safety and safety culture in primary health care: a systematic review

          Background Patient safety in primary care is an emerging field of research with a growing evidence base in western countries but little has been explored in the Gulf Cooperation Council Countries (GCC) including the Sultanate of Oman. This study aimed to review the literature on the safety culture and patient safety measures used globally to inform the development of safety culture among health care workers in primary care with a particular focus on the Middle East. Methods A systematic review of the literature. Searches were undertaken using Medline, EMBASE, CINAHL and Scopus from the year 2000 to 2014. Terms defining safety culture were combined with terms identifying patient safety and primary care. Results The database searches identified 3072 papers that were screened for inclusion in the review. After the screening and verification, data were extracted from 28 papers that described safety culture in primary care. The global distribution of the articles is as follows: the Netherlands (7), the United States (5), Germany (4), the United Kingdom (1), Australia, Canada and Brazil (two for each country), and with one each from Turkey, Iran, Saudi Arabia and Kuwait. The characteristics of the included studies were grouped under the following themes: safety culture in primary care, incident reporting, safety climate and adverse events. The most common theme from 2011 onwards was the assessment of safety culture in primary care (13 studies, 46%). The most commonly used safety culture assessment tool is the Hospital survey on patient safety culture (HSOPSC) which has been used in developing countries in the Middle East. Conclusions This systematic review reveals that the most important first step is the assessment of safety culture in primary care which will provide a basic understanding to safety-related perceptions of health care providers. The HSOPSC has been commonly used in Kuwait, Turkey, and Iran. Electronic supplementary material The online version of this article (10.1186/s12875-018-0793-7) contains supplementary material, which is available to authorized users.
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            Reviewing audit: barriers and facilitating factors for effective clinical audit.

            To review the literature on the benefits and disadvantages of clinical and medical audit, and to assess the main facilitators and barriers to conducting the audit process. A comprehensive literature review was undertaken through a thorough review of Medline and CINAHL databases using the keywords of "audit", "audit of audits", and "evaluation of audits" and a handsearch of the indexes of relevant journals for key papers. Findings from 93 publications were reviewed. These ranged from single case studies of individual audit projects through retrospective reviews of departmental audit programmes to studies of interface projects between primary and secondary care. The studies reviewed incorporated the experiences of a wide variety of clinicians, from medical consultants to professionals allied to medicine and from those involved in unidisciplinary and multidisciplinary ventures. Perceived benefits of audit included improved communication among colleagues and other professional groups, improved patient care, increased professional satisfaction, and better administration. Some disadvantages of audit were perceived as diminished clinical ownership, fear of litigation, hierarchical and territorial suspicions, and professional isolation. The main barriers to clinical audit can be classified under five main headings. These are lack of resources, lack of expertise or advice in project design and analysis, problems between groups and group members, lack of an overall plan for audit, and organisational impediments. Key facilitating factors to audit were also identified: they included modern medical records systems, effective training, dedicated staff, protected time, structured programmes, and a shared dialogue between purchasers and providers. Clinical audit can be a valuable assistance to any programme which aims to improve the quality of health care and its delivery. Yet without a coherent strategy aimed at nurturing effective audits, valuable opportunities will be lost. Paying careful attention to the professional attitudes highlighted in this review may help audit to deliver on some of its promise.
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              Evaluation of hospital disaster preparedness by a multi-criteria decision making approach: The case of Turkish hospitals

              Considering the unexpected emergence of natural and man-made disasters over the world and Turkey, the importance of preparedness of hospitals, which are the first reference points for people to get healthcare services, becomes clear. Determining the level of disaster preparedness of hospitals is an important and necessary issue. This is because identifying hospitals with low level of preparedness is crucial for disaster preparedness planning. In this study, a hybrid fuzzy decision making model was proposed to evaluate the disaster preparedness of hospitals. This model was developed using fuzzy analytic hierarchy process (FAHP)-fuzzy decision making trial and evaluation laboratory (FDEMATEL)-technique for order preference by similarity to ideal solutions (TOPSIS) techniques and aimed to determine a ranking for hospital disaster preparedness. FAHP is used to determine weights of six main criteria (including hospital buildings, equipment, communication, transportation, personnel, flexibility) and a total of thirty-six sub-criteria regarding disaster preparedness. At the same time, FDEMATEL is applied to uncover the interdependence between criteria and sub-criteria. Finally, TOPSIS is used to obtain ranking of hospitals. To provide inputs for TOPSIS implementation, some key performance indicators are established and related data is gathered by the aid of experts from the assessed hospitals. A case study considering 4 hospitals from the Turkish healthcare sector was used to demonstrate the proposed approach. The results evidenced that Personnel is the most important factor (global weight = 0.280) when evaluating the hospital preparedness while Flexibility has the greatest prominence (c + r = 23.09).
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                Author and article information

                Contributors
                eheidaranlu@gmail.com
                att.tavan@gmail.com
                mmsalaree@gmail.com
                sarhangy@yahoo.com
                Yasernurse84@yahoo.com
                at.tavan@yahoo.com
                Journal
                BMC Emerg Med
                BMC Emerg Med
                BMC Emergency Medicine
                BioMed Central (London )
                1471-227X
                13 October 2022
                13 October 2022
                2022
                : 22
                : 168
                Affiliations
                [1 ]GRID grid.411521.2, ISNI 0000 0000 9975 294X, Trauma Research Center, Nursing Faculty, , Baqiyatallah University of Medical Sciences, ; Tehran, Iran
                [2 ]GRID grid.411521.2, ISNI 0000 0000 9975 294X, Trauma Research Center, Nursing Faculty, , Baqiyatallah University of Medical Sciences, ; Tehran, Iran
                [3 ]GRID grid.411521.2, ISNI 0000 0000 9975 294X, Health Research Center, life style institute, Nursing faculty, , Baqiyatallah University of Medical Sciences, ; Tehran, Iran
                [4 ]GRID grid.412105.3, ISNI 0000 0001 2092 9755, Disasters and Emergencies Research Center, Institute for Futures Studies in Health, , Kerman University of Medical Sciences, ; Kerman, Iran
                Article
                728
                10.1186/s12873-022-00728-z
                9559852
                36224543
                6b9d34e7-2e28-455d-a3fb-445c34a42501
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 2 July 2022
                : 23 September 2022
                : 6 October 2022
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                Emergency medicine & Trauma
                functional preparedness,hospital,disasters,audit,action research,emergency,incidents

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