Disaster Risk Management in the Iranian Hospitals: Challenges and Solutions

Hospital disaster risk management accreditation standards have been developed since 2016. However, the country's hospitals are still not well prepared in this regard. This study aimed to identify the implementation challenges of the disaster Risk Management Program in the country's hospitals and provide solutions to improve it.

This study was conducted as qualitative research in 2019. Purposeful semi-structured interviews were conducted with 35 managers of disaster management centers of the Ministry of Health, medical universities, and hospitals in the country and continued until the saturation stage. Graneheim and Landman's contractual content analysis method was used for data analysis and MAXQDA 12 software was used for data management. Lincoln and Guba's criteria were used to ensure the accuracy and reliability of the data.

By analyzing the interviews, 6 main challenges (gap in the policy of the Ministry of Health, limited resources, weakness in planning, lack of coordination and information management, negative attitude at the managerial level, challenges of knowledge, skills, and attitude of human resources) and 31 sub-challenges in disaster risk management were identified in hospitals. Inadequate structures and weaknesses in planning at various levels, lack of transparency of laws, burnout of hospitals, weaknesses in the information management process, weaknesses in knowledge, skills and attitudes of managers and employees were the main side challenges. twenty-seven solutions were detected that reforming management structures, securing hospitals, effective and efficient management of resources, reforming policies, creating databases, and using new methods in training and practicing hospital preparedness were among the most important solutions presented.

The implementation of disaster risk management programs in the country's hospitals at the levels of policy-making, planning, and implementation is associated with challenges and problems. Paying attention to the structure and organization of disaster management at the Ministry of Health, universities, and hospitals, reforming the structure, laws and national instructions and processes in the programs of the Ministry of Health can lead to improving disaster preparedness in hospitals.