背景:在卫生系统中,医院是提供重要医疗服务的复杂机构。他们的复原能力在减轻灾害的社会影响方面发挥着至关重要的作用。医院必须具备抵御风险的能力,保持其基本结构和运作,并通过增强各种能力并迅速从潜在风险的影响中恢复来增强其准备。它使医院能够达到更高的准备水平。因此,本研究旨在开发一种为医院量身定制的复原力模型,以有效地应对危机和灾难.
方法:这项混合方法研究于2023年进行了三个阶段:(1)确定影响医院组织韧性的因素,(2)专家小组对影响因素进行评价。(3)遵循标准化流程,我们给个人发放了371份问卷,如大学职员经理和主管,护理经理,和研究单位经理。通过将组分乘以10,得到360(10*36)来确定样品大小。因此,我们选取了371名参与者的样本量.结构方程模型(SEM)被用来检验变量之间的因果关系。使用SPSS25.0和AMOS22软件进行这些步骤。最后,我们确定并提出了最终的模型。我们利用AMOS22,并应用SEM来评估变量之间的相关性,显著性水平为0.05。
结果:研究结果表明,适当的建模确定了包含36个组件的五个维度。这些维度包括脆弱性,准备,支持管理,响应性和适应性,灾难后的恢复。该模型表现出很好的拟合,如X2/d指数所示,其值为2.202,拟合优度指数(GFI)为0.832,估计均方根误差(RMSEA)为0.057,调整后的比较拟合指数(CFI)为0.931,平滑拟合指数(NFI)为0.901。
结论:增强医院的复原力对于有效防范和应对事故和灾难至关重要。开发用于测量弹性的本地化工具可以帮助识别漏洞,确保服务连续性,并告知康复计划。所提出的模型是评估医院弹性的合适框架。关键因素包括人力资源稀缺,医院专业化,和创伤中心能力。医院应优先考虑有效的资源分配,信息技术基础设施,在职培训,废物管理,和一个积极的组织框架来建立弹性。通过采用这种方法,医院可以更好地应对危机和灾难,最终减少伤亡,提高整体准备。
BACKGROUND: In the health system, hospitals are intricate establishments that offer vital medical services. Their resilience plays a crucial role in mitigating the societal repercussions of disasters. A hospital must possess the capacity to withstand risks, preserve its fundamental structure and operations, and enhance its preparedness by augmenting various capabilities and promptly recovering from the impacts of potential risks. It enables the hospital to attain a heightened level of readiness. Therefore, this study aimed to develop a resilience model tailored for hospitals to navigate crises and disasters effectively.
METHODS: This mixed-method study was conducted in 2023 in three phases: (1) Identification of the factors influencing the organizational resilience of the hospital, (2) Evaluation of the influential factors by an expert panel. (3) Following the standardization process, we administered 371 questionnaires to individuals, such as university staff managers and supervisors, nursing managers, and research unit managers. The sample size was determined by multiplying the components by 10, resulting in 360 (10 * 36). Therefore, we selected a sample size of 371 participants. Structural Equation Modeling (SEM) was employed to examine the causal relationships between variables. These steps were performed using SPSS 25.0 and AMOS 22 software. Finally, we identified and presented the final model. We utilized AMOS 22 and applied the SEM to assess the correlation between the variables, with a significance level of 0.05.
RESULTS: Findings indicate that the appropriate modeling identified five dimensions comprising 36 components. These dimensions include vulnerability, preparedness, support management, responsiveness and adaptability, and recovery after the disaster. The model demonstrates a good fit, as indicated by the X2/d indices with a value of 2.202, a goodness of fit index (GFI) of 0.832, a root mean square error of estimation (RMSEA) of 0.057, an adjusted comparative fit index (CFI) of 0.931, and a smoothed fit index (NFI) of 0.901.
CONCLUSIONS: Enhancing hospital resilience is crucial for effective preparedness and response to accidents and disasters. Developing a localized tool for measuring resilience can help identify vulnerabilities, ensure service continuity, and inform rehabilitation programs. The proposed model is a suitable framework for assessing hospital resilience. Key factors include human resource scarcity, hospital specialization, and trauma center capacity. Hospitals should prioritize efficient resource allocation, information technology infrastructure, in-service training, waste management, and a proactive organizational framework to build resilience. By adopting this approach, hospitals can better respond to crises and disasters, ultimately reducing casualties and improving overall preparedness.