title: Validation of a framework for measuring hospital disaster resilience using factor analysis.
abstract: Hospital disaster resilience can be defined as "the ability of hospitals to resist, absorb, and respond to the shock of disasters while maintaining and surging essential health services, and then to recover to its original state or adapt to a new one." This article aims to provide a framework which can be used to comprehensively measure hospital disaster resilience. An evaluation framework for assessing hospital resilience was initially proposed through a systematic literature review and Modified-Delphi consultation. Eight key domains were identified: hospital safety, command, communication and cooperation system, disaster plan, resource stockpile, staff capability, disaster training and drills, emergency services and surge capability, and recovery and adaptation. The data for this study were collected from 41 tertiary hospitals in Shandong Province in China, using a specially designed questionnaire. Factor analysis was conducted to determine the underpinning structure of the framework. It identified a four-factor structure of hospital resilience, namely, emergency medical response capability (F1), disaster management mechanisms (F2), hospital infrastructural safety (F3), and disaster resources (F4). These factors displayed good internal consistency. The overall level of hospital disaster resilience (F) was calculated using the scoring model: F = 0.615F1 + 0.202F2 + 0.103F3 + 0.080F4. This validated framework provides a new way to operationalise the concept of hospital resilience, and it is also a foundation for the further development of the measurement instrument in future studies.
authors.affiliation: Center for Emergency and Disaster Management, School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland 4059, Australia. amigo-008@163.com.
authors.forename: Shuang
authors.initials: S
authors.lastname: Zhong
authors.affiliation: School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland 4059, Australia. mj.clark@qut.edu.au.
authors.forename: Michele
authors.initials: M
authors.lastname: Clark
authors.affiliation: Center for Emergency and Disaster Management, School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland 4059, Australia. x.hou@qut.edu.au.
authors.forename: Xiang-Yu
authors.initials: XY
authors.lastname: Hou
authors.affiliation: School of Nursing, Shandong University, #44 Wenhua West Road, Jinan, Shandong 250012, China. yulizh@sdu.edu.cn.
authors.forename: Yuli
authors.initials: Y
authors.lastname: Zang
authors.affiliation: Center for Emergency and Disaster Management, School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland 4059, Australia. gj.fitzgerald@qut.edu.au.
authors.forename: Gerard
authors.initials: G
authors.lastname: FitzGerald
mesh_terms: D002681:China; D003430:Cross-Sectional Studies; D004189:Disaster Planning; D005163:Factor Analysis, Statistical; D006761:Hospitals; D011795:Surveys and Questionnaires