title: Factors affecting preparedness and capacity to manage pandemic influenza: perceptions of healthcare managers.
abstract: OBJECTIVE
  Numerous interventions seeking to increase preparedness for pandemic influenza have been implemented, but low compliance of healthcare providers has been reported in many instances. The aim of this study was to identify factors that affect preparedness for pandemic influenza by examining: hospital managers' perceptions of measures implemented to promote preparedness for pandemic influenza; hospital managers' assessments of the readiness and capability of their hospitals to manage pandemic influenza; and the effectiveness of a national pandemic preparedness programme in Israel over time.
  
  
  METHODS
  A quasi-experiment was conducted following implementation of a national pandemic preparedness programme in Israel. A survey assessed hospital managers' perceptions of the effectiveness of the programme, and the preparedness and capacity of their hospitals to manage pandemic influenza. Two independent evaluations of preparedness for biological threats were conducted, based on a validated tool that included 60 objective parameters.
  
  
  METHODS
  Correlations between perceived preparedness and capacity and components of the preparedness programme were analysed using Statistical Package for the Social Sciences Version 17. Stepwise logistic regression was used to determine the components that influence preparedness and capability to manage pandemic influenza.
  
  
  RESULTS
  All general hospital managers in Israel were approached twice (first and second evaluations). Ninety-one percent rated themselves as highly/very highly prepared for pandemic influenza, and 87% rated themselves as highly/very highly capable of dealing with pandemic influenza. Strong correlation was found between hospital managers' perceived preparedness and capacity to manage pandemic influenza (rho = 0.761, P = 0.000), and between perceived preparedness and familiarity with the disease (rho = 0.605, P = 0.003). Familiarity with guidelines accounted for 35% of the variance in perceived capability (adjusted R(2) = 0.346, P = 0.002). Inclusion of preparedness evaluations explained an additional 15% of the variance (R(2) change = 0.146, P = 0.026). An increase in mean total score for emergency preparedness was found in the second evaluation compared with the first evaluation.
  
  
  CONCLUSIONS
  Familiarity with guidelines and preparedness evaluations affect the perceptions of healthcare managers regarding preparedness and capability to manage pandemic influenza.
authors.affiliation: Emergency and Disaster Management Division, Ministry of Health, Tel Aviv, Israel; PREPARED Centre for Emergency Response Research, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Department of Emergency Medicine, Recanati School of Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: adini@netvision.net.il.
authors.forename: B
authors.initials: B
authors.lastname: Adini
authors.affiliation: Emergency and Disaster Management Division, Ministry of Health, Tel Aviv, Israel; PREPARED Centre for Emergency Response Research, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Laor
authors.affiliation: PREPARED Centre for Emergency Response Research, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Department of Emergency Medicine, Recanati School of Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: L
authors.initials: L
authors.lastname: Aharonson-Daniel
mesh_terms: D001291:Attitude of Health Personnel; D057191:Capacity Building; D006740:Hospital Administrators / Q000523:psychology*; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D007557:Israel / Q000453:epidemiology; D058873:Pandemics / Q000517:prevention & control*; D015397:Program Evaluation
keywords: Emergency management; Emergency preparedness; Emergency response; Evaluation; Guidelines; Pandemic influenza; Public health