National Training on Safe Hospitals - Sri Lanka - Module 2 Session 2-3 - 14Sept22-24

Module 2: Safe Hospital Assessment

Module 2 Sessions Session Number and Title Topics Time

AllotmentSession 1: Identifying Hazards

– Hospital Hazards– Hospital Risk Management

Framework

~1 hour

Session 2: Assessing Structural, Non-structural, and Functional Components and Prioritizing Gaps

– Components of Safe Hospital

– WPRO’s “Safe Hospitals’ Vulnerability Assessment Tool

– Feedback on Tool– Prioritization Matrix

~3 hours

Session 3: Presentation of Assessment Results and Prioritized Gaps

The Executive Report ~2 hours

Mod 2 Session 2:Assessing Structural, Non-structural, and Functional

Components and Prioritizing Gaps

Module 2 Session 2 Objectives

At the end of this module, participants will be able to:

1.Discuss the following components for “Safe Hospital”:

a. Structuralb. Non-structuralc. Functional



2.Make a descriptive assessment of their hospital using the WPRO’s Safe Hospitals’ Vulnerability Assessment Tool.



3.Identify and prioritize the 3 critical “Safe Hospitals” gaps of their hospital for action planning in the following components:

a. Structuralb. Non-structuralc. Functional

4 Topics in Session 2: •Components of a Safe Hospital•Vulnerability Assessment using WPRO’s Tool•Feedback on Tool •Prioritization Matrix

Topic 1: Components of a Safe Hospital

Safe hospitals need to remain structurally sound, well organized, and fully operational at times of emergency and disaster.

To ensure this, there must be proper monitoring of its structural, non-structural and functional components.


Structural Components

Load-bearing components of a building


Structural Components

Primary load-bearing components that make a building stand Foundation Column (posts and pillars) Beams (girders, joists) Floors Walls Roofs

product of

structural engineers, masons, labor contractors


Structural components:• building location• design specifications• materials used

crucial for the building to withstand adverse natural events

Non-load-bearing parts of building or attached to the structure

Non-structural Components


Non-structural Components

All non-load-bearing parts including contents of the building or attached to the structure • Ceilings, windows, partitions• Pipes, mechanical and electrical systems• HVAC (heating, ventilating, air con)• Equipment, supplies• Furnishings• etc.

done by: architects, interior designers

mechanical and electrical engineers purchased by owners after construction


Non-structural components:• architectural elements (such as ceilings,

windows, and doors)• medical and laboratory equipment• lifelines (mechanical, electrical, and plumbing

installations)• safety and security issues


Non-structural components:

essential to the daily operations if damaged, would not be able to function, and may even cause physical injury to patients and personnel


Functional Components

Topic 1: Components of a Safe Hospital Functional components:

• site and accessibility• internal circulation and interoperability• equipment and supplies• emergency standard operations procedures and

guidelines • ………

important in the continuous operations of hospitals and health facilities

Safe Hospital

StructuralComponent

Emergency Exit System

LifelineFacilities

MedicalFacilities

ArchitecturalElements

Non-structuralComponent

FunctionalComponent

Electricity System

Medical Gas Supply System

Fire System

Communication System

Water Supply SystemCritical Systems

National Training on Safe Hospitals - Sri LankaNational Training on Safe Hospitals - Sri LankaCritical Elements of a Safe Hospital

Critical Elements of a Safe Hospital

Safe Hospital

StructuralComponent

Non-structuralComponent

FunctionalComponent

All the components must not be vulnerable to hazards = overall indicators

for a safe hospital!

Mod 2 Session 2 Topic 1

Any questions?

Topic 2: Safe Hospitals’ Vulnerability Assessment using WPRO’s Tool

2010

Safe Hospital’s Vulnerability Assessment

Various assessment methods and tools

Usually using a checklist with structural, non-structural, and functional indicators for a safe hospital

Some with numerical scoring PAHO – Safe Hospital Index

Others with descriptive assessment (yes or no answers) WPRO, Philippines

Regional assessment tool (PAHO; WPRO); country-specific assessment tool (Philippines)



Category A is for facilities deemed able to protect the life of their occupants and likely to continue functioning in disaster situations.

Category B is assigned to facilities that can resist a disaster but in which equipment and critical services are at risk.

Category C designates a health facility where the lives and safety of occupants are deemed at risk during disasters.

Safe Hospital Index - PAHO


Safe Hospital Index - PAHOSafety index

Category Type

What should be done?

0 – 0.35Category

C

Urgent measures are required immediately, as the health facility’s current safety levels are not sufficient to protect patients and staff during and after a disaster event.

0.36 – 0.65Category

B

Necessary measures are required at some point, as the health facility’s current safety levels can potentially put at risk patients and staff during and after a disaster event.

0.66 – 1Category

A

Preventative measures are suggested at some point, as the health facility’s current safety levels can cause acceptable damages, which nevertheless reduce the overall safety level of the installation.


Safe Hospital Indicators

Topic 2: Safe Hospitals’ Vulnerability Assessment using WPRO’s Tool

2010

Feedback on WPRO’s Assessment Tool

World Health Organization Western Pacific Regional Office (WPRO)

Safe Hospitals’ Vulnerability Assessment Tool

Get FEEDBACK from participants onADAPTATION

(clarity and understandability; validity; applicability; usefulness; etc.)

In preparation for a Sri Lanka’s and SEARO’s Tool!

Topic 2: Vulnerability Assessment using WPRO’s Tool

How to use the WPRO Checklist adapted for the Training Course

Hospital Teams -

Go through each and all indicators; one component at a time; starting with structural, then non-structural, and then functional.


How to use the WPRO Checklist adopted for the Training Course

Assess each indicator item accordingly: • YES• NO – need slight to moderate improvement• NO – need marked improvement• UNSURE of Status• NOT APPLICABLE

*“NO” and “UNSURE” answers = WEAKNESSES or GAPS.



Feedback on WPRO’s Checklist –

As you go through the checklist, note and jot down areas / items which are not clear, not easy to understand; not valid; not applicable, and not useful in Sri Lanka setting; etc.Accomplish the feedback form provided and submit to the facilitators.



After answering all indicator items and accomplishing the feedback form, go the identification and prioritization of gaps using a prioritization matrix. (Topic 4 of Module 2)

Topic 3: Feedback on WPRO’s Safe Hospitals’ Vulnerability

Assessment Tool

See also questionnaire in hand-outs!

Topic 4: Prioritization Matrix and

Prioritization of Gaps

Prioritization Matrix – What is It?

A tool (a table) used to narrow down options through a systematic comparison of choices using a set of agreed upon criteria.

Usually done by a team.

Prioritization Matrix – How to Do It?1. Agree on goal to be achieved.

Example: To select from a list of gaps in each “Safe Hospital” component 3 critical ones that will be prioritized for action planning.

2. Create the list of criteria and a scoring system for prioritization.

Examples of criteria for gaps: magnitude of problem, urgency, impact, etc.

Examples of scoring system: 1 – lowest; 3 – highest.

Prioritization Matrix – How to Do It?

3. Create the table showing the choices and the criteria.

Gaps Magnitude of problem

Urgency Impact Total scores

Rank

1.2.3.4. 5. 6.


4. Each member of a team is asked to rank each gap in each of the agreed criteria using the agreed scoring system.

5. Add the scores for each gap area and place them in the appropriate boxes in the table.

6. The gaps with the top 3 high scores will be the team’s choices for the 3 critical gaps for action planning.




Rank

1.2.3.4. 5. 6.




Rank

1. 3+2+1 1+2+2 2+2+1 16 32. 1+3+3 2+2+3 3+2+1 20 23. 3+2+2 2+1+2 1+2+1 16 34. 3+2+3 2+2+1 2+2+3 20 25. 2+2+1 3+2+3 3+2+3 21 16. 1+1+1 1+1+1 3+2+1 12 4

Key: 1 – lowest; 3 – highest

3 Members


NOTE:

As a group, you can develop your own criteria.• Your group can identify factors that may be

more appropriate in your own setting.

You can develop your own scoring rubric or matrix (e.g. 1 = least urgent to 10 = most urgent).

Prioritization Matrix – How to Do It?Gaps Magnitude of problem

Urgency Impact Capacity to address

A = Existing programs and policiesB = Availability of budgetC = Availability of people

Total scores

Rank

A B C

Mod 2 Ses 2 Topics 2, 3, & 4

Any questions? On instructions

for the workshop activities?

Module 2 Session 3: Presentation of

Assessment Results and

Prioritized Gaps

Expected outputs:

•Presentation of executive summary of assessment.

•Presentation of list of prioritized gaps for action planning


Instructions:

•In this session, you will simulate a situation wherein you are to report to the hospital executive committee (or hospital leadership).

•The contents of the report should come from the result of your workshop on prioritizing.


Executive Report on Safe Hospital’s Vulnerability

Assessment

Format

Executive Report on Safe Hospital’s Vulnerability Assessment

Format of Report Name of Hospital / Health Facility:

Type: Government or Private:

Bed Capacity: • Confidentiality clause of assessment report:• Assessment Processes and Scope: • Date of Assessment:• Members of Assessment Team:


Format of Report

Hospital Hazards Identification and Risk AnalysisList of Gaps per Areas in Each Safe Hospital Component (Structural, Non-structural, Functional)General Descriptive Assessment Statements of Gaps per Area in Each Safe Hospital Component (Structural, Non-structural, Functional)


Format of Report

Prioritization Processes Done and Prioritization Matrix of Gaps

Identified 3 Critical Gaps in Each Safe Hospital Component (Structural, Non-structural, Functional) for Action Planning

GO TO WORKSHOPS and WORKSHEETS

For Sessions 2 and 3Module 2 Session 2:

Assessing Structural, Non-structural, and Functional Components and Prioritizing Gaps

Module 2 Session 3:

Presentation of

Assessment Results and Prioritized Gaps

Closing:Module 2

Topic 3: Feedback on WPRO’s Safe Hospitals’ Vulnerability Assessment Tool

Dear Colleagues:

Thank you for taking the time to go through the document of “Safe Hospitals in Emergencies and Disasters: Structural, Non-structural and Functional Indicators”. Below are several questions kindly asking for your feedback on the document.

Your input will be invaluable in further development of the indicators for use in your country and in the South-East Asia Region.


1. Is the document clear and understandable?

1.1. Which segments or particular items/indicators are difficult to understand?

1.2. If possible, how would you suggest that this/these be improved?


2. Are the indicators valid in your setting?

2.1. Which specific indicator is not valid in your setting?

2.2. What about the indicator/s that makes it invalid in your setting?


3. Are the indicators applicable to your setting?

3.1. Which specific indicator is not applicable to your setting?

3.2. What about the indicator/s that makes it

inapplicable to your setting?


4. Is the document useful in your setting?

4.1 Why is the document not useful in your setting? 4.2 What improvements, if any, would you suggest to make it useful in your setting?


5. Overall, can you think of any areas for improvement in the document?

5.1. What specific revisions or additions could you suggest, if any, to improve on the document?

Module 2 Objectives

Module 2 Objectives


3. Prioritize gaps in the following “Safe Hospital” components:

• Structural • Non-structural • Functional

Module 2 Objectives and Expected OutcomesObjectives Expected Outputs

Identify hazards experienced or might be experienced by participants’ hospital.

Hazards commonly experienced and might be experienced

Do a general risk analysis of safety of hospital based on identified hazards.

General risk analysis

Utilize WPRO’s Safe Hospitals’ Vulnerability Assessment Tool.

Detailed descriptive assessment of safety of hospital re:structural, non-structural, and functional indicators

Feedback on WPRO’s toolPrioritize gaps in “Safe Hospital” components for action planning.

Three prioritized gaps in each “Safe Hospital” component for action planning

Module 2: Concept Map of Objectives and Expected Outputs

Your HOSPITAL

Identify potential hazards

Do general risk analysisHazards Vulnerabilities Risks

Detailed Assessment of Vulnerabilities(Structural / Non-structural / Functional)

Action Planning

Weaknesses / Gaps

Prioritized Gaps

What do we do with the gaps that you have identified and prioritized?

We have to do an action plan to correct the gaps!

REDUCE RISKPROTECT HEALTH FACILITIES

SAVE LIVES

Make your hospital safe and safer and SAFEST!

Module 2

Any questions?

Module 2: Safe Hospital Assessment

The End

Healthcare

National Training on Safe Hospitals - Sri Lanka - Module 2 Session 2-3 - 14Sept22-24