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A socio-ecological analysis of hospital resilience to extreme weather events

机译：医院对极端天气事件的应变能力的社会生态分析

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Hospitals play a critical role in helping communities respond effectively to extreme weather events (EWEs). Despite predictions of more EWEs, little is known about the process by which hospital infrastructure resilience to such events can be built. Using Gunderson and Holling's Adaptive Cycle, a new theoretical perspective based on socio-ecological resilience theory is provided to understand this process. Data were collected using semi-structured interviews, observations of disaster drills and disaster planning meetings, as well as additional documentary analysis of past incident reports. The research findings were then refined and validated in a focus group meeting with respondents. The findings indicate that there are significant organizational barriers which prevent facilities managers improving the resilience of hospital facilities to future EWEs. It was found that the disaster planning process is ad hoc and non-inclusive, focused on man-made disasters and compliance driven, top-down approach, under-resourced and is driven by a general ignorance of the importance of resilient-built facilities to health care delivery during an EWE. It is concluded that to produce more resilient hospital infrastructure, there needs to be a more well-resourced, integrated and collaborative approach to disaster management planning which enables health facilities managers to play a more central role in disaster planning decisions. There also need to be better systems, technologies and training implemented to manage information about health infrastructure performance before, during and after EWEs.
机译：医院在帮助社区有效应对极端天气事件（EWE）中发挥着关键作用。尽管预计会有更多的EWE，但对于建立医院基础设施对此类事件的抵御能力的过程知之甚少。利用Gunderson和Holling的适应性循环，提供了一种基于社会生态弹性理论的新理论视角来理解这一过程。使用半结构化访谈，对灾难演习的观察和灾难规划会议以及对过去事件报告的其他文档分析，来收集数据。然后，在与受访者举行的焦点小组会议上对研究结果进行完善和验证。调查结果表明，存在重大的组织障碍，这些障碍阻碍设施管理人员提高医院设施对未来EWE的适应力。结果发现，灾难计划过程是临时性且非包容性的，着眼于人为灾难和合规驱动，自上而下的方法，资源不足，并且是由于人们普遍不了解弹性建筑设施对在EWE期间提供医疗保健服务。结论是，要建立更具弹性的医院基础设施，就需要采用资源更丰富，整合和协作性更高的灾难管理计划方法，使医疗机构的管理人员能够在灾难计划决策中发挥更重要的作用。还需要在EWE之前，期间和之后实施更好的系统，技术和培训来管理有关卫生基础设施绩效的信息。

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