شناسایی متغیرهای اثرگذار بر تصمیم گیری تخلیه اضطراری بیمارستان ها در شرایط بحرانی به روش تحلیل مضمون و با استفاده از نرم افزار MAXQDA
محورهای موضوعی : -مدیریت خدمات بهداشتی و درمانیسعید امجدی 1 , سعید صیاد شیرکش 2 , مینا جمشیدی 3
1 - گروه مدیریت دولتی، واحد تهران مرکزی، دانشگاه آزاد اسلامی، تهران، ایران
2 - گروه مدیریت دولتی، واحد تهران مرکزی، دانشگاه آزاد اسلامی، تهران، ایران
3 - گروه مدیریت آموشی، واحد تهران مرکزی، دانشگاه آزاد اسلامی، تهران، ایران
کلید واژه: تصمیم‌گیری, بحران و شرایط بحرانی, مدیریت بحران, تخلیه اضطراری بیمارستان,
چکیده مقاله :
مقدمه: امروزه با توسعه روزافزون فناوری و هم‌زمان با گسترش جمعیت، شاهد افزایش حوادث، سوانح و بحران‌ها هستیم. سوانح طبیعی بخشی از طبیعت محیط زیست ما انسان‌ها شده و به عوامل بسیار زیادی از جمله عوامل طبیعی و عوامل انسانی بستگی پیدا کرده و در نتیجه ساختار پیچیده‌ای به خود می‌گیرند که مبارزه با آن‌ها را عملا بسیار دشوار و پیچیده مینماید. مسئله مطرح اینست که تصمیم‌گیرنده در تخلیه بیمارستانی چه مواردی را باید مورد توجه قرار دهد و چه عواملی در این تصمیم‌گیری اثرگذار هستند، همین عوامل چگونه پس از تصمیم تحت تأثیر قرار می‌گیرند و چگونه این عوامل در فرآیند تصمیم دخالت دارند. روش پژوهش: روش تحقیق در طبقه توسعه‌ای قرار می‌گیرد. برای گردآوری اطلاعات جهت پیشینه و ادبیات تحقیق از روش کتابخانه‌ای استفاده گردید. بدین منظور مقالات، کتب، پایان‌نامه‌ها و منابع اینترنتی معتبر و قابل ارجاع، پایگاه‌های اطلاعاتی و مستندات مرتبط در موضوعات حوزه تصمیم‌گیری در شرایط بحرانی، تخلیه اضطراری و مباحث مدیریت بحران بیمارستانی، جستجو، مطالعه و مورد بررسی قرار گرفت. پس از بررسی ادبیات موضوع به تدوین پروتکل مصاحبه، شامل سوالاتی با هدف شناخت متغیرهای اثرگذار بر تصمیم‌گیری پرداخته شد. سپس به انجام مصاحبه با خبرگانی که دعوت به مصاحبه را پذیرفتند، اقدام شد. مصاحبه ها از 7 نفر از خبرگان و تا زمان اشباع نظری ادامه یافت. پس از آن به روش تحلیل مضمون با رویکرد 6 مرحله‌ای براون و کلارک جملات کلیدی استخراج، کدگذاری و تحلیل آن صورت پذیرفت. در انجام تحلیل‌ها از نرم افزارهای MAXQDA و Excel استفاده گردید.
Introduction: Today, with the increasing development of technology and the expansion of the population, we are witnessing an increase in incidents, accidents and crises. Natural disasters have become a part of the nature of our human environment and depend on many factors, including natural factors and human factors, and as a result, they take on a complex structure that makes combating them very difficult and complicated. The issue is what should be considered by the decision maker in hospital evacuation and what factors are effective in this decision, how these factors are affected after the decision and how these factors are involved in the decision process. Methods: The research method is placed in the developmental category. The library method was used to collect information for the background and literature of the research, after reviewing the subject literature, the interview protocol was compiled, including questions with the aim of knowing the variables influencing decision-making. Then interviews were conducted with the experts who accepted the invitation to the interview. Interviews with 7 experts continued until theoretical saturation. After that, key sentences were extracted, coded and analyzed using thematic analysis method with the 6-step approach of Brown and Clark. MAXQDA and Excel software were used for the analysis. Results: Review of studies and interviews led to the identification of 1156 codes. which was classified into 28 components and 5 dimensions.
1- Amjadi, S. Planning, designing, implementation and evaluation of exercise and maneuvers focusing on health and safety systems. Tehran: Royan Pajo; 2016.
2- Yazdani M, Mojtahedi M, Loosemore M, Sanderson D, Dixit V. Hospital evacuation modelling: A critical literature review on current knowledge and research gaps. International Journal of Disaster Risk Reduction. 2021; 66: 102627.
3- Liu H, Chen H, Hong R, Liu H, You W. Mapping knowledge structure and research trends of emergency evacuation studies. Safety Science, 2020 Jan 1; 121: 348-61.
4- Yazdani M, Mojtahedi M, Loosemore M, Sanderson D. A modelling framework to design an evacuation support system for healthcare infrastructures in response to major flood events. Progress in disaster science, 2022 Jan 1; 13: 100218.
5- Liu J, Zhai C, Yu P. A probabilistic framework to evaluate seismic resilience of hospital buildings using bayesian networks. Reliability Engineering & System Safety, 2022 Oct 1; 226: 108644.
6- Khorram-Manesh A, Phatthar Apornjaroen P, Mortelmans LJ, Goniewicz K, Verheul M, Sörensen JL, Pereira I, Ricklin ME, Faccincani R, Dark PM, Carlström E. Current perspectives and concerns facing hospital evacuation: The results of a pilot study and literature review. Disaster medicine and public health preparedness, 2022; 16(2): 8-650.
7- Haghpanah F, Ghobadi K, Schafer BW. Multi-hazard hospital evacuation planning during disease outbreaks using agent-based modeling. International Journal of Disaster Risk Reduction, 2021 Dec 1; 66: 102632.
8- Heydari M, Lai KK, Xiaohu Z. How to manage red alert in emergency and disaster unit in the hospital? evidence from London. Frontiers in Public Health, 2021 Sep 21; 9: 634417.
9- Barten DG, Fijten MH, Gaakeer MI, Klokman VW, Mortelmans LJ, van Osch F, Peters NA, Wijnands JJ, Tan EC, Boin A. Three decades of hospital evacuations in the Netherlands: A scoping review. International Journal of Disaster Risk Reduction; 2022 Aug 22: 103252.
10- Khankeh, H. R. Hospital readiness in emergencies and disasters. Tehran: University of Welfare and Rehabilitation Sciences Publications; 2012.
11- Phattharapornjaroen P, Carlström E, Holmqvist LD, Sittichanbuncha Y, Khorram-Manesh A. Assessing Thai Hospitals’ Evacuation Preparedness Using the Flexible Surge Capacity Concept and Its Collaborative Tool. International Journal of Disaster Risk Science, 2023 Feb; 14(1): 52-63.
12- Nekoie-Moghadam M, Kurland L, Moosazadeh M, Ingrassia PL, Della Corte F, Djalali A. Tools and checklists used for the evaluation of hospital disaster preparedness: a systematic review. Disaster medicine and public health preparedness, 2016 Oct; 10(5): 781-8.
13- Acar YA, Mehta N, Rich MA, Yilmaz BK, Careskey M, Generoso J, Fidler R, Hirsch J. Using standardized checklists increase the completion rate of critical actions in an evacuation from the operating room: a randomized controlled simulation study. Prehospital and disaster medicine, 2019 Aug; 34(4): 393-400.
14- Yaghoubi T, Ardalan A, Zavareh DK, Khankeh H, Nejati A, Ebadi A. Decision-making on hospital emergency evacuation in disasters and emergencies: findings from a systematic review. Iranian Red Crescent Medical Journal, 2017; 19(11): 8.
15- Schultz CH, Koenig KL, Lewis RJ. Implications of hospital evacuation after the Northridge, California, earthquake. New England Journal of Medicine, 2003 Apr 3; 348(14): 55-1349.
16- Sternberg E, Lee GC, Huard D. Counting crises: US hospital evacuations, 1971–1999. Prehospital and Disaster Medicine, 2004 Jun; 19(2): 7-150.
17- Elliott D. Disaster and crisis management. The handbook of security; 2014: 36-813.
18- Zane R, Biddinger P, Hassol A, Rich T, Gerber J, DeAngelis J. Hospital evacuation decision guide. Agency for Healthcare Research and Quality, US Department of Health and Human Services; 2010 May: 1-55.
19- Gall M, Cutter SL. 2005 events and outcomes: Hurricane Katrina and beyond. InEmergency Management; 2019 Jul 19: 191-217. Routledge.
20- Raker EJ, Lowe SR, Arcaya MC, Johnson ST, Rhodes J, Waters MC. Twelve years later: The long-term mental health consequences of Hurricane Katrina. Social Science & Medicine, 2019 Dec 1; 242: 112610.
21- Horowitz A. Katrina: A history, 1915–2015. Harvard University Press; 2020 Dec 31.
22- Bleemer Z, van der Klaauw W. Long-run net distributionary effects of federal disaster insurance: the case of Hurricane Katrina. Journal of urban economics, 2019 Mar 1; 110: 70-88.
23- Raker EJ, Woods T. Disastrous Burdens: Hurricane Katrina, Federal Housing Assistance, and Well-Being. RSF: The Russell Sage Foundation Journal of the Social Sciences, 2023 Sep 1; 9(5): 43-122.
24- Lichtveld M, Covert H, El-Dahr J, Grimsley LF, Cohn R, Watson CH, Thornton E, Kennedy S. A community-based participatory research approach to Hurricane Katrina: when disasters, environmental health threats, and disparities collide. American journal of public health, 2020 Oct; 110(10): 9-1485.
25- Mayer BW, Moss J, Dale K. Disaster and preparedness: lessons from Hurricane Rita. Journal of Contingencies and Crisis Management, 2008 Mar; 16(1): 14-23.
26- Keeley JE, Safford H, Fotheringham CJ, Franklin J, Moritz M. The 2007 southern California wildfires: lessons in complexity. Journal of Forestry, 2009 Sep 1; 107(6): 96-287.
27- Khaledi S, Kamali S, Monammadi F. The Synoptic Analysis of Heavy Snowfall in Gillan Plain (2014). Journal of Natural Environmental Hazards, 2017 Dec 22; 6(14): 35-46.
28- Rezaei, M., Ghabadi Janbazi, A., & Jafarzadeh, M. Snowfall trend in the central plain of Gilan and its consequences. Studies in Human Settlement Planning, 2010: 5(11): 47-60.
29- Shiwakoti N, Tay R, Stasinopoulos P. In an emergency evacuation situation what would you do?. Transportation research procedia, 2020 Jan 1; 48: 860-9.
30- karimizarchi, M. H., Shishebori, D. Comparison of Models in Predicting Cumulative Cases of Hospitalization and Death of Covid-19 (Case Study: Bahabad city. Journal of healthcare management), 2023; 14(3): 7-17.
