Background: The man-made and natural disasters have adverse effects with sound, apparent, and unknown consequences. Among various components of disaster management in health sector, the most important role is performed by health-treatment systems, especially hospitals. Therefore, the present study aimed to evaluate the Surge capacity of hospitals of Kerman Province in disaster in 2015.Materials and Methods: This is a quantitative study, conducted on private, military, and medical sciences hospitals of Kerman Province. The sampling method was total count and data collection for the research was done by questionnaire. The first section of the questionnaire included demographic information of the studied hospitals and second part examined the hospital capacity in response to disasters in 4 fields of equipment, physical space, human resources, and applied programs. The extracted data were analyzed by descriptive statistics.Results: The mean capability of implementing the Surge capacity programs by hospitals of Kerman Province in disasters and in 4 fields of equipment, physical space, human resources, and applied programs was evaluated as 7.33% (weak). The Surge capacity capability of state hospitals in disasters was computed as 8% and compared to private hospitals (6.07%) had a more suitable condition.Conclusion: Based on the results of study and significance of preparedness of hospitals in response to disasters, it is proposed that managers of studied hospitals take measures to promote the hospital response capacity to disasters based on 4 components of increasing hospital capacity.

Background: Hospital administrators play a key role in the effective management of Surge capacity in disasters, but there is little information available about the characteristics required to manage this.Objectives: In this study, we aimed to identify characteristics of hospital administrators that are important in the effective management of Surge capacity in disasters.Materials and Methods: This was a qualitative study. Semi-structured purposive interviews were conducted with 28 hospital administrators who had experience working in Surge situations in hospitals during disasters. Framework analysis was used to analyze the data.Results: Three themes and 12 subthemes were identified. The themes were as follows: 1) crisis managerial characteristics, 2) personal characteristics, and 3) specific requirements.Conclusions: In this study, some characteristics that had a positive impact on the success of a manager in a hospital Surge situation were identified. These characteristics ought to be taken into account when appointing hospital administrators and designing training programs for hospital administrators with the aim of being better prepared to face disasters.

Introduction: Successful and effective management of large-scale disasters and epidemics requires pre-established systematic plans to minimize the damage and control the situation. With an increasing number of people in need of urgent medical care, hospitals must improve their response capacity, being at the forefront of responding to disasters and incidents. One way to develop the hospital capacity in disaster response is by reverse triage (RT).Objective: The current study was conducted to investigate the role of RT to create additional hospital Surge capacity in one of the major referral academic hospitals of Isfahan, Iran.Method: This cross-sectional study was conducted in 2015 at Al-Zahra Subspecialty Hospital, Isfahan, Iran. The ten most common diseases leading to hospitalization in each ward of the hospital in 2014 were reviewed and, based on the prevalence, sorted and listed. Academic instructions for making a decision and possibility of early discharge was written and approved by an expert panel. On a day that was not set previously, the pre-selected in-charge person of each department was asked to run the RT following the instructions, and the number and percentage of those who were eligible for discharge via RT were determined.Results: The total BOR in Al-Zahra Hospital in 2014 was about 80%, so it was estimated that almost 140 out of 700 beds are vacant. The results showed that by using RT, 108 (20%) hospitalized cases could be discharged, and considering the bed occupancy rate of about 80% and 140 vacant beds, a total of 248 beds could be provided following RT.Conclusion: Running RT in 41 wards and units of Isfahan Al-Zahra Hospital, on average, added 108 beds to the hospital capacity. This increment is not the same in all wards, as the role of intensive care units in RT for Surge capacity is insignificant.

Background: Failed attempts to improve the delivery of healthcare to communities show distinct flaws that have a higher impact during a major incident or disaster (MID). This study evaluates the concept of Surge capacity, which intends to achieve a balance between the needs and resources in affected areas by providing staff, stuff, structure, and system. Methods: A systematic literature review was performed according to the PRISMA statement and by using PubMed, Scopus, and Google Scholar, and related keywords. Results: There were limited publications about flexible Surge capacity (FSC). However, the sum of data obtained indicated the need for flexibility in expanding major incidents or disasters, demanding new resources, which may neither be available on time nor reachable due to infrastructural damage. Conclusion: FSC is a novel concept based on international guidelines. It refers to the extra and adjustable human and material resources that can be mobilized by activating nonprofessional but educated staff and different but accepted facilities in a fast, smooth, and productive way. Public health and public education play an essential role in obtaining such flexibility.

Objective: Hospitals are expected to be able to provide quality services during disasters. However, hospital capacity is limited and most hospital beds are almost always occupied. The aim of this study was to determine the feasibility of increasing hospital Surge capacity during disasters through identification of patients suitable for safe early discharge. Methods: This cross-sectional study was conducted from May 2017 to February 2018 in two phases. In phase I, the Early Discharge Checklist was developed by a multidisciplinary panel of experts. Then in phase II, the checklist was used to assess the dischargeability of 396 in-patients in general wards of hospitals in Alborz province, Iran. Data were analyzed through the SPSS software (v. 22. 0) and the results were presented by descriptive and analytical statics at a significance level of less than 0. 05. Results: Of 396 patients, (64. 65%) were male, (68. 9%) were married, and (38. 6%) aged more than 54. Moreover, (34. 6%) patients were dischargeable. Patients in cardiology wards were more dischargeable. At follow-up assessment, 33. 3% of patients had been discharged after 48 hours. There was a significant relationship between patient dischargeability and 48-hour hospitalization status (p=0. 001). Dischargeability had no significant relationships with patients’ demographic characteristics (p>0. 05). Conclusion: A considerable percentage of in-patients are dischargeable during disasters. The Early Discharge Assessment Checklist, developed in this study, is an appropriate tool to provide reliable data about early dischargeability in disasters.

Background: The present study aimed to evaluate the Surge capability of Shahid Rajaee Trauma Hospital in Shiraz City, Iran, in response to a mass causality incident. Materials and Methods: This descriptive study was conducted in Shahid Rajaee Hospital in Shiraz in 2017. The Delphi technique was used in this study. Three checklists were used for the Emergency Department, Operating Room, and Intensive Care Unit. The Surge capacity was calculated for each unit based on the formulas derived from different studies. Results: The Surge capacities of the Emergency Department, Intensive Care Unit, and Operating Room were obtained 36%, 20%, and 17. 5%, respectively. Shahid Rajaee Hospital of Shiraz can quickly increase its capacity by 27% based on the scenario defined in this study. However, if an accident leads to more causalities, it will likely face several limiting factors for increasing the Surge capacity. Conclusion: Due to the critical role of hospitals in the crisis, it seems that the studied hospital should look for ways to increase its Surge capacity to cope with unexpected accidents as soon as possible.