Learning from the past: a scoping review of hospital disaster preparedness assessment

Despite the recognized importance of hospital disaster preparedness (HDP), efforts to improve it have been limited. Improvement in HDP will need an in-depth comprehension of the prevailing gaps in addition to evidence of the best practices. However, a comprehensive review that synthesizes the findings from HDP assessments across diverse contexts and translates them into actionable insights is currently lacking. Considering these gaps, this scoping review aims to examine current practices, identify recurring gaps, consolidate best practices, and provide actionable recommendations through an in-depth literature review. A scoping review was done using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines. A comprehensive search strategy using keywords related to HDP was carried out in three databases: PubMed, Scopus, and Web of Science. Eligibility criteria were defined according to the population, intervention, comparison, and outcome. The search included studies from January 2015 to December 2024. Screening and data extraction were done by two independent reviewers, and the extracted data were subjected to a narrative synthesis. Data extraction and analysis were manually performed using Excel. 46 eligible articles were identified from 10,656 records, the majority from Iran and Saudi Arabia. Cross-sectional studies dominated, and the majority utilized the hospital safety index tool. Two-thirds of hospitals reported a moderate level of preparedness. Substantial variability in hospital safety scores was observed, with structural safety ranging from 28% to 76.16%, nonstructural safety from 17.02% to 73.2%, and functional preparedness from 11.35% to 95%. Most hospitals lacked adequate structural safety, backup communication systems, proper safety measures for furniture and medical equipment, training programs, comprehensive emergency planning, staff welfare strategies, and adequate logistics and supplies. HDP should be viewed as an evolving, ongoing process, requiring a balanced HDP framework that addresses all aspects of preparedness, region-specific guidelines tailored to the unique needs and risks of the hospital, and context-driven interventions to enhance hospital resilience.