10.36172/EKONOMISTI.2023.XIX.02.TENGIZ.VERULAVA.KETEVAN.OMANADZE.TEA.LAZARASHVILI

Expanded Summary

Background: A disaster causes a large number of people to become ill or injured, which is a heavy burden on the health system causing significant social and financial harm to the state. Disasters are both natural (earthquakes, tsunamis, floods) and man-made (wars, terrorism). Disaster management requires risk assessment, structural and non-structural prevention and emergency planning, warning and evacuation preparedness (1). Hospitals play a major role in disaster management (2). Their prompt and efficient service can be crucial in in reducing the death rate caused by disasters.

In order to overcome the obstacles presented by wars and natural disasters, hospitals must improve their disaster preparedness. Hospital disaster preparedness is a continuous process that aims to ensure the resilience and functioning of the hospital during disasters and to respond effectively to quickly overcome negative consequences (3). Hospitals should have a proper disaster preparedness plan in place for this. Because of the increase in terrorism-related incidents, the concept of disaster preparedness was developed in the early 1990s (4).

The ability of a hospital to respond to disasters is determined by its size, functional capacity, availability of appropriate equipment, and availability of appropriately qualified health care personnel. According to studies conducted in various countries, hospital staff have a relatively low level of knowledge about disaster preparedness planning, which was primarily due to a lack of disaster medicine training programs (5, 6). Experts believe that developing a single concrete plan for disaster preparedness in hospitals is necessary in order to standardize protocols (7, 8). WHO has developed a special tool for assessing health system preparedness to deal with disasters in order to ensure preparedness and response to emergency situations (9).

Due to its geographical location, the South Caucasus, particularly Georgia, has always been an object of special interest of dominant international actors. In the last 30 years of independence, Georgia has endured civil war and military conflicts with Russia (the Abkhazian-Samachablo conflict in the 1990s and the August 2008 war), resulting in a large number of casualties and health damage, as well as limited opportunities for both military forces and civilians. The Caucasus region, especially Georgia, is still considered an explosive zone of war conflicts. Several studies have been carried out to evaluate various aspects of disaster preparedness. Based on the aforementioned, it is relevant to investigate the disaster preparedness of hospitals in Georgia. It should be emphasized that Georgia has not had any similar studies done.

Methods: As part of the quantitative research method, a survey of 50 top managers of six medical institutions in the regions bordering the separatist regions of Georgia was conducted.

Results: Emergency management is planned in hospitals. However, most of the respondents have not done emergency training (71.4%) and disaster management practices are not conducted (80%). Only half of the respondents (52%) indicated that there is a hospital emergency/disaster preparedness committee, which does not frequently hold regular meetings (79.6%). According to 64% of the respondents, the emergency/disaster committee of the hospital is not multidisciplinary and does not include qualified individuals from various directions. A large number of respondents agree that the hospital uses a triage system (98%) and has a documented method of patient tracking (82%). However, most of respondents said they do not have the ability to track patients transferred from their institution to another (70%) and the institution cannot control scheduled patients who are discharged during catastrophic situations (72%). The management of critical incidents was not adequately integrated into the emergency plan.

Conclusion: Effective preparedness for crises and disasters is a continuous process that must be continuously supervised and monitored by the health care system. The results of this analysis indicated a moderate level of preparedness for emergencies. Hospital strengths were identified in the triage system, as well as the communication, warning, and notification component, while hospital weaknesses were identified in the medical organization's preparedness and training component, as well as the stress management component during critical situations.

Disasters can cause short-term disruptions in the family or they can be long-term and dramatically change the lives of family members, especially when there is loss. The psychological and social effects of catastrophic occurrences harm the affected population's mental health and psychosocial well-being. To lessen the negative effects of trauma in victims, it is crucial to include psychologists and psychiatrists in hospitals.

The study found that medical organizations were extremely underprepared for disasters, with a very low rate of personnel training. In this regard, the medical organization's staff training and preparedness always ensure a better outcome for the victims.

The study's findings revealed that hospitals have a moderate level of disaster preparedness. The received conclusions and recommendations will help to raise the level of education of medical organization staff in order to ensure effective management of crisis situations and catastrophic events.

The results revealed a moderate level of crisis and disaster preparedness in hospitals. In order to improve the level of preparedness for crisis and disaster events, certain changes are advised to be made in hospitals. These results demonstrate a lack of interest in emergency management planning training. Special training is required to raise the awareness of hospital staff on the management of emergency situations.

Keywords. Anti-crisis management, Emergency disaster preparedness, Crisis situations, Healthcare System, Hospitals, Georgia