The Hospital Safety Index

The Hospital Safety Index, a tool developed by PAHO and a group of Caribbean and Latin American experts, is being widely used by health authorities to gauge the probability that a hospital or health facility will continue to function in emergency situations. 

More than half of the 16,000 hospitals in Latin America and the Caribbean are in areas at high risk for disasters. The Hospital Safety Index helps health facilities assess their safety and avoid becoming a casualty of disasters.

The Hospital Safety Index provides a snapshot of the probability that a hospital or health facility will continue to function in emergency situations, based on structural, nonstructural and functional factors, including the environment and the health services network to which it belongs.  By determining a hospital’s Safety Index or score, countries and decision makers will have an overall idea of its ability to respond to major emergencies and disasters. The Hospital Safety Index does not replace costly and detailed vulnerability studies.  However, because it is relatively inexpensive and easy to apply, it is an important first step toward  prioritizing a country’s investments in hospital safety.

Determining the Hospital Safety Index is a new way of managing risk in the health sector. It allows a health facility's level of safety to be monitored over time. Safety no longer has to be a 'yes-or-no' or an 'all-or-nothing situation, but can instead be improved gradually.

The Hospital Safety Index was developed through a lengthy process of dialogue, testing and revision, over a period of two years, initially by the Pan American Health Organization’s Disaster Mitigation Advisory Group (DiMAG) and later with input from other specialists in Latin America and the Caribbean. 

Calculating the Hospital Safety Index

There are a number of steps to calculating a health facility’s Safety Index. First, an Evaluation Team uses the standardized Safe Hospitals Checklist to assess the level of safety in 145 areas of the hospital.  Once the Checklist has been completed, the Evaluation Team collectively validates the scores and enters them into a scoring calculator, which weights each variable according to its relative importance to a hospital's ability to withstand a disaster and continue functioning.  The safety score is calculated automatically.

The final Safety Index score places a health facility into one of three categories of safety, helping authorities determine which facilities most urgently need interventions:

Calculating the safety score allows health facilities to establish maintenance and monitoring routines and look at actions to improve safety in the medium term. This quick overview will give countries and decision makers a starting point for establishing priorities and reducing risk and vulnerability in healthcare facilities.

Components of the Hospital Safety Index