Hospital Safety Index

How can we tell whether a hospital is safe? What does “safe” really mean? And what can we do to raise a health facility’s level of safety? For many years, there have been more questions than answers about these issues. One critical challenge has been to agree on baseline indicators against which to measure progress in this critical field. Now this and other concerns are being addressed by experts from the PAHO/WHO Disaster Mitigation Advisory Group (DiMAG), which has developed an instrument called the Hospital Safety Index to assess the existing safety level in health facilities should they be affected by a disaster. This instrument will help develop a list of priority facilities in which to take corrective measures and monitor progress in the Region.

The Hospital Safety Index compiles information on a number of variables: a health facility’s level of complexity, the population it serves, specialties, health staff, available services, location, risk of natural hazards, and the history of disasters at the site. An assessment is then made of the level of safety of the hospital’s structural and nonstructural components and functional and organizational aspects. Specific features of each component are assessed and each receives a safety rating of high, medium, or low, according to established standards. Values are assigned to these ratings depending on the importance of each feature to give a weighted score. This enables health authorities to set priorities and timeframes to improve the safety of a specific facility.

This approach to verifying the safety of health facilities will rely on a cadre of trained multidisciplinary assessment teams that include engineers, architects, health staff, hospital directors, and others. A health facility can be evaluated in just a few hours and the cost is low. This makes it possible to assess a large number of health facilities in a short period of time. While the Hospital Safety Index does not replace detailed vulnerability studies, it does allow preliminary information to be quickly gathered to identify which facilities require immediate or near-term interventions. Those health facilities that obtain a satisfactory rating should establish maintenance and monitoring routines and consider actions to improve their level of safety in the medium-term.

This methodology has been used successfully in Mexico, where the Index has been applied in more than 100 health facilities, and to a lesser degree in Costa Rica, Cuba, Dominica, Peru, and Saint Vincent and the Grenadines.