This document outlines Module 2 of a training on safe hospitals. It covers 3 sessions on identifying hazards, assessing structural, non-structural and functional components, and presenting assessment results and prioritized gaps. Session 2 focuses on using WHO's vulnerability assessment tool to evaluate components and identify gaps. Participants will discuss components, conduct assessments using the tool, provide feedback, and prioritize the 3 most critical gaps in each component for action planning.

1. Module 2:
Safe Hospital
Assessment

2. Module 2 Sessions
Session Number and Title Topics Time
Allotment
Session 1: Identifying
Hazards
– Hospital Hazards
– Hospital Risk Management
Framework
~1 hour
Session 2: Assessing
Structural, Non-structural,
and Functional
Components and
Prioritizing Gaps
– Components of Safe
Hospital
– WPRO’s “Safe Hospitals’
Vulnerability Assessment
Tool
– Feedback on Tool
– Prioritization Matrix
~3 hours
Session 3: Presentation of
Assessment Results and
Prioritized Gaps
The Executive Report ~2 hours

3. Mod 2 Session 2:
Assessing Structural, Non-structural,
and Functional
Components and
Prioritizing Gaps

4. Module 2 Session 2 Objectives
At the end of this module, participants will be able
to:
1.Discuss the following components for “Safe
Hospital”:
a. Structural
b. Non-structural
c. Functional

5. Module 2 Session 2 Objectives
At the end of this module, participants will be able
to:
2.Make a descriptive assessment of their hospital
using the WPRO’s Safe Hospitals’ Vulnerability
Assessment Tool.

6. Module 2 Session 2 Objectives
At the end of this module, participants will be able
to:
3.Identify and prioritize the 3 critical “Safe
Hospitals” gaps of their hospital for action planning
in the following components:
a. Structural
b. Non-structural
c. Functional

7. 4 Topics in Session 2:
•Components of a Safe Hospital
•Vulnerability Assessment using
WPRO’s Tool
•Feedback on Tool
•Prioritization Matrix

8. Topic 1: Components of a Safe Hospital
 Safe hospitals need to remain structurally
sound, well organized, and fully operational
at times of emergency and disaster.
 To ensure this, there must be proper
monitoring of its structural, non-structural
and functional components.

9. Topic 1: Components of a Safe Hospital
Structural Components
Load-bearing components of a building

10. Topic 1: Components of a Safe Hospital
Structural Components
Primary load-bearing components that make a
building stand
 Foundation
 Column (posts and pillars)
 Beams (girders, joists)
 Floors
 Walls
 Roofs
product of
structural engineers, masons, labor contractors

11. Topic 1: Components of a Safe Hospital
Structural components:
• building location
• design specifications
• materials used
crucial for the building to withstand adverse
natural events

12. Non-load-bearing parts of building or
attached to the structure
Non-structural
Components

13. Topic 1: Components of a Safe Hospital
Non-structural Components
All non-load-bearing parts including contents of
the building or attached to the structure
• Ceilings, windows, partitions
• Pipes, mechanical and electrical systems
• HVAC (heating, ventilating, air con)
• Equipment, supplies
• Furnishings
• etc.
done by:
architects, interior designers
mechanical and electrical engineers
purchased by owners after construction

14. Topic 1: Components of a Safe Hospital
Non-structural components:
• architectural elements (such as ceilings,
windows, and doors)
• medical and laboratory equipment
• lifelines (mechanical, electrical, and plumbing
installations)
• safety and security issues

15. Topic 1: Components of a Safe Hospital
Non-structural components:
essential to the daily operations
if damaged, would not be able to function, and
may even cause physical injury to patients and
personnel

16. Topic 1: Components of a Safe Hospital
Functional Components

17. Topic 1: Components of a Safe Hospital
Functional components:
• site and accessibility
• internal circulation and interoperability
• equipment and supplies
• emergency standard operations procedures and
guidelines
• ………
 important in the continuous operations
of hospitals and health facilities

18. National Training oonn SSaaffee HHoossppiittaallss -- SSrrii LLaannkkaa
Critical Elements of a Safe Hospital
Safe Hospital
Structural
Component
Emergency Exit System
Lifeline
Facilities
Medical
Facilities
Architectural
Elements
Non-structural
Component
Functional
Component
Fire System
Electricity System
Water Supply System
Medical Gas Supply System
Communication System
Critical Systems

19. Critical Elements of a Safe Hospital
Safe Hospital
Structural
Component
Non-structural
Component
Functional
Component
All the components must not be
vulnerable to hazards = overall indicators
for a safe hospital!

20. Mod 2 Session 2 Topic 1
Any questions?

21. Topic 2: Safe Hospitals’ Vulnerability
Assessment using WPRO’s Tool
2010

22. Safe Hospital’s Vulnerability Assessment
 Various assessment methods and tools
 Usually using a checklist with structural, non-structural,
and functional indicators for a safe hospital
 Some with numerical scoring
 PAHO – Safe Hospital Index
 Others with descriptive assessment (yes or no answers)
 WPRO, Philippines
 Regional assessment tool (PAHO; WPRO); country-specific
assessment tool (Philippines)

23. Safe Hospital’s Vulnerability Assessment

24. Safe Hospital’s Vulnerability Assessment
Safe Hospital Index - PAHO
Category A is for facilities deemed able to protect the life of
their occupants and likely to continue functioning in disaster
situations.
Category B is assigned to facilities that can resist a disaster
but in which equipment and critical services are at risk.
Category C designates a health facility where the lives and
safety of occupants are deemed at risk during disasters.

25. Safe Hospital’s Vulnerability Assessment
Safe Hospital Index - PAHO
Safety index Category
Type What should be done?
0 – 0.35 Category
C
Urgent measures are required immediately, as the
health facility’s current safety levels are not
sufficient to protect patients and staff during and
after a disaster event.
0.36 – 0.65 Category
B
Necessary measures are required at some point, as the
health facility’s current safety levels can potentially
put at risk patients and staff during and after a
disaster event.
0.66 – 1 Category
A
Preventative measures are suggested at some point, as
the health facility’s current safety levels can cause
acceptable damages, which nevertheless reduce the
overall safety level of the installation.

26. Safe Hospital’s Vulnerability Assessment
Safe Hospital Indicators

27. Topic 2: Safe Hospitals’ Vulnerability
Assessment using WPRO’s Tool
2010

28. Feedback on WPRO’s Assessment Tool
World Health Organization
Western Pacific Regional Office (WPRO)
Safe Hospitals’ Vulnerability Assessment Tool
Get FEEDBACK from participants on
ADAPTATION
(clarity and understandability; validity; applicability;
usefulness; etc.)
In preparation for a Sri Lanka’s and SEARO’s Tool!

29. Topic 2: Vulnerability Assessment using
WPRO’s Tool
How to use the WPRO Checklist adapted for the
Training Course
Hospital Teams -
Go through each and all indicators; one
component at a time; starting with structural, then
non-structural, and then functional.

30. Topic 2: Vulnerability Assessment using
WPRO’s Tool
How to use the WPRO Checklist adopted for the
Training Course
Assess each indicator item accordingly:
• YES
• NO – need slight to moderate improvement
• NO – need marked improvement
• UNSURE of Status
• NOT APPLICABLE
*“NO” and “UNSURE” answers = WEAKNESSES or GAPS.

31. Topic 2: Vulnerability Assessment using
WPRO’s Tool
How to use the WPRO Checklist adopted for the
Training Course
Feedback on WPRO’s Checklist –
As you go through the checklist, note and jot down areas /
items which are not clear, not easy to understand; not valid;
not applicable, and not useful in Sri Lanka setting; etc.
Accomplish the feedback form provided and submit to the
facilitators.


32. Topic 2: Vulnerability Assessment using
WPRO’s Tool
How to use the WPRO Checklist adopted for the
Training Course
After answering all indicator items and
accomplishing the feedback form, go the
identification and prioritization of gaps using a
prioritization matrix. (Topic 4 of Module 2)

33. Topic 3: Feedback on WPRO’s
Safe Hospitals’ Vulnerability
Assessment Tool
See also questionnaire in hand-outs!

34. Topic 4:
Prioritization Matrix and
Prioritization of Gaps

35. Prioritization Matrix – What is It?
A tool (a table) used to narrow down options through
a systematic comparison of choices using a set of
agreed upon criteria.
Usually done by a team.

36. Prioritization Matrix – How to Do It?
1. Agree on goal to be achieved.
Example:
To select from a list of gaps in each “Safe Hospital”
component 3 critical ones that will be prioritized for
action planning.
2. Create the list of criteria and a scoring system for
prioritization.
Examples of criteria for gaps:
magnitude of problem, urgency, impact, etc.
Examples of scoring system: 1 – lowest; 3 – highest.

37. Prioritization Matrix – How to Do It?
3. Create the table showing the choices and the criteria.
Gaps Magnitude
of problem
Urgency Impact Total
scores
Rank
1.
2.
3.
4.
5.
6.

38. Prioritization Matrix – How to Do It?
4. Each member of a team is asked to rank each gap in each
of the agreed criteria using the agreed scoring system.
5. Add the scores for each gap area and place them in the
appropriate boxes in the table.
6. The gaps with the top 3 high scores will be the team’s
choices for the 3 critical gaps for action planning.

39. Prioritization Matrix – How to Do It?
Gaps Magnitude
of problem
Urgency Impact Total
scores
Rank
1.
2.
3.
4.
5.
6.

40. Prioritization Matrix – How to Do It?
Gaps Magnitude
of problem
Urgency Impact Total
scores
Rank
1. 3+2+1 1+2+2 2+2+1 16 3
2. 1+3+3 2+2+3 3+2+1 20 2
3. 3+2+2 2+1+2 1+2+1 16 3
4. 3+2+3 2+2+1 2+2+3 20 2
5. 2+2+1 3+2+3 3+2+3 21 1
6. 1+1+1 1+1+1 3+2+1 12 4
Key: 1 – lowest; 3 – highest
3 Members

41. Prioritization Matrix – How to Do It?
NOTE:
As a group, you can develop your own criteria.
• Your group can identify factors that may be
more appropriate in your own setting.
You can develop your own scoring rubric or matrix
(e.g. 1 = least urgent to 10 = most urgent).

42. Prioritization Gaps Magnitude Matrix – How to Do It?
of problem
Urgency Impact Capacity to
address
·A = Existing
programs and
policies
·B = Availability
of budget
·C = Availability
of people
Total
scores
Rank
A B C

43. Mod 2 Ses 2
Topics 2, 3, & 4
Any questions?
On instructions
for the
workshop
activities?

44. Module 2 Session 3:
Presentation of
Assessment Results
and
Prioritized Gaps

45. Session 3: Presentation of Assessment Results and
Prioritized Gaps
Expected outputs:
•Presentation of executive summary of assessment.
•Presentation of list of prioritized gaps for action
planning

46. Session 3: Presentation of Assessment Results and
Prioritized Gaps
Instructions:
•In this session, you will simulate a situation wherein
you are to report to the hospital executive committee
(or hospital leadership).
•The contents of the report should come from the
result of your workshop on prioritizing.

47. Executive Report on Safe
Hospital’s Vulnerability
Assessment
Format

48. Executive Report on Safe Hospital’s
Vulnerability Assessment
Format of Report
Name of Hospital / Health Facility:
Type: Government or Private:
Bed Capacity:
• Confidentiality clause of assessment report:
• Assessment Processes and Scope:
• Date of Assessment:
• Members of Assessment Team:

49. Executive Report on Safe Hospital’s
Vulnerability Assessment
Format of Report
Hospital Hazards Identification and Risk Analysis
List of Gaps per Areas in Each Safe Hospital Component
(Structural, Non-structural, Functional)
General Descriptive Assessment Statements of Gaps per
Area in Each Safe Hospital Component (Structural, Non-structural,
Functional)

50. Executive Report on Safe Hospital’s
Vulnerability Assessment
Format of Report
Prioritization Processes Done and Prioritization Matrix of
Gaps
Identified 3 Critical Gaps in Each Safe Hospital Component
(Structural, Non-structural, Functional) for Action Planning

51. GO TO
WORKSHOPS and WORKSHEETS
For Sessions 2 and 3
Module 2 Session 2:
Assessing Structural, Non-structural, and Functional
Components and Prioritizing Gaps
Module 2 Session 3:
Presentation of
Assessment Results and Prioritized Gaps

52. Closing:
Module 2

53. Topic 3: Feedback on WPRO’s Safe Hospitals’
Vulnerability Assessment Tool
Dear Colleagues:
Thank you for taking the time to go through the document of
“Safe Hospitals in Emergencies and Disasters: Structural,
Non-structural and Functional Indicators”.
Below are several questions kindly asking for your feedback
on the document.
Your input will be invaluable in further development of the
indicators for use in your country and in the South-East Asia
Region.

54. Topic 3: Feedback on WPRO’s Safe Hospitals’
Vulnerability Assessment Tool
1. Is the document clear and understandable?
1.1. Which segments or particular items/indicators
are difficult to understand?
1.2. If possible, how would you suggest that
this/these be improved?

55. Topic 3: Feedback on WPRO’s Safe Hospitals’
Vulnerability Assessment Tool
2. Are the indicators valid in your setting?
2.1. Which specific indicator is not valid in your
setting?
2.2. What about the indicator/s that makes it invalid
in your setting?

56. Topic 3: Feedback on WPRO’s Safe Hospitals’
Vulnerability Assessment Tool
3. Are the indicators applicable to your setting?
3.1. Which specific indicator is not applicable to
your setting?
3.2. What about the indicator/s that makes it
inapplicable to your setting?

57. Topic 3: Feedback on WPRO’s Safe Hospitals’
Vulnerability Assessment Tool
4. Is the document useful in your setting?
4.1 Why is the document not useful in your setting?
4.2 What improvements, if any, would you suggest to
make it useful in your setting?

58. Topic 3: Feedback on WPRO’s Safe Hospitals’
Vulnerability Assessment Tool
5. Overall, can you think of any areas for
improvement in the document?
5.1. What specific revisions or additions could you
suggest, if any, to improve on the document?

59. Module 2 Objectives

60. Module 2 Objectives
At the end of this module, participants will be able
to:
3. Prioritize gaps in the following “Safe Hospital”
components:
• Structural
• Non-structural
• Functional

61. Module 2 Objectives and Expected Outcomes
Objectives Expected Outputs
Identify hazards experienced or
might be experienced by
participants’ hospital.
Hazards commonly experienced and
might be experienced
Do a general risk analysis of safety
of hospital based on identified
hazards.
General risk analysis
Utilize WPRO’s Safe Hospitals’
Vulnerability Assessment Tool.
Detailed descriptive assessment of
safety of hospital re:structural, non-structural,
and functional indicators
Feedback on WPRO’s tool
Prioritize gaps in “Safe Hospital”
components for action planning.
Three prioritized gaps in each “Safe
Hospital” component for action
planning

62. Module 2: Concept Map of Objectives and Expected Outputs
Your HOSPITAL
Identify potential hazards
Do general risk analysis
Hazards Vulnerabilities Risks
Detailed Assessment of Vulnerabilities
(Structural / Non-structural / Functional)
Action Planning
Weaknesses / Gaps
Prioritized Gaps

63. What do we do with the gaps that you
have identified and prioritized?

64. We have to do an action plan to
correct the gaps!
Make your hospital safe and safer and SAFEST!
REDUCE RISK
PROTECT HEALTH FACILITIES
SAVE LIVES

65. Module 2
Any questions?

66. Module 2:
Safe Hospital
Assessment
The End