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Summary
Background
The massive loss in life and destruction of property in Dubai just as the entire world
justifies the need to prevent these disasters from occurring if possible as well as preparing for any
disaster medically to prevent unnecessary loss of life. The primary healthcare facilities are
mandated with the role of upholding the safety of the patients in the hospital, the health workers,
and also the visitors to the facility. Upholding safety of all the parties calls the institution to make
all the necessary precautions. Performing drills a preferable method of evaluating if an institution
is prepared for disasters. Evaluation of an institution performance during a drill in Dubai is not
currently standardized. There is a need for a common ground of evaluation to recommend for
Development of a drill evaluation tool based on the existing information and observation will aid
in a customized drill evaluation tool for Dubai which is likely to serve the country better than
developed foreign tools that don’t put into consideration internal factors affecting drill
performance in Dubai.
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Problem statement
Overview
Just as many countries in the world, the United Arab Emirates there are different classes of
health care facilities. Primary health care is one of the classification well recognized by the World
Health Organization. Primary health care health facilities are immediate health facilities assessable
to the citizens that offer immediate healthcare facilities. Having the high health standards in Dubai,
the primary health care facilities are well equipped to offer most if not all of the most common
medical services (Abdellatif et al., 2017). The patient to hospital bed ration in Dubai was 1.9 per
1000 citizens which is a considerably lower ratio when compared to some highly developed
countries which have a ratio of more than eight hospital beds per 1000 people. Therefore, the
hospitals tend to be more crowded when to compare to the highly developed countries. High
population in hospitals means higher tension in case a disaster happens within the institution
Many primary health care facilities in Dubai invest much in educating both medical
professionals and the community on the management of disasters. No matter how much we invest
in preparation for disasters, it might be impossible to determine the efficiency of the investment
without experiencing circumstances or events that happen during disasters. Even if the real
how efficient a primary health facility is efficient in managing the disaster. Evaluation of
effectiveness in managing a disaster calls for evaluation of many aspects of emergency response.
The parameters of how efficient is efficient are hard to describe. In Dubai, the question of how
efficient is efficient is hard to answer because there are no set standard parameters to describe
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emergency response. There is no known common drill evaluation tool in Dubai. Without a standard
drill evaluation tool, it is hard to quantitatively and qualitatively describe emergency response in
a health facility. There is a need to create a standard drill disaster evaluation tool which will be
used to rate how good or poor is a health facility for managing disasters. The results from the
evaluation tool will be used to make comparisons and make recommendations for better disaster
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Hypothesis
1. Development of a Dubai drill evaluation tool will aid in assessing the preparedness of
Objectives
Overall Objective
1. To prevent life loss and property loss to disasters in Dubai due to disasters.
Specific Aims
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Background and Significance
Disaster is a sudden and calamitous event that is likely to lead to loss of property, life or
cause injury to the people affected (Khan, Kausar, & Ghani, 2017). The damage caused by a
calamity can be either mental, socioeconomic, political, or cultural or take any other dimension,
therefore, hardly has a defined parameter of measurement (Srivastava, 2010, p. 01). Disaster can
eruptions, and also earthquakes. Human-caused disasters to include, a terrorist attack, plane
crashes car accidents, and many more. Disasters affect almost all parts of the world, what varies is
the kind of disasters that are common in some areas, as an example the United States of America
is sited in the Circum-Pacific Belt which predisposes it to Drought hurricane. The same Circum-
Pacific Belt is a region is described to be one of the most common regions faced by the world
Most of the western countries are prone to seismic activities with the Dubai being part. The
GCC is made of seven emirates which are centers for tourist and business activities. Dubai harbors
a population of 2,104,895 which is the highest populated city (“World Capital Institute,” 2013)
which is a significantly high number of people in case of a major disaster. According to the sun
news in 2017, an earthquake struck the Iraq-Iran border killing 328 and injuring scores (Adu,
2017). This was one of the most disastrous earthquakes that ever struck the country. Dubai also
has a record of human-made calamities, on September 1983, Gulf air 771 was bombed as it
approached the Abu Dhabi international airport killing a total of 112 people ("Gulf Times, Qatar,"
1983). In 2017, Dubai skyscraper explosion, a 63 storey building exploded under un-identified
caused injuring 16 and killing one ("Dubai hotel fire: Inferno at 63-storey address downtown hotel
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near New Year’s Eve fireworks display," 2016). These are many more examples of natural and
Loss of life and destruction of property on the incidence of a disaster can be minimized by
ensuring that everyone is prepared for any disaster that may attack as well as ensuring that
immediate responders act within viable time ("Preventing, preparing for, responding to, and
recovering from disasters," n.d.). Preparation for disaster response may not be as simple as it
sounds. It calls for the commitment of some stakeholders mainly because it may be an expensive
investment and it requires the commitment and involvement of almost everyone in an institution,
particularly in a primary health care facility. Once the stakeholders have passed the budget for
disaster preparation, then the management has the mandate to ensure that safety requirements are
available within the hospital. Priority should be given to disasters that are common in that specific
primary health care facility. The management also has to provide skilled safety professionals who
will adequately train everyone at the hospital how to manage disasters. Once the training has been
adequately provided and maybe, refresher courses offered as well as other steps that might be taken
to ensure that the knowledge sticks into the beneficiaries heads, a drill is always necessary.
In this phase, the intention of the drill is first identified. The critical lesson or skill to be
gained can be from past training session or from another idea that you want the beneficiaries to
gain. All the factors about the drill should be considered including chances for an accident during
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Pre-drill participant assessment
In this phase, the participants are assessed for confidence in how they should manage a
situation. The phase is crucial to access what the beneficiaries are confidently ready to practice in
A post-drill briefing session is a crucial phase in carrying out a drill. During the phase, the
outcome of the drill is discussed to the beneficiaries. The phase gives the management a chance to
pin-point flaws that might have been noted during the drill.
Follow-up assessment
The follow-up session is primarily meant to refresh knowledge to the beneficiaries. Follow-
up assessment is not necessarily one because the more exposed beneficiaries are to the knowledge
the better they are likely to understand ("Four phases of drills and exercises evaluation," n.d.).
There are three known methods of evaluating preparedness for a disaster which is, using
surveys, a drill by the help of a structured evaluation tool, and video analysis of team performance
(Kaji, Langford, & Lewis, 2008). Surveys are used to collect information from the beneficiaries
either to inquire what they might have acquired from disaster management training. Surveys can
also be used to evaluate the success of a drill by inquiring questions related to the drill. Video
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analysis can be used together with a drill to view the actual response of beneficiaries in case of a
simulated disaster situation. A structured evaluation tool is used to rate the level of preparedness
of a specific group of people or institution in numbers. All the three methods can be used
Pressurized by the urge to evaluate the performance of disaster drills on the acceptable
common ground, the Johns Hopkins University Evidence-based Practice Center developed the first
evaluation tool composed of a set of evaluation modules and addendums in the year 2004 ("New
evaluation tool helps determine if hospital disaster drills are effective," 2004). In 2005, In 2005,
the Agency for Healthcare Research and Quality requested John Hopkins University to develop a
bridge evaluation tool that all hospitals should use to evaluate their preparedness for disasters
(Kaji, Langford, & Lewis, 2008). The evaluation tool composed of the most important drill
efficiency evaluation elements, the modules and addendums, and recommendations on what is
expected of an excellent evaluation tool. If used correctly, the abridged evaluation too is effective
in identifying the weaknesses and strength of a hospital disaster management strategy ("Evaluation
of hospital disaster drills," 2011). Even though the evaluation tool ranks institutional preparedness
for disasters, it is not meant to pass or fail certain institutions disaster management preparedness
rather foster further and constant development of the health institution strategies to manage
possible disasters.
It is hard to define how good is good without set standards and parameters that should
define the efficiency of a system. Evaluation of performance in a disaster live drill without
reference key parameters to consider is also likely to introduce bias in a case where one focuses
more on what he or she thinks looks good or bad, therefore, forgetting other aspects of a live
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Research Methods and Design
The primary population in concern for the live disaster evaluation tool will be the patients
in primary hospital facilities around Dubai, the health care providers and visitors that will be
visiting the hospital during the drill. The main challenge to evaluating the performance of the drill
evaluation tool is that the tool cannot be evaluated without subjecting it to the real disaster and
The population sample cannot be defined at this stage. The reason why it will not be defined
is that the number of patients in a primary health care facility in Dubai may vary drastically due to
many factors. Some of the factors include the location of the primary healthcare facility, the type
of services offered in the hospital as well as other external forces like outbreaks of diseases. Even
though, all the patients that will be in the hospital facility will be evaluated through different
methods as discussed in the previous chapter- video footage observation, use of questionaries’ and
by use of standard set John Hopkins Hospital evaluation tool. The evaluation tool will be subjected
to different predetermined standards of drills and tested for credibility. Two replicates of the drills
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The sample selected for the evaluation of the new tool will be random. From a total of all
Dubai outpatients, 2212371 visited the primary health care facilities in the year 2005 (Abdellatif
et al., 2017). This population that visits the primary health care facilities will serve as the subjects
for the study to develop a disaster evaluation tool. All the collected data will be considered in
After the Dubai disaster evaluation tool has been developed, it will have to be verified for
reliability. There will be three main methods used to collect data to validate the credibility of the
newly developed disaster evaluation tool. Video footage evaluation will be the first tool to evaluate
how the tool performs. Video footage of a real-time disaster will be studied keenly and evaluated
using the new tool. Questionnaires will be the second method of data collection; they will be
offered to the subjects who will participate in the testing drills and the data collected will be
compared to the kind of data produced by the new evaluation tool. The third and final method that
will be used to collect data for verification of the new tool credibility will be the John Hopkins
already existing tool for evaluation efficiency of hospital institutions preparation for disaster. The
The evaluation modules will be developed from literature reviews and evaluate the current
practices on-going in the hospitals. The following are some parameters that will be evaluated and
rated in one to five star with the matching description. Organizational preparedness for internal
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vendor and supplies preparedness and efficiency, the primary health employees preparedness, the
time taken to channel the information about the disaster, the correctness of the information
channeled, and many more as listed in John Hopkins model. Only the appropriate evaluation
variation in different hospital zones risks, the flexibility of use of the evaluation tool as
environments vary, safety and security of the persons under the drill test subjects, and the culture
Data will be collected from questionnaires, which will be administered to the drill subjects
randomly. The collected data will then be used to evaluate the preparedness of the primary health
facility using the newly prepared evaluation tool. The collected data will then be compared to the
data collected from the original John Hopkins disaster preparedness evaluation tool. All the
possible data collection sources will be considered in the evaluation Just as John Hopkins model.
Data Analysis
Data analysis in this specific work will be based on a comparison between the collected
data from the newly proposed evaluation tool and the evaluation from the John Hopkins disaster
evaluation tool. The efficiency of the new tool to determine the preparedness of the institution
against disasters will be determined by comparing the data from both sources baring error created
by human judgment.
Ethics Issues
It is against ethics to use human as test samples in research work (Kapp, 2006). In our case
where we might need more than one drill to evaluate the drill evaluation tool performance, it might
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be limited to conducting own drills. The research will have to majorly depend on the drills
organized by primary healthcare facilities which might mean longer study time and use of more
resources.
Study limitations
Since the study will be based on real-time drill studies, as mentioned before the research
on the efficacy of the drill might have to depend on the drill organized by the primary healthcare
facilities. Organizing a drill in a facility that you are not part of management will take more
The study is also likely to demand many resources, carrying out real-time drill evaluation
will call for more than a single person. In cases where there will be no drill activities of preference,
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References
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