Action at the Organizational Level to Strengthen the Response Capacity of Hospital

Introduction: Japan frequently experiences natural disasters, and there is concern about a major earthquake in the Tokyo area, where more than three million people live. The University of Tokyo Hospital is one of the disaster base hospitals in Tokyo, and strengthening disaster response capacity is important. This study aimed to identify the factors associated with staff behavior towards disaster response. Methods: Two different surveys were conducted, a paper-based questionnaire for the departments of the University of Tokyo Hospital (UTH) and an online-based questionnaire for individuals. Eighteen departments in UTH were selected for the paper-based questionnaire because they were considered important in determining hospital functions during a disaster. For the online-based questionnaire, hospital staff were recruited for voluntary participation. Each questionnaire was developed based on the previously reported survey conducted earlier. Results: Out of 18 departments, 17 departments responded to the survey. There was no significant relationship between the preparedness for disaster and the work content of the section. 338 staff responded to the individual survey. Strong trends were observed in many items related to behavior and knowledge of local conditions and disaster response in hospitals. Some background factors, such as age and profession, were significantly associated with respondents’ behavior and knowledge. Some barriers were observed consistently across sections and individuals. The three main barriers were: lack of leadership, lack of employee engagement, and heavy workload. Conclusion: This study identified some factors, both in departments and individuals, that may influence behavior towards disaster response in the hospital. Based on these findings, three actions are considered necessary: vision and mission with effective leadership, commitment through education and training, operational efficiency and human resource management. Further improvement of disaster preparedness in UTH is necessary at the organizational level.