Factors affecting emergency evacuation of Iranian hospitals in fire: A qualitative study

BACKGROUND: Fire is one of the most important threatening factors for hospitals and needs special attention. The present study was conducted to explain the factors affecting hospital emergency evacuation following fire based on hospital administrators' experiences. MATERIALS AND METHODS: This was a qualitative study conducted employing the content analysis approach. Participants included 22 hospital administrators in Tehran, Lorestan, Kurdistan, and Ilam provinces. The participants were purposefully selected and included until reaching principle of data saturation. Data were collected through in-depth semi-structured interviews from November 2019 to August 2020 and analyzed by the content analysis method. RESULTS: Factors affecting hospital emergency evacuation during fire were categorized into five main categories and 17 subcategories including response to incident (five subcategories of fire nature, emergency evacuation, service provision, coordination and communication; and collaboration and companionship), human factors (two subcategories of individual characteristics and competencies), hospital preparedness (three subcategories of planning, safety and security; and information management system), environmental factors (two subcategories of hospital design and infrastructure; and weather condition), and finally ethical values (five subcategories of human dignity, trust, altruism, responsibility and accountability; and empathy). CONCLUSION: The results of this study indicated that during fire in Iranian hospitals, several factors in addition to available standard guidelines affect the emergency evacuation process that need to be considered. Hospital emergency evacuation during fire is a complex process and necessitates a full and high-level hospital preparedness, so using the results of this study can be used to develop and practice evacuation plans and improve the hospital preparedness.