Seismic resilience index evaluation for healthcare facilities: A case study of hospital in Tehran

Due to the fact that Iran is located in one of the most earthquake-prone areas throughout the world, it is of great importance to pay specific attention to the performance of healthcare facilities after the occurrence of an earthquake to identify how they would serve patients and potential victims during and after the seismic events. Health centers should play a pivotal role in rescue operations during severe accidents, especially the emergency department, which normally stands at the frontline of caring for the patients and injured individuals. In this research, the seismic resilience index of an emergency department located in Iran has been investigated as an indicator, representing the post-earthquake level of medical services to the patients. This study, also, identifies the recovery mechanism of the hospital to the normal conditions after the coming earthquake. When it comes to assessing the hospital's seismic resilience index, officials should meet the need of "patient satisfaction" and the best parameter satisfying this need is the waiting time of patients, as a good indicator for the capacity of the hospital in critical circumstances, which is considered in this study as the main measure for the depiction of functionality curve as well. The considered case study is modeled by discrete event simulation in Anylogic software. The results indicate an increase in patient waiting time due to changes in hospital admission rate after the event. Having examined the changes in waiting time and quality of treatment in normal and seismic scenario conditions, the results show that the peak waiting time in the emergency department is equal to 20 h during the seismic scenario. While plotting the functionality curve, it is determined that right after the occurrence of the earthquake, the loss reduction of the emergency department would reach 24% while the value of the seismic resilience index would be approximately 86%. As a final approach, a plan for the promotion of resiliency is proposed by which the waiting time can be reduced up to 35%, enabling decision-makers to have fruitful and proper crisis management when a calamity strikes.