Hospital Resilience After the 2015 Earthquake in Nepal: Results From Semi-structured Interviews With Hospital Staff

Background: Resilient hospitals are increasingly recognized as a cornerstone of disaster reduction in global policies such the Sendai Framework for Action. However, current hospital resilience frameworks emerged from pre-disaster conceptualizations, and have not been verified real-life contexts nor frontlines. Our aim was to study tertiary hospital's after 2015 earthquake Nepal, experienced by its staff. Methods: We undertook qualitative Tribhuvan University Teaching Hospital (TUTH), where we conducted 18 semi-structured interviews with inductively created themes describe burden hospital, analyze individual In addition, deductively documented system, according system dimensions: means (redundancy resourcefulness), ends (robustness rapidity). Results: terms robustness, TUTH increased capacity victims elective activities were temporarily interrupted quality care priority. Three stages rapidity identified: critical address immediate needs, stabilizing until re-started routine activities, recovery rapidity. addition plan, emerging adaptations played major role redundancy resourcefulness. found that depended on three determinants: safety, meaningfulness, sense belonging. Conclusions: results complexity planned adaptations, well interdependencies resilience. Frameworks plans improve must reflect flexibility response, concern well-being staff is central sustainable response improved