International Scientific Journal

Thermal Science - Online First

online first only

Safe healthcare facilities - their place and role in resilient cities

Given that mankind has occasionally been exposed to the devastation of catastrophic proportions throughout its history (extreme weather events, natural disasters, bioterrorism and pandemics are having an increased global impact),which are increasing in the 20th century due to climate change, the risk reduction measures are being taken at the global level to reduce the severity of the consequences. Natural and technological disasters in the European countries have caused significant loss of life and damage to structures and infrastructure, which has led to the ratification of conventions at the world level in the field of disaster preparedness (Hyogo Framework for Action and Sendai Framework for Disaster Risk Management). Hospitals and other healthcare facilities are amongst those most jeopardized. The paper gives an overview of the methodology in the field of defining the resilience of healthcare facilities through determining the Hospital Safety Index (HSI). Through the application of this and other methodologies in a case study conducted in Serbia, the paper examines the direct correlations between HSI and climate change. Paper gives the results of HSI calculation considering modules 2-4 and possibilities for the potential use of the module 1 (research on hazards) in separate evaluation.
PAPER REVISED: 2017-12-06
PAPER ACCEPTED: 2018-01-22
  1. Tompkins, E., & Hurlston, L.-A. Public-private partnerships in the provision of environmental governance: A case of disaster management. In E. Boyd & C. Folke (Eds.), Adapting institutions: Governance, complexity and social-ecological resilience, pp. 171-189, 2012, Cambridge, GB: Cambridge University Press
  2. UNISDR 2009 UNISDR Terminology on Disaster risk reduction, Geneva: United Nations International strategy for Disaster Reduction (UNISDR), 2009, accessed on 11.7.2016
  3. Desouza, K., Flanery, T. Designing, planning and managing resilient cities: A conceptual framework, Cities, 35, pp. 89-99, 2013
  4. Chang, S., McDaniels, R. Fox, J., Dhariwal, R. Longstaff H. Toward Disaster-Resilient Cities: Characterizing Resilience of Infrastructure Systems with Expert Judgments, Risk analysis, Vol. 34, no 3., p.p. 416-433, 2014, DOI: 10.1111/risa.12133
  5. Zhong, S, Clark, M., Hou, H., Zang, Y., Ftizgerald, G. Validation of a Framework for Measuring Hospital Disaster Resilience Using Factor Analysis, International Journal of Environmental Research and Public Health, 11, p.p. 6335-6353; 2014, doi:10.3390/ijerph110606335
  6. IFRC (International Federation of Red Cross and Red Crescent Societies) World Disasters Report 2010. Focus on Urban Risk. Geneva: International Federation of Red Cross and Red Crescent Societies, 2010
  7. UNISDR Sendai Framework for Disaster Risk Reduction 2015 - 2030, Geneve: The United Nations Office for Disaster Reduction, 2005,, accessed on 11.7.2016
  8. UNISDR, Hyogo Framework for Action 2005-2015: Building the Resilience of Nations and Communities to Disasters, Geneva: United Nations International strategy for Disaster Reduction, 2005, accessed on 1.08.2016
  9. OECD, Protection of Critical infrastructure and the role of investment policies relating to national security, Paris: Investment Division, Directorate for Financial and Enterprise Affairs Organization for Economic Co-operation and Development, 2008, accessed on 10.7.2016
  10. Albanese, J.; Birnbaum, M.; et al. Fostering disaster resilient communities across the globe through the incorporation of safe and resilient hospitals for community-integrated disaster responses. Prehosp. Disaster Med. 2008, 23, 385-390
  11. Braun, B.I.; Wineman, N.V.; Finn, N.L.; et al. Integrating hospitals into community emergency preparedness planning. Ann. Intern. Med. 2006, 144, 799-811
  12. Paturas, J.L.; Smith, D.; Smith, S.; Albanese, J. Collective response to public health emergencies and large-scale disasters: Putting hospitals at the core of community resilience. J. Bus. Contin. Emer. Plan. 2010, 4, 286-295
  13. Cimellaro, G.P.; Reinhorn, A.M.; Bruneau, M. Framework for analytical quantification of disaster resilience. Eng. Struct. 2010, 32, 3639-3649
  14. Sauer, L.M.; McCarthy, M.L.; Knebel, A.; Brewster P., Major influences on hospital emergency management and disaster preparedness. Disaster Med. Public Health Prep. 2009, 3, S68-S73
  15. Barbera, J.A.; Yeatts, D.J.; Macintyre, A.G. Challenge of hospital emergency preparedness: Analysis and recommendations. Disaster Med. Public Health Prep. 2009, 3, S74-S82
  16. WHO News release, Protecting hospitals and health centers before disasters saves lives,, accessed on 01.08.2016.
  17. World Health Organization, 2015, Hospital Safety Index - Guide for evaluators, Pan American Health Organization,, accessed on 10.08.2016
  18. "Poplave u Srbiji 2014." ,
  19. Pisla, M.; Domente, S.; Chetraru, L.; Ostaficiuc, R. Evaluation of hospital safety in the Republic of Moldova, Chsiinau: Republican Center for Disaster Medicine, 2010, accessed on 11.7.2016
  20. WHO Regional Office for Europe Assessment of health-system crisis preparedness: Croatia, Copenhagen, 2011,, accessed on 27.07.2016
  21. Aiello, A.; Pecce, M.; Sarno, L.; Perrone, D.; Rossi, F. A Safety Index for Hospital Buildings. Disaster Advances. 2012, 5, 270-277
  22. Ardalan, A., Kandi, M., Talebian, M.T., Khankeh, H., Masoumi, G., Mohammadi, R., Maleknia, S., Miadfar, J., Mobini, A., Mehranaminiran, S. Hospitals Safety from Disasters in I.R.Iran: The Results from Assessment of 224 Hospitals, 2014, 6, retrieved from: ecurrents.dis.8297b528bd45975bc6291804747ee5db
  23. Akcioni plan adaptacije na klimatske promene, ("Official Gazette of the City of Belgrade", no. 65/, accessed on 11.7.2016