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Section I


he Hospital Safety Index, a tool developed by the Pan American Health Organization and a group
of Caribbean and Latin American experts, is being widely used by health authorities to gauge the
overall level of safety of a hospital or health facility in emergency situations.
The Hospital Safety Index helps health facilities to assess their safety and avoid becoming a casu-
alty of disasters by providing a snapshot of the probability that a hospital or health facility will con-
tinue to function in emergency situations, based on structural, non-structural and functional factors,
including the environment and the health services network to which it belongs.
By determining a hospital’s Safety Index or score, countries and decision makers will have an over-
all idea of its ability to respond to major emergencies and disasters. The Hospital Safety Index does not
replace costly and detailed vulnerability studies. However, because it is relatively inexpensive and easy
to apply, it is an important first step toward prioritizing a country’s investments in hospital safety.
There are a number of steps to calculating a health facility’s Safety Index.
General information about the health facility: The hospital’s disaster committee should com-
plete this form prior to the evaluation. It includes information on a health facility’s level of complexity,
the population it serves, specialty care and other available services, and health staff. Below is a short
extract from this form. Click here to print this form.

Safe Hospitals Checklist: The trained team of Evaluators then uses the Safe Hospitals Checklist
to assess the level of safety of 145 areas of the health facility, grouped by location, structural, non-
structural and functional components. Once the Checklist has been completed, the Evaluation Team
collectively validates the scores and enters them into a scoring calculator, which weighs each variable
according to its relative importance to a hospital’s ability to withstand a disaster and continue func-
tioning. The safety score is calculated automatically.
The final Safety Index score places a health facility into one of three categories of safety, helping
authorities determine which facilities most urgently need interventions:
 Category A is for facilities deemed able to protect the life of their occupants and likely to con-

tinue functioning in disaster situations.

 Category B is assigned to facilities that can resist a disaster but in which equipment and criti-

cal services are at risk.

 Category C designates a health facility where the lives and safety of occupants are deemed at

risk during disasters.

Calculating the safety score allows health facilities to establish maintenance and monitoring rou-
tines and look at actions to improve safety in the medium term. This quick overview will give countries
and decision makers a starting point for establishing priorities and reducing risk and vulnerability in
health care facilities.
Below is a short extract from several areas of the form. Click here to print or photocopy additional
copies of these forms.

Guide for Evaluators: The Guide for Evaluators provides guidance and standardized criteria for
10 evaluating the components of a health facility individually and as part of the health services network.
A multidisciplinary team of Evaluators, which can include engineers, architects, health staff,
hospital directors and others who have undergone previous training, uses the Guide. The
Guide explains the methodology and rationale for the Hospital Safety Index as well as how
to calculate and interpret the health facility’s safety score. Click here to view or download
the Guide for Evaluators.
Evaluation of Small and Medium-Sized Health Facilities
This tool uses the same methodology as Hospital Safety Index and has
been adapted to the Caribbean. It aims to improve the safety and response
capacity of smaller health facilities in emergency situations. In this guide,
smaller facilities are defined as those of low complexity, which together
with major hospitals, make up the health network. These include primary
care facilities that offer certain specialized services (obstetrics and gyne-
cology; pediatrics internal medicine and general surgery) and often have
20 beds or less.
Health facilities that belong to a country’s health network have different functions.
Therefore, achieving an optimal level of safety can be progressive in nature and undertaken in a differ-
ent manner than with larger hospitals.
Click on the appropriate link below to consult or download information about the Evaluation of
Small and Medium-Sized Health Facilities and the forms to calculate your facility’s safety score:
Background Information and Guidelines: This
comprehensive reference guide discusses the com-
ponents of the Evaluation of Small and Medium-
Sized Health Facilities and offers guidance on points
to consider (structural, non-structural and functional
aspects of the facility) as one completes the Safe
Hospitals Checklist. Download this material.
Safe Hospitals Checklist for Small and Medi-
um-Sized Facilities: The evaluation team leader will
distribute a copy of the Checklist to each evaluator.


The team is comprised of specialists in a variety of
technical areas, who will complete the correspond-
ing section the Checklist according to their area of expertise. Below is a short extract from several
areas of the form. Click here to download these forms.

Intervention Plan: The matrix summarizes the evaluation’s results and helps to plan solutions.
Click here to download this form.

Download the complete publication Evaluation of Small and Medium-Sized Health Facilities.