How public hospitals manage epidemic crises? Lessons from Iranian public hospitals

BACKGROUND: The public hospital preparedness is essential for epidemic disaster like COVID‑19 pandemic. This study was conducted to present a hospital management preparedness model of Iran’s public hospitals for the epidemic. MATERIALS AND METHODS: The method of this study was an exploratory sequential mix method study (qualitative–quantitative). In this study, qualitative and quantitative methods were used in four stages. (1) Interviews with hospital managers to identify hospital management experiences during the COVID‑19 epidemic and categorize the results in themes and subthemes, (2) assessing the performance of public hospitals in managing the coronavirus epidemic in a quantitative method, (3) present the initial hospital management model for a public hospital in epidemic conditions using an expert panel, and (4) validation of the model using the Delphi method. RESULTS: Experiences of hospital managers and specialists were categorized into eight themes: information gathering and environmental analysis, general and operational planning, provision of equipment and physical and financial resources, training and empowerment of human resources, a compilation of instructions and job descriptions, review and ensuring maximum readiness, monitoring and follow‑up of service provision and existing problems, evaluation and feedback of performance problems and level of preparation and 51 sub‑themes. The quantitative study indicated that all the investigated indicators had a significant decrease in the first month and an increase in the epidemic’s continuation. The results were categorized in nine themes and 59 sub‑themes, and finally, the model was validated in one round by the Delphi method. CONCLUSION: In Iran, managers have valuable experiences in COVID‑19 epidemy management, but these experiences are scattered and not organized. In this study, by a qualitative–quantitative, a model was presented that contains essential points obtained from the experience of hospital managers and experts in actual disaster conditions and is appropriate and fits hospital structure and infrastructure of the health system in Iran.