Design and Validation of an Instrument for Assessing the Preparedness of Hospital Emergency Departments in Response to Disasters and Emergencies: A Mixed-Method Qualitative Study

Introduction: Hospitals are among the critical infrastructures of society that must continue to provide services under all circumstances. Hospital safety is one of the essential components of disaster and emergency management, and its observance enhances hospital preparedness and maintains its structure and function during crises. To assess the level of readiness and performance of hospitals in dealing with disasters and emergencies, it is necessary to identify and extract the key indicators of hospital preparedness. Therefore, this study aimed to develop and validate a checklist for assessing the preparedness of hospital emergency departments in responding to disasters and emergencies. Methods: This qualitative study was conducted using a mixed-method approach at Tabriz University of Medical Sciences in 2024–2025. In the first stage, articles related to hospital emergency preparedness in disasters were identified through searches in databases, including Science Direct, Google Scholar, Medline, Web of Science, EMBASE, PubMed, SID, and Magiran. Dimensions and criteria of the preparedness checklist were extracted from these studies. In the second stage, based on the findings from the literature review and expert opinions, a preparedness assessment checklist was developed. To verify content validity, the opinions of 22 experts in the field of disaster and emergency management were obtained and CVI (Content Validity Index) and CVR (Content Validity Ratio) were calculated. To determine reliability, the intraclass correlation coefficient (ICC) was used, and to determine internal consistency reliability, the Cronbach coefficient alpha (Cronbach’s alpha) was calculated for each factor and the entire instrument. Results: Through qualitative content analysis, a total of 85 items were initially extracted. After reviewing overlaps and evaluating content validity, the number of items was reduced to 79. The results indicated that all items had acceptable CVR values, confirming their appropriateness. Moreover, the CVI values for all items were above 0.79, indicating satisfactory content validity. Reliability testing yielded a Cronbach’s alpha coefficient of 0.83 and an intra-class correlation coefficient (ICC) of 0.82 in the test–retest analysis, confirming the instrument’s internal consistency and stability. Conclusion: The developed checklist is a valid and reliable tool for assessing the preparedness of hospital emergency departments in dealing with disasters and emergencies. Utilizing this instrument enables managers and policymakers to identify strengths and weaknesses within their emergency departments and take corrective measures to enhance preparedness. Furthermore, it provides a standardized tool for benchmarking and harmonizing hospital emergency preparedness at the national level.