{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T15:49:50Z","timestamp":1789487390073,"version":"build-2803163510"},"reference-count":27,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,8,26]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to explore the key factors influencing hospital disaster preparedness and identify practical strategies for strengthening preparedness within the Iranian healthcare system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This qualitative study used conventional content analysis. Data were collected through semi-structured interviews and analysed using MAXQDA 2022. Data collection and analysis continued concurrently until data saturation was achieved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study was conducted in eight hospitals across four provinces of Iran between January 2023 and February 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>22 healthcare professionals with experience in hospital disaster preparedness were recruited using purposive sampling. Eligible participants had at least 3 years of experience in disaster preparedness or emergency management and represented managerial, clinical and disaster management roles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven themes and 20 subthemes influencing hospital disaster preparedness were identified, encompassing leadership and governance, organisational culture, human resources, infrastructure and resources, training and knowledge, communication and coordination and policy and planning. Six additional themes and 25 subthemes described strategies to improve preparedness, including strengthening leadership, empowering the workforce, enhancing infrastructure resilience, promoting scenario-based training, improving communication systems and expanding integrated information technologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hospital disaster preparedness is influenced by interconnected organisational, managerial, structural and cultural factors. Implementation of context-specific, stakeholder-informed strategies may contribute to strengthening hospital disaster preparedness by improving organisational resilience, coordination and emergency response capacity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-122558","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T14:00:54Z","timestamp":1789480854000},"page":"e122558","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Key factors and practical strategies to strengthen hospital disaster preparedness: a qualitative study in Iran"],"prefix":"10.1136","volume":"16","author":[{"given":"Ali Reza","family":"Yusefi","sequence":"first","affiliation":[{"name":"Student Research Committee, Sirjan School of Medical Sciences, Sirjan, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Sadeghi","sequence":"additional","affiliation":[{"name":"Department of Public Health, Sirjan School of Medical Sciences, Sirjan, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3561-2619","authenticated-orcid":false,"given":"Jamshid","family":"Bahmaei","sequence":"additional","affiliation":[{"name":"Department of Public Health, Behbahan Faculty of Medical Sciences, Behbahan, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omolbanin","family":"Atashbahar","sequence":"additional","affiliation":[{"name":"Department of Public Health, Sirjan School of Medical Sciences, Sirjan, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda","family":"Dastyar","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, Jiroft University of Medical Sciences, Jiroft, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"2026091507003989000_16.9.e122558.1","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.ccc.2019.06.007","article-title":"Augmenting Critical Care Capacity in a Disaster","volume":"35","author":"Seda","year":"2019","journal-title":"Crit Care Clin"},{"key":"2026091507003989000_16.9.e122558.2","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1017\/S1049023X22001212","article-title":"Establishing the Domains of a Hospital Disaster Preparedness Evaluation Tool: A Systematic Review","volume":"37","author":"Munasinghe","year":"2022","journal-title":"Prehosp Disaster Med"},{"key":"2026091507003989000_16.9.e122558.3","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1017\/dmp.2020.434","article-title":"Hospital Preparedness Challenges in Biological Disasters: A Qualitative Study","volume":"16","author":"Aminizadeh","year":"2022","journal-title":"Disaster Med Public Health Prep"},{"key":"2026091507003989000_16.9.e122558.4","unstructured":"World Health Organization . 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