Integrating Inter-Professional Insights for Enhanced Disaster Response: A Cross-Sectional Analysis in Jubail’s Royal Commission Hospital, Saudi Arabia

Introduction

Disasters present significant challenges to the community’s ability to function, often exceeding its capacity to manage without external assistance. They can be caused by natural, man-made, or technological hazards. Factors such as climate change, population displacement, armed conflicts, rapid and unplanned urbanization, technological risks, and public health emergencies are expected to increase the frequency and severity of their impacts.¹ The International Federation of Red Cross Society (IFRCS) defines disasters as any unanticipated events that cause a society to become dysfunctional, resulting in extreme economic, infrastructural, and human losses to the point where society is unable to handle the negative effects.²

The frequency of natural disasters has significantly increased over the past few decades, with a discernible increase of about 80% observed between 1980 and 2009.³ Nearly 7000 natural disasters were recorded by the Emergency Events Database (EED) between 1994 and 2013, claiming 1.35 million lives and affecting hundreds of millions more. Nearly 8000 people perished in the years that followed as a result of various natural disasters.⁴ Understanding the spatiotemporal pattern of historical earthquake disasters and the resultant socioeconomic consequences is essential for designing effective disaster risk reduction measures.⁵

More than 80% of natural disaster events in the last century occurred in the Middle East and North Africa, concentrated in just nine countries: Afghanistan, Pakistan, Iran, Sudan, Somalia, Algeria, Morocco, Yemen, and Egypt. Hydrological disasters (flooding and landslides) accounted for 63% of all disasters in 2015, surpassing the previous century.⁶ This dramatic increase highlights the urgency of addressing disaster preparedness, particularly in regions prone to such events, and underscores the importance of our study focused on Jubail, Saudi Arabia.

Jubail Industrial City in the Eastern province on the Arabian Gulf coast of Saudi Arabia is home to the largest industrial city in the world, with a total population of 684,531 as of 2021.⁷ It also houses the Middle East’s largest and the world’s fourth-largest petrochemical company, SABIC.⁷ The city’s advanced industrial infrastructure, high population density, and strategic economic importance make it vulnerable to various disaster risks, including industrial accidents, chemical spills, and potential natural disasters. These factors necessitate a thorough assessment of disaster preparedness in the region.

Inter-professional collaborative practice involves effective communication and decision-making, enabling a seamless blend of knowledge and skills from different professionals. Essential factors for effective teamwork include recognizing the significance of individual roles within the team, maintaining open communication, fostering autonomy, and ensuring equal access to resources.⁸ Conversely, poor inter-professional collaboration can adversely affect disaster management efforts. Ensuring that all employees are familiar with the organization’s disaster management plan is crucial. Healthcare facilities are obligated to conduct regular fire and disaster drills to allow staff to practice emergency skills.^9,10

Several studies have focused solely on healthcare providers’ preparedness for disasters, excluding other professional groups such as administration and engineering. For instance, a 2022 study in the United Arab Emirates found that health professionals had moderate levels of knowledge, positive attitudes, and high readiness to engage in disaster management.¹¹ Similarly, a 2018 study in Riyadh, Saudi Arabia, assessed the knowledge, practices, and attitudes regarding disaster and emergency preparedness among Emergency Department (ED) staff, revealing satisfactory levels of knowledge but neutral attitudes and practices.¹² Another 2022 study aimed to assess disaster preparedness among Saudi Red Crescent Authority (SRCA) medical staff and found a lack of available drills.¹³ A study conducted in the Eastern region of Saudi Arabia concluded that most hospitals had sufficient resources for disaster management; however, the overall effectiveness of hospitals’ disaster preparedness was slight to moderate.^14,15

Given the significant industrial and economic role of Jubail, there is an urgent need to ascertain the level of preparedness for disasters that could occur without warning. Identifying the degree of hospitals’ preparedness in this region can be used to develop effective strategies for managing potential catastrophes. The Royal Commission Jubail (RCJ) is a government agency in Saudi Arabia responsible for the planning, development, and management of Jubail Industrial City.¹⁶ It plays a pivotal role in transforming Jubail into one of the world’s largest and most advanced industrial cities, attracting investments, promoting industries, and driving economic diversification efforts in the region.

Understanding the inter-professional preparedness of the staff at the Royal Commission Hospital (RCH) in Jubail is critical for enhancing the hospital’s disaster response capabilities. This study aims to evaluate inter-professional disaster preparedness and management at RCH in Jubail, Saudi Arabia. By investigating the preparedness levels across different professional groups, this study aims to provide comprehensive insights into the effectiveness of current disaster management strategies and identify areas for improvement, ultimately contributing to the safety and resilience of Jubail and similar urban-industrial environments.

Materials and Methods

Study Design and Sample

This cross-sectional descriptive study was conducted at the Royal Commission Hospital (RCH) in Jubail, a secondary care facility with a capacity of 206 beds. Since its opening in February 1989, RCH has provided inpatient, outpatient, and emergency services to a diverse population including Royal Commission employees and their families, individuals from Jubail Industrial City, referrals from primary healthcare centers, SABIC company employees and families, and self-paying patients.¹⁷ The study sample comprised a broad spectrum of hospital staff encompassing healthcare providers in both patient-facing and non-patient-facing roles as well as non-medical personnel. Healthcare providers included doctors, nurses, pharmacists, laboratory technicians, paramedics, and radiology technicians, while non-medical staff included administrative workers, engineers, housekeepers, and security officers. The total sample size was 521 candidates, with healthcare providers constituting 312 (59.9%) and non-healthcare providers 209 (40.1%).

Data Collection and Analysis Plan

Plan Survey Instrument

The survey instrument was adapted from the World Health Organization (WHO) National Health Sector Emergency Preparedness and Response Tool.^18,19 This comprehensive tool consisted of 22 questions spread across seven sections: emergency response plan, meaning of disaster, command and control, communication, safety and security, triage, and infection control. The questionnaire was designed to assess the awareness and preparedness levels of the hospital staff.

Questionnaire Validity

To ensure the validity of the questionnaire, it was reviewed by a panel of experts in emergency management and healthcare administration. The Cronbach’s alpha value for the questionnaire was 0.87, indicating high reliability. The questionnaire was administered in English, the primary language used for professional communication in the hospital.

Data Collection Procedure

Data were collected through an online survey platform, and responses were automatically recorded in Google Sheets for subsequent retrieval and analysis. Participants were assured of confidentiality and were briefed about the study’s objectives and their role in it. The survey ensured that participants could not skip any questions, thus minimizing missing data.

Statistical Analysis

Data were analyzed using IBM SPSS software version 23. Descriptive statistics such as frequencies and percentages were employed for qualitative data. The Chi-square test was used to evaluate the significance of associations between categorical variables. Significance was set at the 5% level, and two-tailed probabilities were reported for all tests. Visual aids like charts and figures were created to facilitate data interpretation and comparison.

Ethical Considerations

The study was approved by the Institutional Review Board (IRB) of King Saud University Research and Ethics Committee (Ref No: KSU-HE-23-044). Informed consent was obtained from all participants, and the survey included information about the study’s purpose, the voluntary nature of participation, and the strict confidentiality of the data collected.

Results

Demographic Characteristics of the Participants

The study included 521 participants, comprising 312 healthcare providers (59.9%) and 209 non-healthcare providers (40.1%). The gender distribution showed a slightly higher representation of females (54.1%) compared to males (45.9%). The predominant age groups were 31–35 years (38.0%) and 36–40 years (32.8%), indicating that the majority of participants were in the midst of their professional careers. Most participants had 5–10 years of experience (44.0%), providing a range of perspectives from relatively new to highly experienced professionals (Table 1).

Table 1 General Characteristics of the Participants (n=521)

Awareness and Preparedness Levels

The Results revealed notable disparities in awareness and preparedness between healthcare and non-healthcare providers. A significantly higher proportion of healthcare providers (76.9%) were aware of the hospital’s emergency response plan compared to 56.2% of non-healthcare providers (χ² = 52.165, p < 0.001). Similarly, 86.5% of healthcare providers understood the meaning of disaster, compared to 54.1% of non-healthcare providers (χ² = 27.931, p < 0.001). Awareness of the command center for incident meetings was more common among healthcare providers (73.4%) than non-healthcare providers (45.2%) (χ² = 42.934, p < 0.001). Additionally, healthcare providers showed higher awareness of job description sheets listing the duties of hospital employees (90.1% vs 72.7%, χ² = 26.927, p < 0.001) (Table 2).

Table 2 Comparison Among Qualifications Groups According to the Awareness Regarding Emergency Response Plan, Meaning of Disaster and Command and Control

Communication Protocols

Regarding communication protocols, 76.9% of healthcare providers were aware of a designated place for setting up press conferences during events, compared to 56.2% of non-healthcare providers (χ² = 54.304, p < 0.001). A notable majority (86.5%) of healthcare providers were aware of communication protocols with other hospitals for patient transportation when beds were unavailable, while only 54.1% of non-healthcare providers were aware of this (χ² = 67.825, p < 0.001). Awareness of the code blue team for rapid response was significantly higher among healthcare providers (93.9%) compared to non-healthcare providers (82.8%) (χ² = 16.599, p < 0.001). Most healthcare providers (89.1%) were aware of communication systems within or outside the hospital, compared to 63.2% of non-healthcare providers (χ² = 50.440, p < 0.001) (Table 3).

Table 3 Comparison Among Qualifications Groups According to the Awareness About Communication

Safety and Security Protocols

The capability to handle chemical incidents was recognized by 79.2% of healthcare providers compared to 58.9% of non-healthcare providers (χ² = 48.883, p < 0.001). Awareness of areas for radioactive, biological, and chemical decontamination was higher among healthcare providers (70.5%) than non-healthcare providers (42.1%) (χ² = 48.393, p < 0.001). Awareness of guidance signs at the entrance of the emergency department was reported by 83.3% of healthcare providers and 55.5% of non-healthcare providers (χ² = 50.188, p < 0.001) (Table 4).

Table 4 Comparison Among Qualifications Groups According to the Awareness About Safety and Security

Triage Procedures

Awareness of the triage area at the emergency department entrance was significantly higher among healthcare providers (87.2%) compared to non-healthcare providers (58.9%) (χ² = 80.222, p < 0.001). Similarly, healthcare providers were more aware of clearly identified entrance and exit routes (90.1% vs 66.0%, χ² = 46.105, p < 0.001). Awareness of the trauma resuscitation room was also higher among healthcare providers (82.1%) compared to non-healthcare providers (51.7%) (χ² = 56.250, p < 0.001). Awareness of a designated area for separated exposure and suturing wounds was 77.9% among healthcare providers, compared to 44.5% among non-healthcare providers (χ² = 63.287, p < 0.001). Awareness of a designated burn unit was 50.6% among healthcare providers and 34.4% among non-healthcare providers (χ² = 53.873, p < 0.001) (Table 5).

Table 5 Comparison Among Qualifications Groups According to the Awareness About Triage

Infection Control

Awareness of infection control concepts was significantly higher among healthcare providers (93.6%) compared to non-healthcare providers (82.2%) (χ² = 35.875, p < 0.001). Most healthcare providers (91.7%) were aware of the hospital’s infection control program, compared to 61.2% of non-healthcare providers (χ² = 71.039, p < 0.001). Awareness of infection control training for staff was reported by 91.3% of healthcare providers and 58.9% of non-healthcare providers (χ² = 79.572, p < 0.001) (Table 6).

Table 6 Comparison Among Qualifications Groups According to the Awareness About Infection Control

Discussion

This study aimed to evaluate disaster preparedness and management among an inter-professional team at the Royal Commission Hospital (RCH) in Jubail, Saudi Arabia. The findings revealed a stark contrast in awareness levels regarding emergency response plans, disaster management, and infection control between healthcare and non-healthcare providers. These disparities underscore a critical gap in the preparedness and knowledge framework within healthcare settings. The heightened awareness among healthcare providers is a positive sign, reflecting their direct involvement in patient care and emergency protocols. However, the significantly lower awareness among non-healthcare providers, who play equally pivotal roles in managing hospital operations during disasters, points to a significant shortfall in comprehensive emergency preparedness. This gap hampers effective interdepartmental coordination during emergencies and potentially compromises patient safety and overall hospital responsiveness.^20,21

Furthermore, our findings show a notable difference in understanding the concept of disaster itself. Healthcare providers, being at the forefront, are more attuned to the implications and complexities of disasters.²² This disparity might be attributed to the focused training and regular exposure healthcare providers receive, which is often lacking for non-healthcare staff. Bridging this knowledge gap is essential, as every member of the hospital team plays a vital role in disaster response, from logistics and communication to direct patient care.²³

Regarding infection control, while healthcare providers demonstrate a commendable level of awareness, the relatively lower awareness among non-healthcare staff is a concern. Infection control is a critical component of hospital safety, and its importance transcends professional boundaries within a healthcare environment.²⁴ A holistic approach to training and education about infection control protocols is necessary to foster a culture of safety that permeates all levels of the hospital staff.²⁵

To address these challenges, healthcare facilities must adopt a multifaceted approach. This approach should include regular and comprehensive training programs that are tailored to the specific roles and responsibilities of both healthcare and non-healthcare staff. Furthermore, fostering an environment of open communication and regular drills can significantly enhance the understanding and preparedness of all staff members.²⁶ Additionally, employing innovative methods such as simulation training and interactive workshops could further reinforce disaster preparedness and infection control measures.²⁷

The implications of this varied level of awareness extend beyond the immediate response to disasters. In hospitals, where efficient coordination and quick decision-making are crucial, these gaps can lead to delays in response, miscommunication, and ultimately, suboptimal patient care.²⁸ Particularly in scenarios like chemical incidents or infectious disease outbreaks, where non-healthcare staff roles are critical in areas such as logistics, sanitation, and crowd management, their preparedness can greatly influence the overall effectiveness of the hospital’s response.²⁹ Thus, ensuring a uniformly high level of awareness and preparedness across all staff categories becomes imperative for maintaining operational efficiency and patient safety.

Recognizing the essential role of non-healthcare providers in disaster scenarios, hospitals should implement targeted educational initiatives. These programs should be designed to address the specific knowledge gaps identified in our study, ensuring that all staff are familiar with emergency protocols and infection control measures.³⁰ Regular involvement of non-healthcare staff in disaster drills and simulations can provide practical experience and build confidence in handling real-world scenarios. Additionally, creating a platform for inter-professional dialogue and learning can promote a deeper understanding of each role’s importance in disaster management, fostering a collaborative and well-coordinated response system.³¹

Beyond individual training programs, there is a need for systemic changes in the way hospitals approach disaster preparedness and infection control. This involves integrating these key areas into the core values and operational strategies of healthcare facilities.³² By embedding disaster preparedness and infection control into the organizational culture, hospitals can ensure a consistent and proactive approach to these critical issues. Leadership at all levels must champion this cultural shift, emphasizing the importance of preparedness across all departments and roles.³³

Furthermore, the integration of technology and data-driven insights can play a pivotal role in enhancing disaster preparedness. The use of advanced analytics to monitor and predict potential disaster scenarios, coupled with technology-driven training modules, can significantly augment the preparedness levels of all staff.³⁴ Leveraging these technologies not only streamlines the training process but also provides real-time data and situational awareness, which are crucial during actual disaster events.³⁵

In addition, there is a critical need for regular policy reviews and updates in line with evolving disaster scenarios and infection control challenges.³⁶ Policies should be dynamic and adaptable, allowing for quick modifications in response to emerging threats and new evidence-based practices.^37,38 Engaging a wide range of stakeholders, including healthcare and non-healthcare staff, in policy formulation and review processes can ensure that these policies are comprehensive and relevant to the needs of all involved.^39,40

In summary, our study highlights the pressing need for an integrated and inclusive approach to disaster preparedness and infection control in healthcare settings. While healthcare providers show commendable awareness, the focus must now shift to elevating the understanding and preparedness of non-healthcare staff. By doing so, hospitals can ensure a more robust, cohesive, and efficient response to emergencies, significantly improving patient care and staff safety.

Limitations

While the study offers valuable insights into the comprehension of emergency response plans, disaster management, and infection control among healthcare professionals, several Limitations must be acknowledged. Firstly, the composition of the study’s sample might not fully represent the diverse spectrum of professionals spanning different domains, both within healthcare and beyond. A broader and more diverse sample could provide a more comprehensive understanding of the levels of awareness across various roles and departments.

The reliance on self-reported feedback presents another limitation, as it could be susceptible to social desirability bias. Respondents might tailor their answers to align with perceived expectations, potentially diverging from their authentic awareness levels. This aspect might particularly influence the responses of non-healthcare staff, who could feel pressured to demonstrate a higher level of awareness than they actually possess.

Additionally, the study faces the potential issue of selection bias. Those professionals who opted to participate might inherently exhibit a keener interest or greater awareness of emergency response plans, disaster management, and infection control compared to those who did not participate. This could lead to an overestimation of the overall awareness levels within the hospital setting.

Another limitation is the cross-sectional nature of the study, which provides a snapshot at a single point in time. This approach limits the ability to assess changes in awareness or the impact of any interventions over time. Longitudinal studies could offer more insight into the dynamics of awareness and preparedness among hospital staff.

Furthermore, the study did not explore the depth of understanding or the practical application of knowledge regarding emergency response and infection control measures. The assessment of awareness levels did not include evaluations of how this knowledge translates into actual behavior or practice in emergency situations.

Lastly, the geographical and institutional context of the study may limit the generalizability of the findings. The specific characteristics of the healthcare setting in Jubail, Saudi Arabia, might not be applicable to hospitals with different operational structures, resources, or cultural backgrounds.

In light of these limitations, future research should aim to incorporate a more diverse participant pool, adopt longitudinal designs, and include practical assessments of knowledge application in real-world scenarios. Additionally, expanding the research to various geographical and institutional contexts would enhance the generalizability of the findings.

Recommendations

Based on the findings of our study, several key Recommendations emerge to enhance emergency preparedness and response effectiveness. Firstly, it is crucial to develop and implement comprehensive training programs targeted specifically at non-healthcare professionals. These programs should bridge the observed knowledge gap by focusing on emergency response plans and the unique roles non-healthcare staff play during crises. Training initiatives should be thorough, regular, and tailored to the specific needs of non-healthcare staff.

Fostering collaboration between healthcare providers and non-healthcare professionals is essential. This can be achieved through cross-disciplinary knowledge exchange and joint emergency drills, promoting a holistic approach to disaster preparedness, enhancing overall facility readiness.

Ongoing education and professional development are vital for all staff. Continuous learning opportunities should update knowledge, address new challenges, and maintain awareness of evolving strategies and protocols. Topics should include the latest developments in disaster management, innovative response techniques, and emerging global health threats.

Enhancing communication skills is particularly crucial for scenarios such as press conference setups during emergencies. Specialized training in communication techniques will significantly improve coordination and information dissemination during crises.

Incorporating simulation exercises is another critical recommendation. These exercises, mirroring real-world emergency scenarios, allow professionals to practice and refine their roles and responsibilities within emergency response frameworks. Simulations provide a practical and engaging way to enhance understanding and readiness, preparing staff for real-life situations.

These recommendations converge on a central goal: to build and sustain a culture of preparedness within healthcare organizations. This involves an integrated approach, combining training, policy development, regular reviews, and an emphasis on emergency preparedness at an institutional level. A well-prepared, informed, and cohesive workforce, inclusive of both healthcare and non-healthcare professionals, is fundamental to managing emergencies effectively, ensuring the safety and welfare of both patients and staff.

Conclusions

The findings of our study reveal a substantial disparity in awareness and preparedness levels for emergency response and disaster management between healthcare and non-healthcare providers. Healthcare providers generally demonstrated higher awareness levels, reflecting their direct involvement in patient care and emergency protocols. In contrast, non-healthcare providers exhibited significantly lower awareness, highlighting the need for targeted training and comprehensive preparedness programs. Addressing these gaps is essential for maintaining operational efficiency and ensuring patient safety during emergencies. By implementing the recommended strategies, healthcare facilities can significantly improve their emergency response capabilities and overall preparedness.