Business continuity management framework for hospitals based on system dynamics analysis

Hospital facilities are critical infrastructures for disaster response that required 24-hours continuous operation to fully respond to community needs. However, it is demonstrated that the capacity of many general hospitals during unpredicted disasters has been compromised to the structural damage of building facilities and interference of non-structural functions itself. Hence the aim is to enhance hospital disaster preparedness and facility adaptation to deal with these heightened incidences. The purpose of this thesis is to develop a business management framework for hospitals to maintain functionality in the aftermath of a major disaster. To achieve this aim, research were conducted within constructionist ontology and interpretivist epistemology, underpinned by quantitative methods capturing multiple realities embedded in hospital stakeholders’ experiences. The research adopts a system dynamics model to form causal interdependencies between hospital functional continuity factors in three dimensions. These factors are mainly derived from hospital safety assessment guide by World Health Organization so to define business continuity conditions in a complex hospital system. System dynamics using Vensim PLE software is applied to a Shanghai hospital case study to evaluate and verify its functional continuity subsystem performance by giving functional continuity factors simulation functions. Through simulation results, critical factors which affect hospital continuous operational level are identified. Based on this, business continuity framework is proposed; pre-event risk mitigation to reduce the effects of the disaster on facility, during-event emergency response plan to organize efficient evacuation and backup resource, and post-event recovery service to completely recover all the facility functions.