Efficiently assembling hospital staff during a large-scale disaster is necessary to prevent hospital dysfunction. Confirming the willingness of employees to assemble and participate is crucial for formulating a viable business continuity plan (BCP). This study investigated the factors associated with hospital staff’s willingness to participate in hospital work during a large-scale disaster. In 2023, a survey was conducted with the staff of Hospital A (n=905; response rate 58.6%), located in a high-risk earthquake zone. Questionnaire items included participant characteristics, willingness to participate in the event of a disaster, reasons for low willingness, and anxiety levels regarding continued work during a hospital disaster. Logistic regression models were used to evaluate the associated factors. Among the participants, 331 (36.6%) reported high willingness to participate in hospital work in the event of a disaster. Factors associated with low willingness included childcare or elderly care responsibilities, lack of financial guarantees, and higher anxiety levels regarding disaster work. Conversely, full-time employment and a commute time of less than 30 minutes were factors associated with higher willingness. These findings confirm the low willingness of hospital staff to participate in disaster work immediately after a disaster. Welfare benefits addressing childcare and elderly care, financial security, and clarification of roles and working hours can increase staff willingness to participate during a disaster. Hospital managers need to develop appropriate BCPs to ensure the availability of hospital staff for disaster management.

1. [1] The Centre for Research on the Epidemiology of Disasters (CRED), “Human cost of disasters: An overview of the last 20 years 2000–2019,” 2020. https://www.preventionweb.net/files/74124_humancostofdisasters20002019reportu.pdf?startDownload=true [Accessed July 30, 2024]
2. [2] E. Sternberg, “Planning for resilience in hospital internal disaster,” Prehosp. Disaster Med., Vol.18, No.4, pp. 291-299, 2003. https://doi.org/10.1017/s1049023x00001230
3. [3] World Health Organization, “Hospital safety index: Guide for evaluators,” 2nd ed., 2015. https://www.who.int/publications/i/item/9789241548984 [Accessed July 30, 2024]
4. [4] Initial Response Verification Team for the 2016 Kumamoto Earthquake, “The 2016 Kumamoto earthquake initial response verification report,” 2016 (in Japanese). https://www.bousai.go.jp/updates/h280414jishin/h28kumamoto/pdf/h280720shodo.pdf [Accessed July 30, 2024]
5. [5] Y. Yasufumi, N. Susumu, and O. Masahiro, “Current status and problems of business continuity of medical institutions in the 2016 Kumamoto earthquakes,” J. of Japan Society of Civil Engineers (JSCE), Vol.73, No.2, pp. I_207-I_212, 2017 (in Japanese).
6. [6] J. R. Gowing et al., “Disaster preparedness among health professionals and support staff: What is effective? An integrative literature review,” Prehosp. Disaster Med., Vol.32, No.3, pp. 321-328, 2017. https://doi.org/10.1017/S1049023X1700019X
7. [7] R. V. Burke et al., “Factors associated with willingness to respond to a disaster: A study of healthcare workers in a tertiary setting,” Prehosp. Disaster Med., Vol.26, No.4, pp. 244-250, 2011. https://doi.org/10.1017/S1049023X11006492
8. [8] W. Al-Hunaishi, V. C. Hoe, and K. Chinna, “Factors associated with healthcare workers’ willingness to participate in disasters: A cross-sectional study in Sana’a, Yemen,” BMJ Open, Vol.9, No.10, Article No.e030547, 2019. https://doi.org/10.1136/bmjopen-2019-030547
9. [9] H. Nafar et al., “A systematic mapping review of factors associated with willingness to work under emergency condition,” Hum. Resour. Health., Vol.19, No.1, Article No.76, 2021. https://doi.org/10.1186/s12960-021-00622-y
10. [10] R. G. Baskin and R. Bartlett, “Healthcare worker resilience during the COVID-19 pandemic: An integrative review,” J. Nurs. Manag., Vol.29, No.8, pp. 2329-2342, 2021. https://doi.org/10.1111/jonm.13395
11. [11] S. Ghahramani et al., “A systematic review and meta-analysis of burnout among healthcare workers during COVID-19,” Front Psychiatry, Vol.12, Article No.758849, 2021. https://doi.org/10.3389/fpsyt.2021.758849
12. [12] B. Martin et al., “Examining the impact of the COVID-19 pandemic on burnout and stress among U.S. nurses,” J. Nurs. Regul., Vol.14, No.1, pp. 4-12, 2023. https://doi.org/10.1016/S2155-8256(23)00063-7
13. [13] P. Galanis, I. Vraka, D. Fragkou et al., “Nurses’ burnout and associated risk factors during the COVID-19 pandemic: A systematic review and meta-analysis,” J. Adv. Nurs., Vol.77, No.8, pp. 3286-3302, 2021. https://doi.org/10.1111/jan.14839
14. [14] K. Hayami, N. Akiyama, E. Murakami, and M. Yamada, “Questionnaire survey on the possibility of Hospital A staff assembling in case of a disaster due to the revision of the Business Continuity Plan (BCP),” Jpn. J. Disaster Med., Vol.29, No.3, pp. 204-212, 2024. https://doi.org/10.51028/jjdisatmed.29.3_204
15. [15] K. Kinoshita, M. Ishii, and K. Uchiumi, “Survey on the work performed by administrative staff at disaster-based hospitals at the time of the Great East Japan Earthquake,” Jpn. J. Disaster Med., Vol.29, No.2, pp. 95-103, 2024 (in Japanese). https://doi.org/10.51028/jjdisatmed.29.2_95
16. [16] M.A.S. Sultan, J. Løwe Sørensen, E. Carlström, L. Mortelmans, and A. Khorram-Manesh, “Emergency healthcare providers’ perceptions of preparedness and willingness to work during disasters and public health emergencies,” Healthcare (Basel), Vol.8, No.4, Article No.442, 2020. https://doi.org/10.3390/healthcare8040442
17. [17] M. Z. Haroon, I. H. Thaver, and M. I. Marwat, “Are the healthcare providers willing and able to respond to disasters: An assessment of tertiary health care system of Khyber Pakhtunkhwa,” PLoS One, Vol.18, No.11, Article No.e0293720, 2023. https://doi.org/10.1371/journal.pone.0293720
18. [18] M. Harada and T. Takahashi, “About Kumamoto Earthquake,” IRYO, Vol.74, No.4, pp. 203-205, 2017 (in Japanese).
19. [19] G. Santinha, T. Forte, and A. Gomes, “Willingness to work during public health emergencies: A systematic literature review,” Healthcare (Basel), Vol.10, No.8, Article No.1500, 2022. https://doi.org/10.3390/healthcare10081500
20. [20] Kumamoto Red Cross Hospital, “Kumamoto earthquake 2016 activity record of Kumamoto Red Cross Hospital: Lessons from the great earthquake and recommendations for the future,” 2017 (in Japanese).
21. [21] Japan Health Enterprise Foundation, “Summary of results of FY 2021 survey of medical-related services,” 2022. https://ikss.net/about/research_list/20220406-2/ [Accessed July 30, 2024]
22. [22] M. Ozaki and K. Shimazaki, “Change in disaster-prevention consciousness brought by serious damage from a large-scale disaster: Studying the Kumamoto earthquake in 2016,” J. Disaster Res., Vol.13, No.1, pp. 199-204, 2018. https://doi.org/10.20965/jdr.2018.p0199
23. [23] H. J. Boon, “Disaster resilience in a flood-impacted rural Australian town,” Nat. Hazards, Vol.71, No.1, pp. 683-701, 2013. https://doi.org/10.1007/s11069-013-0935-0