DISASTER PLANNING


values, to reduce the spontaneity and subjectivity of those evaluated aspects. Musso and Rittel (1967), as well as, Guevara (1986), clearly explain this. Because most performance sub-aspects cannot be measured in numerals, in order to make evaluator’s judgment sufficiently explicit and communicable, this instrument should help to clearly express the base for the assignment of each scoring scale. The aggregation of the best values accomplished for each aspect becomes the best possible solution and therefore the desired model of the object, to perform in a specific context, according to pre-established criteria. Presentation of scores and final reports,


explaining the results and scoring is finally done. Then the decision makers can decide. There should be a clear explanation about who and how the final decisions will be taken. For example, if solutions considered from ‘fair’ and above it, are the ones to obtain the Idoneity Certificate; then, for those hospitals whose scores are below, there should be clear definitions about what improvements could be recommended, and/or when some improvement could be recommended and by whom, or when there should be a definitive requirement of going into further evaluation. The gathered data should be


systematically stored in a computerised information system and processed during the different phases of the process.


Conclusions and recommendations • The massive emergency produced by an earthquake implies a great number of victims and an enormous variety of injuries so deserves a special functional architectural scheme that facilitates an efficient service.


• Usually a functional collapse in a hospital occurs when the facility is unable to attend this sudden-onset extraordinary massive emergency. However, hospitals cannot maintain idle spaces to accommodate the ideal essential and supporting services for use in the event that an extraordinary situation does occur.


• Hospitals have to be prepared to face the type of massive emergencies caused by a sudden overload of victims affected by a great diversity of injuries. There should be a scheme of transformation of the regular functional architectural scheme of the facility, into a safe facility for the attention of an extraordinary emergency.


• The available essential local medical services should be able to not only resist the effects of an earthquake but also to efficiently keep all its full subsystems working to ensure a regular service and to be rapidly adapted to provide the required services for an extraordinary massive emergency.


• The majority of hospitals that were built during the 20th


design patterns used in Britain, Scandinavian countries and the eastern


IFHE DIGEST 2013 century, have followed the


states of USA, which did not include considerations for an extraordinary number of victims after an earthquake occurs.


• Traditional medical-architectural guidelines recommend the location of the ICU, Obstetric Unit and SU in the highest floors of the hospital, far from public areas, in order to guarantee privacy. In seismic regions it is recommended that these units are relocated in lower floors and, if possible, in an independent low building or platform, in order to either facilitate the evacuation process or to keep these services operative in case of earthquake while the safety of the rest of the building or complex is evaluated. It is necessary to carefully study the new use assigned to those spaces left in the upper floors where relocated essential services were.


• Relationship between essential services (ES) and supporting services (SS) should follow a special scheme. Budget for relocation of ES and the corresponding SS has to be carefully studied as these spaces require special installations and equipment.


Final remarks This evaluation method clarifies the relationships between the aspects that intervene in the vulnerability of a hospital’s design variables and to separate these from those aspects related with the seismic hazard (context variables). The first can be modified in order to reduce the vulnerability of the hospital, however, the latter are fixed and cannot be modified. However, they need to be clearly identified for the accurate estimation of the performance of the different hospitals’ aspects (performance variables) in order to mitigate the risk of not being able to assist the emergency. It is equally useful for both the post-


occupancy evaluation of existing hospitals, and the design plan evaluation during and at the end of the design process of new hospitals. The information gathered will assist official agencies in formulating codes and recommendations applicable in the new hospitals designs.





References • Guevara LT. (2003). Functionality of the architectural program in the remodelling of existing hospitals in seismic zones of Venezuela. Proceedings of the EGS – AGU – EUG Joint Assembly, Poster EAE03-A-14614. April 6-11, 2003, Nice, France. • Guevara LT. (1997). Evaluación preliminar de la


respuesta ante el sismo del 09-07-97 del Hospital Antonio Patricio de Alcalá, Cumaná, Edo. Sucre, Venezuela: Los aspectos arquitectónico-funcionales del Departamento de Emergencia y Medicina Crítica. Rapid Screening Report for the Pan American Health Organization (PAHO/WHO).Caracas.


• Guevara LT et al (1996). Non-structural Seismic Vulnerability Evaluation Method for Health-Care Facilities in Venezuela. Proceedings Eleventh World Conference on Earthquake Engineering, Paper No. 1251. Acapulco, Mexico.


• Guevara P., L. Teresa (1997). Evaluación de la funcionalidad de los espacios para la atención de emergencias por terremotos in Cardona O., Rosales V, Guevara LT: Análisis de vulnerabilidad sísmica del hospital Ramón González Valencia de Bucaramanga. Ministerio de Salud, Bogotá, Colombia.


• Guevara P., LT and Jones-Parra B. (1995-1996). Technical Report: Método para la evaluación cualitativa de la vulnerabilidad sísmica de los aspectos no estructurales en las edifcaciones médico asistenciales en zonas urbanas de Venezuela, Proyecto demostrativo: Distrito Médico de Caracas, parroquias La Candelaria, San Bernardino y San José del municipio Libertador, Caracas. Coordinación de Investigación, Facultad de Arquitectura y Urbanismo, Universidad Central de Venezuela, Caracas.


• Mora J and Mosquera Y. (2005). Mitigación de la vulnerabilidad funcional de los establecimientos de salud ante el riesgo de emergencia masiva por sismo: estudio de caso Hospital Central Universitario Dr. José María Vargas,Tachira.


• Musso A and Rittel H. (1967). Measuring the performance of buildings: Report about a pilot study, S-82-1. St. Louis, Missouri, Washington University.


• Pan American Health Organization, PAHO/WHO (1996). Recommendations. Proceedings International Conference on Disaster Mitigation in Health Facilities. Washington, D. C.


• Pan American Health Organization (1993). Volume 3: Architectural Issues. Series Mitigation of Disasters In Health Facilities: Evaluation and Reduction of Physical and Functional Vulnerability. Pan American Health Organization (PAHO/WHO). Washington D. C.


• Rittel, Horst, Henry Sanoff y Robert Fessenden (1966). Evaluative methods to measure the performance of buildings. Berkeley, California: Department of Architecture, College of Environmental Design, University of California at Berkeley, DA-CED-UC.


• Rittel, Horst (1972). On the Planning Crisis: System Analysis of the First and Second Generations. Bedriftsokonmen No. 8-1972.


• Rittel, Horst (1973). Some principles for the Design of an Educational System for Design DMG-DRS Journal: Design Research and Methods; Vol. 7 No. 2, Apr-Jun 1973.


‘This evaluation method clarifies the relationships between the aspects that intervene in the vulnerability of a hospital’s design variables and to separate these from those aspects related with the seismic hazard.’


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