Table 1
Summary of the core components of the Smart Hospital Initiative.
| PROJECT PHASE | COMPONENT | SPECIFIC ACTIVITIES | TIMELINE |
|---|---|---|---|
| 1 | Assessments | HSI status for safety, development of Green Checklist to establish the level of greening | 2009/2014 Pre‑ and post‑ retrofitting |
| 1 | Retrofitting | Design and construction of improvements to infrastructure | 2009–2014 |
| 2 | Assessments | HSI and Green Checklist for status in terms of safety and greenness | 2015–2017 depending on country |
| 2 | Site selection | Cost‑effectiveness analysis study of proposed retrofits based on the contribution of safety and greening works | 2016–2017 depending on country |
| 2 | Training | Preparatory training for constructors and for staff to enhance familiarity with new systems; emergency planning skills | 2016–2018 |
| 2 | Retrofitting | Design, tendering and construction | 2017–2023, interrupted by Hurricane Maria and COVID‑19 |
| 2 | Training | Focus on maintenance and care of installations | 2019–2022 |
| 2 | Surveys and evaluation | Impact of the project | 2020–2023 |
| 2 | Outreach | Sharing of best practices | 2022 onwards |
Table 2
Summary of population data for the selected countries.
| COUNTRY | NUMBER OF FACILITIES THAT BENEFITTED | CURRENT COUNTRY POPULATION (2022) | CATCHMENT POPULATION FOR SMART HOSPITAL PROJECT |
|---|---|---|---|
| Belize | 6 | 405,273 | 88,600 |
| Dominica | 7 | 72,734 | 27,355 |
| Grenada | 5 | 125,433 | 105,897 |
| St. Vincent and Grenadines | 8 | 103,955 | 39,010 |
| Guyana | 5 | 808,728 | 117,798 |
| Jamaica | 14 | 2.8 million | 307,729 |
| St. Lucia | 16 | 179,861 | 57,763 |
Table 3
Summary of the Smart Hospital HSI data.
| HSI CONSTRUCT | HSI AREA OF ASSESSMENT | QUESTION NUMBERS | DETAILS COVERED | DETAILS NOT INCLUDED |
|---|---|---|---|---|
| Non‑structural | Alternative sources of electricity | 15, 16 | Condition, safety, capacity available | Maintenance, restoration after emergency |
| Non‑structural | Alternative source of water and water reserves | 24, 26 | Condition, capacity available. Storage of mains supply and other non‑potable sources | Location/safety of placement, maintenance, restoration after emergency |
| Non‑structural | Solid waste disposal systems | 35 | Hazardous and non‑hazardous waste systems’ capacity, compliance with regulations and maintenance | |
| Non‑structural | Lab and medical equipment | 45 | Condition, capacity, and range of equipment that are operational | Maintenance and restoration after an emergency |
| Non‑structural | Fire protection system | 56 | Reinstatement after emergency | Details of the fire safety equipment |
| Non‑structural | Access and evacuation routes | 57, 58, 59, 60 | Access and exit routes free of obstacles and signposted | |
| Functional | Documented disaster plans; emergency drills | 67, 69, 86, 87 | Specified actions to be taken, including provision for high‑level hazards | |
| Functional | Emergency protocols | 74 | Admittance and treatment of patients | |
| Functional | Communication with the media and the public | 80 | Responsibilities | |
| Functional | Supplies for use during an emergency | 88, 89, 90 | Medication, instruments, sterilized equipment, life support equipment | Basic supplies for staff, e.g. food, toilet articles |
| Functional | Intra‑hospital epidemiologic surveillance | 92 |
Table 4
Summary of HSI Scoring System.
| SAFETY INDEX | CATEGORY | EVALUATION |
|---|---|---|
| 1 | Low | Unlikely to function |
| 2 | Average | Likely to function |
| 3 | High | Highly likely to function |
Figure 1
Age standardized DM death rates per 100,000 for Belize, Gand Jamaica (PAHO). Natural disasters are parenthesized adjacent to the country impacted.
Figure 2
Age adjusted DM death rates per 100,000 standard population for Grenada, St. Lucia and St. Vincent and the Grenadines (WHO). Natural disasters are parenthesized adjacent to the country impacted.
Figure 3
DM deaths as a percentage of total deaths in Dominica. Natural disasters are parenthesized adjacent to the country impacted.
Figure 4
Country‑specific categorical change in HSI ratings before and after Smart retrofitting. Each line indicates a question from the HSI form for a facility and its corresponding rating.
Figure 5
Belize HSI before and after retrofitting changes in facility ratings (5 facilities represented).
Figure 6
Dominica HSI before and after retrofitting changes in facility ratings (5 facilities represented).
Figure 7
Grenada HSI before and after retrofitting changes in facility ratings (5 facilities represented).
Figure 8
St. Vincent and the Grenadines HSI before and after retrofitting changes in facility ratings (7 facilities represented).
Figure 9
Guyana HSI before and after retrofitting changes in facility ratings (5 facilities represented).
Figure 10
Jamaica HSI before and after retrofitting changes in facility ratings (12 facilities represented).
Figure 11
St. Lucia HSI before and after retrofitting changes in facility ratings (15 facilities represented).
Figure 12
Framework to Assess Utility of Smart Facilities’ Climate Adaptation Strategies (Created with BioRender.com).