SAFE HOSPITAL PROGRAMME, MEXICO

Application for the Sasakawa Award for Disaster Risk Reduction

"Shaping the future"

Mexico's efforts towards resilience achieved a historic milestone on 26 November 2006 through the establishment of the National Committee for Evaluation, Analysis and Certification of the Safe Hospital Programme (PHS). This laid the foundations for the collective work and commitment of 19 institutions, including those for civil protection and health, the armed forces, private and social bodies and international organizations. Experts from each of these institutions were invited to form the Technical Advisory Group, which plans, advises on and evaluates PHS operations. Each of the Mexican states established a corresponding State PHS Evaluation Committee.

Alongside this and other regulatory instruments, a range of activities were carried out, including: the designing of a course for evaluators of safe hospitals (who are tested to obtain official high security credentials); a protocol for evaluation visits that involves at least three different evaluators being present at the institution visited; and the classification of hospitals in cases of emergencies and disasters, prioritising the start of evaluations for highly complex hospitals located in high-risk zones.

The legal framework in Mexico has been modified to strengthen the validity and permanence of the PHS through the: General Civil Protection Law; General Health Law; Mexican Official Standards, and Agreements with the General Health Council – a body that certifies hospitals according to Joint Commission International criteria. These specify that, in order for a hospital to be certified, it must have been evaluated by the PHS. The New National Regulations for Hospital Construction are soon to be published.

The result of the hospital evaluation is officially submitted to the highest authority of each of the public, private and social institutions, encouraging instructions to be given on how to address the results and provide the necessary local, state and federal financial support to raise the safety level of hospitals.

The checklist for Safe Hospitals was applied through a self-evaluation IT platform for 1,308 hospitals. The reliability index made it possible to build the safe hospital comprehensive information system for civil protection (SIIPC.HS), which is integrated with the national risk map so that it can be used in crisis situations and in planning the construction of new hospitals. It is mandatory for each hospital to carry out this self-evaluation six weeks before the visit, which ensures that safety is improved before the formal evaluation.

To harmonize hospital plans for emergencies and disasters with the PHS, the Pan American Health Organization (PAHO) Hospital Planning for Disaster Response course was adopted and has been rolled out in various regions of the country, allowing a network response between institutions during crises.

Through the Ministry of the Interior, Mexico has a Disaster Prevention Fund that plans financial support for the improvement of hospitals. The PHS has a specific protocol for using this resource as a measure to improve and construct new hospitals.

Since 2007, 176 new hospitals have taken the PHS recommendations into account, with an investment of over 1.5 billion US dollars, which represents 9,007 beds and benefits more than 18.5 million people (table 1). In the hospitals graded at level B or C following the PHS evaluation, action taken has included the closure of four hospitals (table 2), and the expansion, refurbishment, improvement and installation of emergency stairways at 93 hospitals through a major investment of 283 million US dollars (table 3). The Mexican Social Security Institute (IMSS) Regional General Hospital 1 in Michoacán, graded at level C, was demolished and replaced by a new one fully incorporating the safe hospital concept within 24 months, and at a cost of 87 million US dollars. The total investment in hospital safety since 2007 has been approximately 2 billion US dollars.

Thanks to the success of the PHS, the Mexican President set up the national "Safe Mexico" crusade, which includes schools, public buildings, hotels and others.

Table 1. Summary of investment in the construction of new medical units based on the Safe Hospital concept

Hospitals / Beds / Population to benefit / Investment
(Mexican pesos) / Investment
(US dollars)
Total / 176 / 9,007 / 18,540,265 / 20,001,770,170 / 1,538,597,705

Table 2. Closure of hospitals evaluated at grade C

Unit / Entity / Comments
Regional General Hospital 1, IMSS / Michoacán / Replacement, investment of 87 million dollars in a new hospital in 24 months.
Area No. 27 General Hospital, IMSS / Mexico City
Area No. 26 General Hospital, IMSS / Mexico City / Closed on 20 March 2012
Gonzalo Castañeda Hospital, ISSSTE (The State Employees Social Security and Social Services Institute) / Mexico City / Closed on 9 September 2009

Table 3. Summary of investment in expansion, refurbishment, improvement, and installation of emergency stairways

Hospitals / Investment (Mexican pesos) / Investment (US dollars)
TOTAL / 76 / 3,686,642,804 / 283,587,908