Date:

Name:

Address:

E-mail:

Personal Information

Sex  Female  Male

Job  Employee  Head of Dep.  Manger  G.M.

Qualification  Secondary  Bachelor  Master  PhD

Age  < 25  25 – 35  36 – 45  > 45

Hospital Beds  < 25  25 – 50  50 – 100  > 100

Daily patient  < 25  25 – 50  50 – 100  > 100

quantity

Integrated Environmental Management Systems

Questionnaire 1/11 in Egyptian Hospitals
 S (1 means strongly disagree (or Not found) and 5 means strongly agree (or Found)) 1 2 3 4 5
A Location, Accessibility, Design, Structure & Architecture
a Location
1 Building is not located in a hazardous area:
2 Not at the edge of a slope
3 Not near water bodies that could erode its foundation
4 Not in flood-prone areas
5 Building has appropriate provisions for addressing hazards related to location such as rainwater drainage
6 Located along or near good roads and adequate means of transportation readily accessible to the community

7 Reasonably free from undue noise, smoke, dust, odours, floods and shall not be located adjacent to railroads, freight
yards, children's playgrounds, airports, industrial plants, disposal plants
b Accessibility
1 No obstructions on the roads leading to the hospital
2 Has access to more than one road (alternative routes) and has separate entrance and exit routes
3 Has well-paved access roads (cemented or asphalt) that are properly identified and labelled
4 Directional signage is available, properly fastened and readable even in darkness
5 Corridors, hallways and aisles must be 2.4-2.6 meters wide
6 Use of ramps as access to second and higher floors
7 Any door to a stairway, ramp, elevator shaft, light and ventilation shaft or chute in a stairway enclosure shall be self-
closing and normally shall be kept closed
c Design (Permit, Documents/Drawings, Structure)
1 Complete set of as-built construction drawings and readily available for reference purposes
2 Construction materials thoroughly checked by a materials/quality assurance/
quality control engineer during construction for conformance to specifications
3 Building alterations conducted with proper consultation with engineers and a review of the original plan of the
building
4 Approved construction plans, technical specifications, structural computations signed and sealed by appropriate
professionals and submitted to and approved by the building official of the local government
5 As-built plans prepared by the contractor or builder or as-found plans commissioned by owners to be prepared by
architecture and engineering professionals
6 Updated as-built plans
7 Building has a simple shape and is symmetrical along both the lateral and longitudinal axes (e.g. square or rectangle),
making it resilient when subjected to stress such as that produced by an earthquake

Integrated Environmental Management Systems

Questionnaire 2/11 in Egyptian Hospitals
 S (1 means strongly disagree (or Not found) and 5 means strongly agree (or Found)) 1 2 3 4 5
8 Building structural members (foundation, columns, beams, floors, slabs, trusses) and non-structural members
conform with requirements for strong winds and earthquake
9 Glass walls, doors and windows resist regional basic wind speeds
10 Number of building floors (storeys) less than five, especially in areas that are vulnerable to earthquake
11 No major structural cracks on structural members. Minor or hairline cracks investigated by a qualified civil or
structural engineer and determined to be localized and repairable.
12 Structures built with fire-resistant and nontoxic materials
13 Structures built with adequate technical competence and proper building inspection and control implemented

14 Cabinets, shelves, appliances and equipment are properly anchored

15 Ramps are present in appropriate areas for moving bed patients and for use by people with disabilities
d Architectural Elements
Circulation, finishing materials and Openings
1 Nurses at the stations can oversee the wards and are accessible to the patients
2 Gender-sensitive wards and sanitary toilets
3 Proper zoning of service areas:
4 Departments most closely linked to the community are located nearest to the entrance (opd, er, administration,
primary health care)
Departments that receive their workloads from the wards or inner zones should be located closer to these zones
5
(radiology, laboratory)
6 Inpatient departments should be in the inner zones
7 Secured and controlled points of entry with available map of the area
8 General service areas such as power plant, boilers, water storage facilities, laundry area and pump house are located
in separate structures
9 Areas to be converted to spaces for patients during disasters properly identified with adequate lighting, electrical
outlets, water supply and lavatories or bathrooms
10 Morgue is located separately from the service areas, preferably with a fence or gate
11 Diagnostic areas with heavy equipment are preferably on the ground floor but are safe from flooding
12 Laboratory, radiology and radiotherapy-medicine facilities are restricted areas
Rroofing
1 Roof’s drainage system has adequate capacity and is properly maintained
2 Roof is leak-proof, insulated and sound-proof

Integrated Environmental Management Systems

Questionnaire 3/11 in Egyptian Hospitals
 S (1 means strongly disagree (or Not found) and 5 means strongly agree (or Found)) 1 2 3 4 5
Safety of ceilings
1 Concrete ceilings have no cracks and leaks
2 Drop ceilings made of materials other than concrete securely fastened
3 Ceiling materials such as fibre cement board, fibreglass, acoustic/gypsum board, wood materials are coated or treated
with fire-retardant paint
4 Light fixtures properly fastened and supported
5 Underside of arches, balconies or overhangs free from structural cracks and falling cement plasters
Safety of doors and entrances
1 Door materials are wind- and fire-resistant
2 Doors securely attached to jambs
3 Doors in rooms for less than 50 people should be 112 cm wide; doors in rooms for more than 50 people (conference
rooms, function rooms) should be 122 cm wide, remotely located from each other and swing out

Main doors are double swing; bathroom door is swing out; emergency room doors are swing in and out
4
Fire exit doors fire-resistant; swing out; with self-enclosing device and panic bar
5
Power-operated doors can be opened manually to permit exit in the event of power failure
6
Automatic doors have manual overrides
7
In high-rise buildings and structures, the interior vertical exit stairwell or staircase has a pressurized fire exit or smoke-
8
proof fire exit suitably sealed against smoke, heat and fire
9 A door designed to be kept closed as a way out, such as a door to a stair or horizontal exit, and provided with a
reliable self-closing mechanism and one not secured in the open position.
10 A door designed to be kept closed shall bear a sign such as: FIRE EXIT, KEEP DOOR CLOSED
Safety of windows
1 Windows have wind and sun protection devices
2 Windows have features to secure the safety of the patient (e.g. Grilles, railings) which are also provided with a fire
exit or fire protection system
3 Windows are leakproof
Safety of walls, divisions, partitions
1 Room partitions made of fire-resistant construction materials
2 Rooms may be subdivided provided that the arrangement allows for direct and constant visual supervision by
nursing personnel

Integrated Environmental Management Systems

Questionnaire 4/11 in Egyptian Hospitals
 S (1 means strongly disagree (or Not found) and 5 means strongly agree (or Found)) 1 2 3 4 5
Safety of exterior elements (cornices, ornaments, facade, plastering)
1 Exterior elements securely fastened to walls
2 Hanging light fixtures properly anchored
3 Electrical wires and cables properly fastened and secured
Safety of floor coverings
1 Nonslip floor materials without crevices in all clinical and service areas and easy-to-clean floor materials in all other
nonclinical areas
2 Reinforced concrete floor slabs
3 Interior finish with fire suppression system
4 Floor finish materials are “Class A” or “Class B” throughout the hospital, nursing home, residential or custodial care
facilities.
B Utilities (Electrical, Water supply, Medical Gas System, Fire Suppression System and Emergency
Exit System)
a Electrical
1 Emergency generator has the capacity to meet priority hospital demands (provision for backup electrical system to
include operating room, intensive care, pathways
Has no vibrating and silent generators; exhaust system should be made of critical type silencer or hospital grade and
2
unit provided with vibration isolators if generator is in the hospital building
3 Generator with automatic transfer switch
4 Protected control panel, enclosed circuit breakers, magnetic contactors or fused or nonfused switches
5 All electrical systems and rooms protected with appropriate chemical automatic fire suppression units
6 Use of energy-saving lighting and bulbs without mercury
7 Adequate lighting in all areas of the hospital, including the grounds
9 Functional electrical and emergency lights with battery backup in all critical areas
10 All exits, including exit signs, stairways and corridors
b Water supply system
1 Water tank storage has sufficient reserve to satisfy the hospital demand for three days at all times
2 Water storage tank has safe installation and location
3 Alternate water source provided (e.g. Deep well, local water utility, mobile water storage tank or fire truck)

4 Water distribution system (valves, pipes, connections) are free from leaks and harmful agents
5 Safe and potable water in emergencies at five litres per outpatient a day and 60-100 litres per inpatient a day and
additional litres for laundry, flushing toilets and other utilities
6 Alternate source of water if the main supply is cut off
7 Identified agencies responsible for timely restoration of water service, supplementary pumping system if the system
fails or services disrupted or for alternative water supply

Integrated Environmental Management Systems

Questionnaire 5/11 in Egyptian Hospitals
 S (1 means strongly disagree (or Not found) and 5 means strongly agree (or Found)) 1 2 3 4 5
c Medical Gas System
1 Medical gases properly stored and secured in well- ventilated areas or compartmented storage areas
2 Safe and appropriate location for storage of medical gases and secured from theft and vandalism
3 Safety of medical gas distribution system (valves, pipes, connections)
ensured
4 Use of standard pipes (fireproof, waterproof)
5 Undergoes regular testing procedures
6 Available backup oxygen tanks in case of emergency patient evacuation
7 Al construction activity involving hazardous operations shall have not less than one hour of fire resistance and all
openings between any buildings and rooms or enclosures for hazardous operations shall be protected with self-
closing or automatic fire doors
d Fire Suppression System
1 Alarm, detection and extinguishing systems have interconnected automatic fire alarm system, automatic heat and/or
detection system and automatic fire suppression system
2 Fire alarm system can be a combination of automatic and manual
3 Fire alarm system is monitored by fire station or accredited monitoring agency
4 Heat and smoke detection installed in corridors of hospitals, nursing homes and residential-custodial care facilities

5 Smoke detectors must not be spaced farther apart than nine meters on centre and more than four and six tenths from
any wall
6 Use of extinguishing agents effective and cause less damage to property
7 Each room provided with portable fire extinguishers
8 Preventive maintenance of firefighting equipment
9 Available fire exit plan and provision of fire exit evacuation plan in conspicuous places at every floor level

e Emergency Exit System

1 The floors of beams of egress illuminated at all points including angles and intersections of corridors and
passageways, landings of stairs and exit doors with bulbs of not less than 0.001 lumens per square centimeter

2 Emergency lighting facilities maintain the specified degree of illumination in the event of failure of the normal
lighting for a period of at least one hour
3 Equipment operational at all times (boiler, air conditioning systems, exhaust)
f Logistic System
1 System for estimating drug requirement, maintaining an inventory, storing and stocking and issuing and controlling
the use of drugs
2 Adequate blood bank facility with guidelines for correct storage and handling of blood and blood products and rapid
procurement in emergencies

Integrated Environmental Management Systems

Questionnaire 6/11 in Egyptian Hospitals
 S (1 means strongly disagree (or Not found) and 5 means strongly agree (or Found)) 1 2 3 4 5
C Safety and Security
1 Available Material Safety Data Sheet (MSDS) that contains the following information: chemical and physical
properties, health hazards, emergency care and first aid storage and handling, personal protection, Reactivity and
environmental and registration data
2 Secured entrance and exit points
3 Equipment for inspection such as metal detectors
4 Closed circuit television (CCTV) cameras with recorder
5 Personal protective equipment (PPE) for universal precaution (gloves, masks, gowns)
6 Sterilizing equipment and supplies
a Equipment in Operating Room and Recovery Room
1 Equipment in the operating room mounted on rollers or roller trolleys must be stable – anchored or fastened near the
operating table during surgery and can be removed afterward
b Radiological Equipment and Other Support Devices
1 Heavy and movable equipment anchored or bolted on the floor (e.g. X-ray machine) or to the wall (x-ray tubes)

2 Available steel frames for securing equipment (e.g. X-ray units, ultrasound scanners, ct scanners, mri scanners)

3 Adequately shielded room (protection from radiation, radio frequencies, magnetic fields)
4 Air conditioned room with controlled humidity
5 Proper segregation and storage of hazardous materials and chemicals
6 Good water supply, plumbing and drainage system
c Laboratory Equipment and Other Support Devices
1 Supplies and contents of laboratories secured on shelves and in racks (i.e. Anchor the cupboards to the walls and
strap the shelves)
2 Floors are without crevices, tiles are grouted (mortar or paste for filling crevices) and sealant regularly maintained

3 Colour-coded bins for proper waste segregation

4 Wastewater disposed to sewage treatment plant
d Medical Equipment in Emergency Rooms/Intensive Care Units/Wards
1 Supplies and contents of medical cabinets secured on shelves/racks which are anchored/strapped to the wall

e Medical Equipment in Pharmacy Departments

1 Proper storage for hazardous materials free from leaks

Integrated Environmental Management Systems

Questionnaire 7/11 in Egyptian Hospitals
 S (1 means strongly disagree (or Not found) and 5 means strongly agree (or Found)) 1 2 3 4 5
f Medical Equipment in Sterilization Units
1 Supplies and contents of sterilization unit cabinets are secured on shelves or racks that are anchored to the walls

2 Heavy and movable equipment anchored or bolted to the floor or to the wall (e.g. Autoclave)
3 Clean and orderly, free from dirt and infectious materials
g Equipment and Other Support Devices in Nuclear Medicine Department and
Radiation Therapy Units
1 Adequately shielded from the hazards of radiation
2 Available standard decontamination area (fixed/mobile)
3 Good ventilation, air conditioning and controlled humidity
4 Equipment and accessories needed for treatment and placed near the bed are supported, anchored or fixed

5 Area monitors complete with alarms; radiation survey meters with audible warning
6 Proper segregation and storage, handling and disposal of chemicals, radioactive and other hazardous materials

7 Presence of the following safety equipment: shields, personal protective equipment, tools for remote handling,
containers for radioactive materials, dose rate monitors with alarm, contamination meters, signs, labels, records and
emergency kits
h Safety and Alarm Systems
1 Signs in the hospital indicate the location of escape routes and firefighting equipment
2 Building layout diagram provided for easy identification
3 Regular checkups of the smoke detectors to ensure they function and have an adequate power supply
4 Visible and accessible equipment for local fire control, including fire hoses and fire extinguishers that should be
placed strategically in corridors, at exit routes and at entrances to high-risk rooms such as laboratories

5 Regular maintenance of the fire extinguishers, the contents of which expire over time and must be replaced regularly

6 Personnel training on use of fire extinguishers

7 System of activating and deactivating the code alert
8 Coordination with local officials to assist the hospital during emergencies and disasters
i Plans for Emergency and Disaster
1 Accessible, tested, updated and disseminated hospital emergency preparedness, response and recovery plan that
includes a hazard prevention and mitigation plan, vulnerability reduction plan and a capacity development plan. This
plan includes the systems, guidelines and protocols for emergency management
2 Includes an evacuation plan in emergencies

Integrated Environmental Management Systems

Questionnaire 8/11 in Egyptian Hospitals
 S (1 means strongly disagree (or Not found) and 5 means strongly agree (or Found)) 1 2 3 4 5
1 Contingency plans for needed medical treatment during different types of disasters, including diseases with an
epidemic potential
2 Manuals for the operation, preventive maintenance, and restoration of critical
3 services
4 Electrical supply and backup generators
5 Drinking water supply and alternate source of drinking water
D Waste management procedures
1 Color-coded bins for proper waste segregation
2 Infectious waste is taken and separated from other medical wastes
3 Human tissues and organs waste is separated from others.
4 Pharmaceutical waste is separated from other medical waste.
5 Sharp waste is separated from other waste in hospital wards.
6 Medical waste is classified according to their toxicity in the hospital
7 Severe infectious medical waste is classified within wards as being high-risk waste
8 Medical waste is collected from wards in daily basis
9 Medical waste is collected separately from others in wards.
10 Medical waste is collected in separately and alone
11 Fully-equipped storages are available in the hospital
12 Temporary storage areas are available within each section of the hospital
13 Air-conditioned storages of human tissues and organs are available in the hospital.
14 Time of storage is assigned in the absence of central air-conditioned storage
15 Period of storage is assigned in the absence of central air-conditioned storage.
16 Hospital participates other hospitals in air-conditioned storages.
17 Storage areas within wards and hospital are disinfected.
18 Sufficient numbers of wheeled containers designed to medical waste transportation in the hospital are available

19 Medical wastes separated from others similar are carried to storage or processing sites.
20 Medical wastes are carried by municipal vehicles from the hospital for getting rid of
21 Other possibilities for carrying medical waste outside the hospital are available.
22 Severe infectious wastes are disinfected inside wards and moved to storage areas.
23 Sharp wastes are disinfected inside wards and moved to storage areas.
24 Liquid and contaminated human blood wastes are disinfected prior disposal
25 Infectious medical wastes are subjected to processing in wards by microwave

Integrated Environmental Management Systems

Questionnaire 9/11 in Egyptian Hospitals
 S (1 means strongly disagree (or Not found) and 5 means strongly agree (or Found)) 1 2 3 4 5
26 Infectious medical wastes are subjected to processing in wards by autoclave sterilization
27 Highly infectious wastes are subjected to processing inside wards by chemical disinfection
28 Medicine wastes are subjected to processing by passivation
29 Medicines wastes are subjected to processing by returning it to main supplier
30 Hospital gets rid of wastes by burying it in a special healthy site
31 Hospital gets rid of wastes by healthy excavation site
32 Hospital gets rid of highly contagious in a burial healthy site.
33 Hospital has incinerator for medical waste disposal
34 Hospital participates with other hospitals in incineration means
35 Hospital develops a plan for medical waste management.
36 A special unit within the hospital holds medical waste management.
37 Hospital makes training program for medical staff on how to deal with medical waste.
38 Hospital develops a training program for hospital support groups (maintenance engineers, technicians, cleaners] on
how to deal with medical waste.
E Communications, Transportation and Information Systems
a Communications and Transportation Systems
1 Backup communications facilities (cellular phone, handheld radios, satellite communication facilities)
2 Equipped ambulances for transport of casualties from the field to the hospital, for moving patients to other facilities
in cases of referral or overload or for evacuating and relocating a hospital service
3 List of identified available and capable ambulances for use during emergencies
4 List of equipment, medical supplies, emergency drugs and training of personnel for ambulances
b Public Information Systems
1 Public information centre where people can go to request information concerning family members
2 Public awareness and public education campaign with warning messages or risk communication
3 Procedures for communicating with the public and media
c Information Management Systems
1 Information management system during monitoring of events in emergencies or disasters
F Human Resources
1 Organization of Hospital Disaster Committees and Emergency Operation Centre
2 A crisis management committee with technical expertise that could advise an executive committee regarding crisis,
emergency and disaster management
3 An emergency response team composed of physicians, nurses, midwives, an emergency management technician-
trained staff, paramedics and trained ambulance driver
4 A health emergency planning group responsible for formulating a health emergency preparedness, response and
recovery plan and other hospital response plans

Integrated Environmental Management Systems

Questionnaire 10/11 in Egyptian Hospitals
 S (1 means strongly disagree (or Not found) and 5 means strongly agree (or Found)) 1 2 3 4 5
a Capability Building of Personnel
1 All of health workers trained in basic life support, cardiopulmonary resuscitation and standard first aid
2 Emergency room medical staff trained in Advanced Cardiac Life Support and
Advanced Pediatric Cardiac Life Support
b Monitoring and Evaluation
1 Post-incident evaluation of emergencies or disasters for which there has been a response
2 Evaluation of emergency simulation exercise or drill at least once a year
G Staff & Patient Satisfaction
a Staff
1 I am happy to work in this hospital
2 I like my job and the work I do.
3 My department is well organized for the work it does.
4 The hospital has adequate safety & health standard
5 Sharp waste is separated from other waste in hospital wards.
6 The hospital has adequate safety & health standard
7 I can keep a reasonable balance between work and personal life.
8 I can keep a reasonable balance between work and personal life.
b Patient
1 If you have a medical question, you can reach a doctor without any problem
2 It’s hard for you to get medical care on short time?
3 Have easy access to the reception of hospital
4 Doctors are good about explaining the reason for medical test
5 The amount you have spent for medical is reasonable
6 General cleanliness in the hospital is adequate
7 Nursing care you are receiving in the hospital is adequate
8 You think the hospital has everything needed to provide complete medical care

Integrated Environmental Management Systems

Questionnaire 11/11 in Egyptian Hospitals