en اورژانس Emergency مروری Review <div style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:Tahoma;"><span style="line-height:2;"><b>Background:</b> Storm events are now occurring with increased frequency and intensity as a consequence of climate change, creating unprecedented challenges for hospitals to maintain continuous operations. While existing research has identified critical factors for hospital resilience, a comprehensive understanding of how these factors interact within a hierarchical framework remains limited. This systematic review attempts to compile the evidence on hospital preparedness for storms and propose a novel conceptual model that prioritizes these critical factors.<br> <b>Material and Methods:</b> A systematic search was carried out following PRISMA 2020 guidelines across six databases (PubMed/MEDLINE, Web of Science, Cochrane, Scopus, Science Direct, ProQuest) and the Google Scholar search engine for publications between January 2000 and August 2025. A total of 32 studies out of the initial 6,115 records met the eligibility criteria after undergoing screening and full‑text review. Thematic synthesis served as the analytical method for the extracted data.<br> <b>Results: </b>Analysis revealed five critical domains, with Leadership, Governance & Policy emerging as the foundational enabler for all other components. Our proposed &quot;Enabling Foundation&quot; model demonstrates that Infrastructure & Planning, Human Resource Management, Coordination & Communication, and Resource Management & Logistics all depend on this foundational layer. Supported by 28 of 32 studies, this hierarchy explains why hospitals with similar resources show divergent storm outcomes and demonstrates that technical investments only achieve maximum impact within strong governance frameworks.<br> <b>Conclusion:</b> The &quot;Enabling Foundation&quot; model represents a paradigm shift from checklist-based preparedness to a hierarchical understanding of hospital resilience. This framework provides policymakers and healthcare administrators with evidence-based guidance for prioritizing investments and developing strategies that enhance hospital readiness for future storm events, ultimately supporting the transformation of healthcare facilities into resilient institutions capable of maintaining continuous care during disasters.</span></span></span></div> Hospital, preparedness, Storms, Systematic review 0 0 http://hdq.uswr.ac.ir/browse.php?a_code=A-10-193-6&slc_lang=en&sid=1 Seyyed Mohammad Reza Hosseini ghodsih1@nums.ac.ir No Department of Health in Emergencies and Disasters, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran. Mahdie Dehnavi dehnavim1@nums.ac.ir No Department of Nursing and Midwifery, Neyshabur University of Medical Sciences, Neyshabur, Iran Zohreh Sarchahi sarchahiz1@nums.ac.ir No Department of Nursing and Midwifery, Neyshabur University of Medical Sciences, Neyshabur, Iran Seyyed Jafar Hosseini hosseinisj1@nums.ac.ir No Department of Health in Emergencies and Disasters, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran. Hasan Ghodsi ghodsih1979@gmail.com Yes Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran.