## 1 Introduction
Although numerous researchers have recognized the pivotal role of resilient hospitals in a disaster response, there has been little research devoted to the vulnerability of hospitals to providing reliable healthcare services to the community during disasters [7]. Moreover, the lack of access to emergency and surgical care in developing countries has been identified as a critical gap in the development of health systems. While human resource challenges receive most attention from governments, efforts to address these should be implemented in tandem with systems-level changes like investment in facilities, establishment of quality systems and determination of processes of care [8]. The novelty of this research paper is the methodology, based on a new approach for developing self-protection plans, the 4-Elements-Model (the 4M) for adaptable self-protection plans, as it considers the users, the activities, the inventory of objects, as well as the human resources working in a given building. The approach was applied in a Spanish case study as an implementation example using the methodology. This paper attempts to show how the generic model can be applied and how the specific factors such as the region-related regulation are important elements when designing a self-protection plan. The criteria considered in the paper depends on the one side, a general methodological approach, the 4 EM, and on the other side a specific approach for any given object intending to develop a self-protection plan. This specific approach is highly dependent on the region-related regulation. Given that the goal of this research is to develop a design process for self-protection plans for public buildings, and specifically a nursing home, it is of great interest for the technician to start from the study of the development throughout the time that this type of center has existed. In this context, according to [PERSON] (1992), the origin of residences in Spain stem from the need to provide society with institutions that fulfill the functions of sheltering, guarding, or reclusing certain individuals with different purposes, among which we could find relief, prevention, cure, or punishment, all for the sake of social welfare [9]. These institutions at first initiated from religious charity. Then, after the advent of the industrial revolution, a process of sensitization of society and an interest in social welfare developed, maintained by the state, or by related public administrations. These institutions did not begin a criterion of predicalization until World War II (WWII) was over. These homes for the indigent elderly are the germ that evolves in the current residences for the elderly, which are directed and attended by personnel who may be religious, or belong to Public or Private Administrations [9]. According to [PERSON], [PERSON] and [PERSON] (1997), in the 1970s there was a turning point when residences for retired people were created in Spain, supported by Social Security funds [10]. With this, article 41 of the Spanish Constitution (CE) is applied, which indicates \"the public powers will maintain a public Social Security regime for all citizens, which guarantees assistance and sufficient social benefits in situations of need....\" [11], through the creation of the National Institute of Social Services in 1978 and the process of transfers to the Autonomous Communities (CCAA) [12]. At present, and according to the Basic Model of Care in Residences for the Elderly of the Ministry of Health and Social Welfare of Castilla Mancha (2012), residences have evolved to \"a model aimed at meeting the new needs of older people, offering comprehensive care with professional criteria and understanding of the person and the social environment in which they reside\" [13]. It is also necessary to indicate that home-type accommodation currently coexists with residences, although the majority alternative to the home is the residence [14].