Emergency preparedness for healthcare
Healthcare facilities and their staff play a key role in emergency preparedness and response efforts for all types of events, including natural or man-made disasters, pandemic outbreaks, or terrorist attacks. Because the availability of healthcare is essential to accommodate the surge in demand for providing care related to a public health emergency, this website is intended to assist healthcare facilities in with all aspects of emergency planning, including mitigation, preparedness, response, and recovery.
This web site is intended to provide basic tools and resources from federal governmental agencies, professional organizations, universities, and state and local public health agencies. We have chosen some selected resources to highlight on this page, including resources for education and training, key documents, products and equipment and sample procedures and lessons learned.
Level of readiness
With growing awareness of the significance of healthcare facilities’ response to emergencies, many are reassessing and upgrading their existing emergency preparedness plans. General elements of emergency management for healthcare facilities include mitigation, preparedness, response, and recovery.
Although hospitals have general emergency management plans in place, they may not have planned for a large-scale incident until federal and state public health groups developed communication plans and networks to address such incidents. Such planning better prepares staff to manage smaller hazardous materials situations, such as industrial accidents – in which both staff and facility may be contaminated unless such incidents are anticipated beforehand. Planning should address the concerns of caregivers and the potential for distribution of a contaminant throughout the emergency department or even the hospital.
Key planning resources
- Premier healthcare alliance: Disaster Preparedness and Response Resources to help guide the Premier membership in its preparation and potential response activities; members will find preparation checklists, proposed disaster playbooks, monthly tips, supplier, regulatory and support offerings and real-time updates during and immediately following a disaster (member log in required).
- CDC’s Healthcare Preparedness Toolbox website features healthcare preparedness tools and resources to help communities plan for public health emergencies. Resources for clinicians can be found under both the “Clinical Resources and Tools” and “Planning Resources” sections.
- CDC Public Health Preparedness and Response Partner Resources
- U.S. Dept. of Health & Human Services
HHS Response and Recovery Resources Compendium Project is an easy to navigate, comprehensive web-based repository of HHS resources and capabilities available to Federal, State, local, territorial and tribal stakeholders before, during, and after public health and medical incidents. The resources in this repository may also be useful for public health and medical emergency management officials. Each topic contains a list of the major HHS capabilities, products and services that support that function, a brief description of each and information on accessing them.
HHS Response and Recovery Resources Compendium links to numerous tools, resources, and situational awareness portals published by non-governmental and governmental partners.
- CDC Public Health Law Program: Emergency Preparedness Central repository for emergency preparedness-related statutes, regulations, orders, reports, and legal tools to aid jurisdictions considering updates and clarifications to their public health emergency legal preparedness activities.
- FEMA maintains an online listing of State Offices and Agencies of Emergency Management
- Facility risk assessment: The facility risk assessment should be a multidisciplinary process, with representatives from all services involved in an emergency situation. This includes infectious disease, infection control and safety staff to assist in differentiating biological from chemical agent exposures and in follow-up management.
- Hazard vulnerability analysis: The Joint Commission has, since 2001, required member hospitals to complete an annual hazard vulnerability analysis (HVA), which is expected to provide a foundation for emergency planning efforts.
Facilities should conduct or review existing HVAs. The process includes assessing the probability of each type of event, the risk it would pose, and the organization’s current level of preparedness. This HVA should also take into account nearby community resources likely to be affected or called upon for assistance – including schools, churches, public transportation, news media, telephone and communication systems, voluntary organizations (such as the Red Cross and the Salvation Army), restaurants, and food suppliers.
Agencies of the U.S. government (specifically the CDC, FDA and FEMA) offer considerable number of resources for emergency management preparedness and response. Public health professionals and clinicians can find training assistance for virtually all disciplines and levels of responsibility.
- CDC opens in a new tab
- CDC Learning Connection/Emergency Management opens in a new tab CDC Learning Connection features emergency preparedness and response learning products for public health professionals and clinicians that were developed by CDC and CDC partners.
- CDC-Sponsored Preparedness and Emergency Response Learning opens in a new tab CDC funds preparedness training based in U.S. schools of public health to meet preparedness and response training and education needs of the US public health workforce. The PERLC provides core competency-based Continuing Education training to state, local, and tribal public health authorities in the area of public health preparedness and response in both short, single-module courses and series.
- FDA’s Emergency Preparedness and Response offers a free online course Training – ICS-100.FDA opens in a new tab on using Incident Command System (ICS) principles in incidents involving FDA-regul opens in a new tabated products.
- FEMA opens in a new tab
- Emergency Management Institute and Federal Emergency Management Agency (EMI/FEMA) Independent Study Program opens in a new tab Emergency Management Institute offers self-paced courses designed for people who have emergency management responsibilities and the general public. All are offered free-of-charge to those who qualify for enrollment.
- FEMA Center for Domestic Preparedness Resident Training: Healthcare opens in a new tabScheduled classroom and simulation courses are offered on a rotating basis. Emergency training for participants of varied disciplines and varied levels of responsibility in FEMA’s Center for Domestic Preparedness. All-hazards preparedness training for state, local, or tribal government emergency responders is fully funded, including travel, meals, and lodging, by the U.S. Department of Homeland Security.
- Additional training resources opens in a new tab
Command and Coordination
- Crisis & Emergency Risk Communication (CERC) Training course on the fundamentals of CDC’s Crisis & Emergency Risk Communication
Facilities should continuously reassess their emergency readiness plans. All facets of planning must be re-examined; most importantly, coordination with local emergency planning agencies in surrounding communities as well as communications with local and state public health should be enhanced.
- The American Hospital Association provides a number of tools and resources that are both timely and useful in assessing and reassessing emergency readiness plans.
Types of emergencies
Natural Disasters and Severe Weather
- The Centers for Disease Control and Prevention (CDC) maintains a comprehensive website with information for emergency preparedness and response and recovery from disasters, including hurricanes, tornadoes, floods, earthquakes, and extreme heat.
- Premier healthcare alliance: Disaster Preparedness and Response Resources to help guide the Premier membership in its preparation and potential response activities (member log in required):
Terrorism, including bioterrorism
Events resulting from terrorism can include virtually any non-weather-related event, including mass casualty and transportation events, chemical incidents, and those resulting from biological and chemical agents.
Biological and chemical agents
Biological agents: Bioterrorism is quite different from a chemical incident. An incident of bioterrorism may be recognized as such only after a number of victims displaying similar symptoms arrive at the emergency department, following an incubation period of unknown length. Diagnosis may be difficult: it may be hard to distinguish biological from chemical exposures (or the possibility of both, immediately after an event like an explosion). Deployment of a biological agent in a public place would impact everyone and everything in the area, including the healthcare facility. Rapid assessment and infection control management are critical.
Identification of chemical or biological agents: When a recognized incident occurs in a community, the key to treating the exposed individuals is identification of the agent. In the case of an industrial, agricultural or transportation accident, that identification may be made early in the event. In the case of a covert action, the hospital must rely on detection equipment used by emergency responders at the site in response to presentation of symptoms. Understanding the decontamination process becomes critical in these “unknown” exposures. Some chemical and biological agents of greatest concern are listed on the CDC Web site.
- CDC provides bioterrorism disease/agent-specific information for both biological agents/diseases and chemical agents.
Chemical agents: CDC provides detailed information on treating exposure to representative chemical agents
Anthrax: Anthrax contamination may raise questions about managing potentially contaminated personnel and the environment.
Clinical assessment: The hospital depends on clinicians in the emergency department to make the initial diagnosis until other information becomes available. Clinicians must remain alert for unusual diseases that could result from an act of bioterrorism. As an event progresses, the public health department will work closely with healthcare organizations to identify patterns and exposed victims. See resources for training programs on learning to identify and treat critical agents.
Local industries and traffic patterns may be more important than size or urban/rural location in assessing impact on the facility. Weather conditions may redirect contaminants into the facility’s vicinity. A transportation accident may be the initiating event; agricultural, industrial, and even home garage accidents are not infrequent. In the aftermath of such accidents, contaminated victims may be transported to the nearest facility, rather than to a major trauma center. Chemicals used in the healthcare facility should be considered as potential sources of accidental spills.