New guides available to help hospital planners protect patients, health care workers

Two new guides are now available to help hospital planners and administrators make important decisions about how to protect patients and health care workers and assess the physical components of a hospital when a natural or manmade disaster, terrorist attack, or other catastrophic event threatens the soundness of a facility. Published by HHS' Agency for Healthcare Research and Quality, the guides examine how hospital personnel have coped under emergency situations in the past to better understand what factors should be considered when making evacuation, shelter-in-place, and reoccupation decisions.

Hospital Evacuation Decision Guide and Hospital Assessment and Recovery Guide are intended to supplement hospital emergency plans, augment guidance on determining how long a decision to evacuate may be safely deferred and provide guidance on how to organize an initial assessment of a hospital to determine when it is safe to return after an evacuation.

"Hospitals should be a safe haven, particularly during an emergency situation, but unfortunately hospitals themselves sometimes find that they are in harm's way," said AHRQ Director Carolyn M. Clancy, MD. "These guides will give hospital planners additional information from their peers who have been through the ordeal of providing care during disaster conditions so they can benefit from lessons learned in the field."

The evacuation guide distinguishes between "pre-event evacuations"— which are undertaken in advance of an impending disaster, such as a storm, when the hospital structure and surrounding environment are not yet significantly compromised — and "post-event evacuations," which are carried out after a disaster has damaged a hospital or the surrounding community. It draws upon past events including; the Northridge, CA, earthquake of 1994; the Three Mile Island nuclear reactor incident of 1979; and Hurricanes Katrina and Rita in 2005. The guide offers advice regarding sequence of patient evacuation and factors to consider when a threat looms.

The assessment and recovery guide helps hospitals determine when to get back into a hospital after an evacuation. Comprised primarily of a 45-page checklist, the guide covers 11 separate areas of hospital infrastructure components, such as security and fire safety, information technology and communication and biomedical engineering that should be evaluated before determining that it is safe to reoccupy a facility.