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Hospitals Are Better Prepared for Mass Casualty Disasters

By Eric Toner, M.D., May 8, 2009

[Editor’s note: Publication of this CBN Report, originally scheduled for April 24, 2009, was delayed by events related to the 2009 H1N1 epidemic.]

On April 23, Center for Biosecurity released the report, Hospitals Rising to the Challenge: The First Five Years of the U.S. Hospital Preparedness Program and Priorities Going Forward. This report was produced by the Center under a contract from the Department of Health and Human Services (HHS), Office of the Assistant Secretary for Preparedness and Response (ASPR). The Center was charged with conducting an independent evaluation of the first 5 years (2002–2007) of the ASPR Hospital Preparedness Program (HPP) to assess the program’s effects on healthcare preparedness for mass casualty disasters. This report presents the results of our research.

Key Finding: Healthcare Coalitions—A Strong Foundation for Preparedness

Based on interviews with 133 individuals at the state and local levels who were involved with disaster preparedness in hospitals across the country, we found that U.S. hospitals are significantly better prepared now than in 2001, and that much of the improvement is attributable to the HPP.

In addition, we found that healthcare coalitions—consisting of hospitals in a city or region working collaboratively with each other and with public health departments and emergency managers—are emerging in most communities across the country and are the most important element of healthcare preparedness.

Our research suggests that by facilitating joint planning and exercises, as well as the sharing of resources and coordinated responses to emergencies, these coalitions have made the country significantly better prepared for common disasters such as hurricanes, bridge collapses, and mass shootings. Healthcare coalitions are also creating a strong foundation for preparedness for much larger catastrophic disasters, such as large earthquakes, pandemic influenza, or the aftermath of nuclear or biological terrorism.

Other Principal Findings

Preparedness efforts to date—including coalition building— although essential, are not sufficient for an effective response to catastrophic disasters. In the future, the HPP should focus on building, strengthening, and linking healthcare coalitions both within and across state lines in order to create the infrastructure needed for a national disaster health and medical response system that will be capable of harnessing all national assets, both public and private, should they be needed to respond to a catastrophic disaster.

The advances achieved to date would be imperiled by significant decreases in federal funding in healthcare preparedness. Although federal funds constitute only a fraction of private sector spending on healthcare preparedness, federal grants are essential catalysts. Preparedness for catastrophic emergencies requires increased and sustained funding because it is a matter of national security.   

We encourage you to read the report in its entirety to learn of our other principal findings and conclusions and to fully understand both the progress that has been made in healthcare preparedness and the challenges that remain. Go to the Executive Summary | Download the Full Report PDF.