Almost all hospitals have response plans in place for chemical releases, natural disasters, epidemics and biological incidents. However, significantly fewer have plans for explosive or incendiary incidents, according to a report released March 24 in National Health Statistics Reports.

In “Hospital Preparedness for Emergency Response: United States, 2008,” authors Richard W. Niska, MD, MPH, and Iris M. Shimizu, PhD, both of the Centers for Disease Control and Prevention’s National Center for Health Statistics, summarized hospital preparedness for responding to public health emergencies, including mass casualties and epidemics of naturally occurring diseases such as influenza.

Niska and Shimizu analyzed data from an emergency response preparedness supplement to the 2008 National Hospital Ambulatory Medical Care Survey (NHAMCS), which uses a national probability sample of nonfederal general and short-stay hospitals in the U.S. Sample data were weighted to produce national estimates.

“While most hospitals had memoranda of understanding (MOUs) with other hospitals to transfer adults during an epidemic, fewer hospitals had MOUs for pediatrics and burns. Less than one-half of hospitals accommodated the needs of children and persons with disabilities during a public health emergency,” Niska and Shimizu wrote.

Other findings in the report included:

• All hospitals had an emergency response plan for at least one of the six hazards studied (epidemic-pandemic, biological, chemical, nuclear-radiological, explosive-incendiary and natural incidents).
• Nearly all hospitals (99 percent) had emergency response plans that specifically addressed chemical accidents or attacks, which were not significantly different from the prevalence of plans for natural disasters (97.8 percent), epidemics or pandemics (94.1 percent) and biological accidents or attacks (93.2 percent).
• Significantly fewer hospitals (81.3 percent) had plans for nuclear or radiological accidents or attacks than for chemical accidents or attacks and natural disasters.
• 79.6 percent of hospitals had plans for explosive or incendiary accidents or attacks than for chemical accidents or attacks, natural disasters, epidemics or pandemics and biological accidents or attacks.
• A little more than two thirds—67.9 percent—of hospitals had plans for all six hazards.

 
The authors also analyzed NHAMCS data on cooperative planning with other hospitals or agencies, including state or local emergency management, emergency medical services, state or local public health departments, state or local law enforcement, fire departments, hazardous materials teams and the FBI.

The 2008 data revealed:

• Nearly all hospitals, 99.6 percent, engaged in cooperative planning with at least one of these eight entities.
• About 93.7 percent of hospitals engaged in cooperative planning in developing or updating an emergency response plan for public health emergencies with the state or local offices of emergency management. This was not significantly different from the prevalence for planning with other hospitals (92.7 percent), emergency medical services (89 percent), state or local public health departments (88.7 percent) or fire departments (86 percent), according to the authors.
• Significantly fewer hospitals included hazardous materials teams (64.3 percent) or the Federal Bureau of Investigation (19 percent) in their emergency response planning.
• About 18.7 percent of hospitals included all eight entities in their emergency response planning, according to the report, which can be accessed here.