Hospital disaster preparedness is so much more than simply writing out a series of steps to be taken in an emergency situation. Instead, once the plan is created, it should be periodically evaluated, tested and updated to mitigate any gaps that are discovered along the way.


There are a few different ways that hospitals can audit their plan. They have varying levels of complexity, but all of them will serve to strengthen the disaster preparedness plan that is in place.


Tabletop Exercises

These are considered discussion-based exercises.  Key personnel must be present to talk through various hypothetical disaster scenarios. By working through these scenarios, potential shortcomings in the current disaster plan can be identified and problem-solving can take place. No actual resources are mobilized during this event.

Tabletop Exercises are cost-effective, low-stress, and allow those participating to offer needed feedback regarding policies and procedures that are in effect.



Drills are an operations-based exercise, meaning that elements of the disaster plan are physically carried out. Drills are used to test one specific operation within one single entity. For example, a hospital could run a drill on their decontamination procedure and use their findings to determine if its staff understands the procedure and are able to carry it out in a timely fashion.


Functional and Full Scale Exercises

A Functional Exercise takes a drill one step further. In a Functional Exercise, the participants are required to make fast decisions as they simulate their actions within the Hospital Incident Command System. A Functional Exercise involves many agencies and is used to test the coordination efforts between them. However, in this type of exercise, first responders do not respond in real time.

A Full-Scale Exercise is the most complex, utilizing all agencies and fully mobilizing all resources as if an actual disaster has taken place. The Hospital Incident Command System carries out the disaster plan and first responders are used to treat mock victims. These types of events are costly and stressful, but provide an accurate depiction of exactly how a disaster preparedness plan would be carried out.

Both Functional and Full Scale Exercises provide much insight. Hospitals are able to:

  • Evaluate how well their communication systems function.
  • Assess their availability of emergency resources, portable equipment and supplemental staff.
  • Analyze their relationships with local agencies and their partnerships with local hospitals, community resources and supply vendors.
  • Correct any shortcomings that are noted during the execution of the plan.


Post-Disaster Analysis

As realistic as a full scale exercise attempts to be, nothing can replicate a true disaster. When one actually occurs, hospitals are forced to quickly realize what areas are deficient in their disaster preparedness plan. For this reason, a thorough post-disaster analysis should be carried out every time after a plan is enacted.

Superstorm Sandy was a great example of this. Some hospitals in the wake of the storm experienced both power and generator failure and were forced to evacuate. An analysis after the event forced hospitals to reconsider where their generators were located as well as having sufficient battery-powered equipment available to provide patient care during emergencies.

As we have stated many times, developing a solid disaster preparedness plan is challenging, but it is absolutely necessary. A regular audit of your current plan will allow for continued improvement and safety in operations.