Hospital preparedness analysis using the hospital emergency analysis tool (the HEAT)

Abstract

Study objectives: We examine the level of emergency preparedness in 24 hospitals in the US Navy Medical Department and 10 civilian medical facilities and also identify hospital emergency preparedness strengths and vulnerabilities through the use of the Hospital Emergency Analysis Tool (HEAT). Methods: A study was instituted using the HEAT, an instrument that gathers data through assessment of 240 critical preparedness factors (CPFs) to assess a hospital's level of emergency preparedness. Each CPF is considered important in a hospital's ability to respond effectively in an emergency situation. The HEAT is administered by a multidisciplinary team. Data were gathered from 2002 to 2004 at 34 facilities through structured, face-to-face interviews of hospital personnel and review of polices, plans, and meeting minutes. Results: A number of significant strengths are resident in these hospitals, as well as vulnerabilities that could detract from the effectiveness of emergency response. Factors found to contribute to effective hospital emergency response include (1) use of the hospital incident command system; (2) antidote and emergency drug caches; (3) physical security and facility lockdown procedures; and (4) basic health care professional knowledge of chemical, biological, radiologic, nuclear, and high-yield explosive emergency response. Weaknesses noted in the first phase of assessment include (1) potential for communications failure; (2) lack of biosurveillance; (3) inadequate inpatient surge capacity; and (4) inadequate isolation capability. Self-assessment scores were found to be significantly higher than those determined by analysis with a team of experts. Conclusion: Early results indicate the HEAT is a powerful tool that can assist hospitals in the identification of critical strengths and weaknesses in their emergency planning efforts. Once identified, factors found to be absent or deficient can be remedied. Follow-up analysis of each facility is planned to evaluate progress. More hospitals need to be examined in the military health system and in the civilian health sector. Study objectives: We examine the level of emergency preparedness in 24 hospitals in the US Navy Medical Department and 10 civilian medical facilities and also identify hospital emergency preparedness strengths and vulnerabilities through the use of the Hospital Emergency Analysis Tool (HEAT). Methods: A study was instituted using the HEAT, an instrument that gathers data through assessment of 240 critical preparedness factors (CPFs) to assess a hospital's level of emergency preparedness. Each CPF is considered important in a hospital's ability to respond effectively in an emergency situation. The HEAT is administered by a multidisciplinary team. Data were gathered from 2002 to 2004 at 34 facilities through structured, face-to-face interviews of hospital personnel and review of polices, plans, and meeting minutes. Results: A number of significant strengths are resident in these hospitals, as well as vulnerabilities that could detract from the effectiveness of emergency response. Factors found to contribute to effective hospital emergency response include (1) use of the hospital incident command system; (2) antidote and emergency drug caches; (3) physical security and facility lockdown procedures; and (4) basic health care professional knowledge of chemical, biological, radiologic, nuclear, and high-yield explosive emergency response. Weaknesses noted in the first phase of assessment include (1) potential for communications failure; (2) lack of biosurveillance; (3) inadequate inpatient surge capacity; and (4) inadequate isolation capability. Self-assessment scores were found to be significantly higher than those determined by analysis with a team of experts. Conclusion: Early results indicate the HEAT is a powerful tool that can assist hospitals in the identification of critical strengths and weaknesses in their emergency planning efforts. Once identified, factors found to be absent or deficient can be remedied. Follow-up analysis of each facility is planned to evaluate progress. More hospitals need to be examined in the military health system and in the civilian health sector.