Hospital disaster staffing: If you call, will they come?


  • David C. Cone, MD
  • Bethany A. Cummings, MA, DO



disasters, emergency departments, hospital personnel


Objective: To assess hospital employees’ attitudes and needs regarding work commitments during disasters.
Methods: A 12-item survey was distributed to employees at nine hospitals in five states. Questions addressed willingness to work during a disaster or its aftermath, support services that could encourage employees to remain for extended hours, and conflict-ing emergency response obligations (e.g., being a vol-unteer firefighter) that might prevent employees from working at the hospital. Anonymity was assured, and approval was obtained from each hospital’s institutional review board.
Results: Of the 2,004 surveys distributed, 1,711 (85 percent) were returned. Eighty-seven percent of respondents were willing to work after a fire/rescue/collapse mass casualty incident. Respondents were otherwise less willing to work in response to a man-made disaster (biological event: 58 percent; chemical event: 58 percent; radiation event: 57 percent) than a natural disaster (snowstorm: 83 percent; flood: 81 percent; hurricane: 78 percent; earthquake: 79 percent; tornado: 77 percent; ice storm: 75 percent; flu epidemic: 72 percent) (p < 0.001 for all comparisons by X2 testing). While 44 percent of respondents would come to work in response to any of the 11 disaster types listed, 19 percent were only willing to cover four or fewer types. Long-distance phone service (694, 41 percent), email access (584, 34 percent), pet care (568, 33 percent), and child care (506, 30 percent) were the most common support needs, and 365 respondents (21 percent) reported a conflicting emergency response obligation.
Conclusions: The majority of hospital workers surveyed were willing to report to work in response to some types of disasters but not others, and some indicated they might not be available at all due to conflicting emergency response obligations.

Author Biographies

David C. Cone, MD

Division of EMS, Section of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut.

Bethany A. Cummings, MA, DO

Valley Health System, Winchester, Virginia.


American College of Emergency Physicians: Hospital Disaster Privileging (Policy #400326). American College of Emergency Physicians Web site. Available at Privileging.htm. Accessed February 9, 2005.

Joint Commission on Accreditation of Healthcare Organizations: 2006 Hospital Accreditation Standards for Emergency Management Planning, Emergency Management Drills, Infection Control, Disaster Privileges. Available at JCAHOaccredstds.pdf. Accessed December 1, 2006.

[No authors listed]: Are you prepared for terrorist attack? New report tells how to train ED staff. ED Manag. 2001; 13(8): 85-88.

Agency for Healthcare Research and Quality: Computer staffing model for bioterrorism response: Version 2.0 BERM. Agency for Healthcare Research and Quality Web site. Available at www.ahrq. gov/research/biomodel.htm. Accessed February 27, 2006.

Hupert N, Mushlin AI, Callahan MA: Modeling the public health response to bioterrorism: Using discrete event simulation to design antibiotic distribution centers. Med Decis Making. 2002; 22(5 Suppl): S17-S25.

Qureshi K, Gershon RR, Sherman MF, et al.: Health care workers’ ability and willingness to report to duty during catastrophic disasters. J Urban Health. 2005; 82(3): 378-388.

Greenberg MI, Jurgens SM, Gracely EJ: Emergency department preparedness for the evaluation and treatment of victims of biological or chemical terrorist attack. J Emerg Med. 2002; 22(3): 273-278.

Burgess JL, Blackmon GM, Brodkin CA, et al.: Hospital preparedness for hazardous materials incidents and treatment of contaminated patients. West J Med. 1997; 167(6): 387-391.

Cone DC, Davidson SJ: Hazardous materials preparedness in the emergency department. Prehosp Emerg Care. 1997; 1(2): 85-90.

Macintyre AG, Christopher GW, Eitzen E Jr, et al.: Weapons of mass destruction events with contaminated casualties: Effective planning for health care facilities. JAMA. 2000; 283(2): 242-249.

Treat KN, Williams JM, Furbee PM, et al.: Hospital preparedness for weapons of mass destruction incidents: An initial assessment. Ann Emerg Med. 2001; 38(5): 562-565.

Laughrun GM: Preparing your hospital to respond to a terrorist attack. Am J Health Syst Pharm. 2002; 59(14): 1329-1330.

Maripolsky V: In disaster’s aftermath, don’t forget the needs of employees. Patient Care Manag. 2002; 17(7): 5-8.

Hick JL, Hanfling D, Burstein JL, et al.: Health care facility and community strategies for patient care surge capacity. Ann Emerg Med. 2004; 44(3): 253-261.

French ED, Sole ML, Byers JF: A comparison of nurses’ needs/concerns and hospital disaster plans following Florida’s Hurricane Floyd. J Emerg Nurs. 2002; 28(2): 111-117.

O’Boyle C, Robertson C, Secor-Turner M: Nurses’ beliefs about public health emergencies: Fear of abandonment. Am J Infect Control. 2006; 34(6): 351-357.

Balicer RD, Omer SB, Barnett DJ, et al.: Local public health workers’ perceptions toward responding to an influenza pandemic. BMC Public Health. Apr 2006; 6: 99.

Barnett DJ, Balicer RD, Blodgett DW, et al.: Applying risk perception theory to public health workforce preparedness training. J Public Health Manag Pract. Nov 2005; Suppl: S33-S37.

Shapira Y, Marganitt B, Roziner I, et al.: Willingness of staff to report to their hospital duties following an unconventional missile attack: A state-wide survey. Isr J Med Sci. 1991; 27(11-12): 704-711.

Longmire AW, Ten Eyck RP: Morbidity of Hurricane Frederic. Ann Emerg Med. 1984; 13(5): 334-338.

Haynes BE, Freeman C, Rubin JL, et al.: Medical response to catastrophic events: California’s planning and the Loma Prieta earthquake. Ann Emerg Med. 1992; 21(4): 368-374.

Klein KR, Rosenthal MS, Klausner HA: Blackout 2003: Preparedness and lessons learned from the perspectives of four hospitals. Prehospital Disaster Med. 2005; 20(5): 343-349.

Lewis CP, Aghababian RV: Disaster planning, Part I. Overview of hospital and emergency department planning for internal and external disasters. Emerg Med Clin North Am. 1996; 14(2): 439-452.

Drenkard K, Rigotti G, Hanfling D, et al.: Healthcare system disaster preparedness, part 1: Readiness planning. J Nurs Adm. 2002; 32(9): 461-469.

Koenig KL, Dinerman N, Kuehl AE: Disaster nomenclature—a functional impact approach: The PICE system. Acad Emerg Med. 1996; 3(7): 723-727.

Ruderman C, Tracy CS, Bensimon CM, et al.: On pandemics and the duty to care: Whose duty? Who cares? BMC Med Ethics. 2006; 7(1): E5.




How to Cite

Cone, MD, D. C., and B. A. Cummings, MA, DO. “Hospital Disaster Staffing: If You Call, Will They Come?”. American Journal of Disaster Medicine, vol. 1, no. 1, Nov. 2006, pp. 28-36, doi:10.5055/ajdm.2006.0007.