Activating physicians within a hospital emergency plan: A concept whose time has come?


  • Kristine M. Gebbie, DrPH, RN
  • Steve Silber, MD, MBA
  • Michael McCollum, MPA
  • Eliot J. Lazar, MD, MBA



emergency response, hospital emergency plan, clinician notification, clinician awareness


Background: Clinicians are an essential component of the medical response to an emergency in which there are actual or suspected injuries. However, little is known about the institutional notification methods for clinicians during emergencies, particularly for off-site staff. Further, there is little knowledge regarding clinicians’ level of awareness of the emergency plans at hospitals with which they are affiliated, or of their knowledge regarding the notification protocols involved in plan activation during an emergency. If physicians are unaware of how to respond to an actual or threatened emergency, the effectiveness of any hospital emergency plan is severely limited.
Objective: This study sought to examine hospital emergency plans, institutional clinician notification, and recall procedures, as well as clinicians’ level of knowledge regarding the emergency notification and recall protocol(s) at the hospital(s) with which they are affiliated.
Methods: Written surveys were sent to hospital emergency coordinators, chiefs of service, and individ-ual clinicians employed by a large, multihospital healthcare system in a major urban area.
Results: We found that 64 percent of respondents’ hospitals had a recall protocol; of those, 53 percent required that the hospital contact clinicians, with 17 percent of those hospitals using a central operator to make the calls. Of the chiefs of services who participat-ed, 56 percent claimed to be very familiar with their facility’s emergency plan, and 53 percent knew that it had been activated at least once in the past year.
Conclusions: Hospital emergency responders are not sufficiently knowledgeable of their institutions’ emergency plans. In order to ensure sufficient surge capacity and timely response, a tiered activation sys-tem, intimately familiar to potential responders, should be developed, taught, and drilled by hospitals to formalize physician call-up.

Author Biographies

Kristine M. Gebbie, DrPH, RN

Director, Center for Health Policy, Columbia University School of Nursing, New York, New York.

Steve Silber, MD, MBA

Vice Chairman of Emergency Medicine, Chairman of the Emergency Preparedness Committee, New York Methodist Hospital, New York, New York.

Michael McCollum, MPA

Project Specialist, Center for Health Policy, Columbia University School of Nursing, New York, New York.

Eliot J. Lazar, MD, MBA

Vice President of Medical Affairs, New York-Presbyterian Healthcare System, New York, New York.


Joint Commission on Accreditation of Healthcare Organizations: Standard EC 1.4: Emergency Management. Chicago: Joint Commission on Accreditation of Healthcare Organizations, 2001.

Affeldt JE: What are the responsibilities of a hospital and its medical staff for developing and implementing an effective community disaster plan? Hosp Med Staff. 1983; 12(6): 25-26.

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.

Huser TJ: Are your disaster plans ready, really ready? J Healthc Prot Manage. 2003; 19(1): 41-48.

Cyganik KA: Disaster preparedness in Virginia Hospital Center—Arlington after Sept 11, 2001. Disaster Manag Response. 2003; 1(3): 80-86.

Berman MA, Lazar EJ: Hospital emergency preparedness—lessons learned since Northridge. N Engl J Med. 2003; 348(14): 1307-1308.

Brennan L, Sage FJ, Simpson A: Major incident planning in South East Thames Region: A survey of medical staff awareness and training. J Accid Emerg Med. 1994; 11(2): 85-89.

Kim DH, Proctor PW, Amos LK: Disaster management and the emergency department: A framework for planning. Nurs Clin North Am. 2002; 37(1): 171-188, ix.

Schultz CH, Mothershead JL, Field M: Bioterrorism preparedness. I: The emergency department and hospital. Emerg Med Clin North Am. 2002; 20(2): 437-455.

Williamson CR: Emergency preparedness: A hospital disaster plan. J Healthc Prot Manage. 1994; 10(2): 116-121.

Quarantelli EL: Ten criteria for evaluating the management of community disasters. Disasters. 1997; 21(1): 39-56.

Auf der Heide K: Disaster planning, part II: Disaster problems, issues, and challenges identified in the research literature. Emerg Med Clin North Am. 1996; 14(2): 453-475.

Rusting RR: Hospitals and disasters: How they fared; what they learned. J Healthc Prot Manage. 2003; 19(2): 110-124.

Guerrieri L, Pugh S: Comply with new standard for disaster volunteers. ED Manag. 2002; 14(11): 128-129.




How to Cite

Gebbie, DrPH, RN, K. M., S. Silber, MD, MBA, M. McCollum, MPA, and E. J. Lazar, MD, MBA. “Activating Physicians Within a Hospital Emergency Plan: A Concept Whose Time Has Come?”. American Journal of Disaster Medicine, vol. 2, no. 2, Mar. 2007, pp. 74-80, doi:10.5055/ajdm.2007.0014.




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