An influenza exercise in a major urban setting. II. Development of a health emergency operations center


  • Wendy H. Lyons, RN, MSL
  • Frederick M. Burkle Jr, MD, MPH, DTM, FAAP, FACEP
  • Alisa Diggs, PA, MPH
  • Teresa Ehnert, MS



pandemic planning, emergency response planning, urban disaster planning, health emergency operations centers, disaster exercises, hospital system planning, NIMS compliance, Incident Command System, Hospital Incident Command System, Medical Coordination Ce


Strong relationships and partnerships must be developed for the mitigation of untoward secondary events and positive outcomes during large-scale disasters. Although a health-related emergency operations center-like structure within the Incident Command Structure is advantageous for every community, the process by which it is developed within a large urban setting will be a unique challenging task and requires unprecedented collaboration, cooperation, and coordination. This study explains the necessary components of a uniquely demanding development process leading to a health-related emergency operations center for Maricopa County,Arizona, the creation of which has significantly improved the effectiveness of multiagency involvement, communication, and decision making. Similar challenges will be faced by other urban settings.

Author Biographies

Wendy H. Lyons, RN, MSL

Vice President, Community Stewardship, Scottsdale Healthcare, Scottsdale, Arizona.

Frederick M. Burkle Jr, MD, MPH, DTM, FAAP, FACEP

Exercise Consultant, Senior Fellow and Scientist, Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts.

Alisa Diggs, PA, MPH

Program Manager, Maricopa County Department of Public Health, Phoenix, Arizona.

Teresa Ehnert, MS

Arizona Department of Health Services, Bureau of Emergency Preparedness, Phoenix, Arizona.


US Census Bureau: Maricopa County, AZ. Available at http:// Accessed January 22, 2010.

Lyons WH, Burkle FM Jr, Roepke DL, et al.: An influenza pandemic exercise in a major urban setting. I. Hospital health systems lessons learned and implications for future planning. Am J Disaster Med. 2009; 4(2): 120-128.

Burkle FM Jr, Hsu EB, Loehr M, et al.: Definition and functions of health unified command and emergency operations centers for large-scale bioevent disasters within the existing ICS. Disaster Med Public Health Prep. 2007; 1(2): 135-141.

Maricopa County Healthcare Disaster Council: H1N1 Healthcare Hotwash Summary. Phoenix, AZ: Maricopa County Healthcare Disaster Council, 2009.

Arizona Hospital and Healthcare Association: Arizona Hospital Mutual Aid Memorandum of Understanding. Phoenix, AZ: Arizona Hospital and Healthcare Association, 2008.

Arizona Department of Health Services: The State of Arizona Plan for Pandemic Flu. Phoenix, AZ: Arizona Department of Health Services, 2006.

Scottsdale Healthcare: Mass Vaccination of Healthcare Workers Exercise Master Sequence of Events (MSEC). Scottsdale, AZ: Scottsdale Healthcare, 2009.

Rough G: Arizona rated the state most ready to handle a flu pandemic, The Arizona Republic, Phoenix, AZ, 2009.




How to Cite

Lyons, RN, MSL, W. H., F. M. Burkle Jr, MD, MPH, DTM, FAAP, FACEP, A. Diggs, PA, MPH, and T. Ehnert, MS. “An Influenza Exercise in a Major Urban Setting. II. Development of a Health Emergency Operations Center”. American Journal of Disaster Medicine, vol. 5, no. 4, July 2010, pp. 247-55, doi:10.5055/ajdm.2010.0030.



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