An influenza pandemic exercise in a major urban setting, Part I: Hospital health systems lessons learned and implications for future planning


  • Wendy H. Lyons, RN, MSL
  • Frederick M. Burkle Jr, MD, MPH, DTM, FAAP, FACEP
  • Deborah L. Roepke, MPA
  • James E. Bertz, MD, DDS, FACS



pandemic planning, urban disaster planning, disaster exercises, hospital system pandemic planning, health emergency operations centers, pandemic triage, emergency preparedness, NIMS Compliance, Hospital Incident Command Centers, Medical Coordination Cente


A 2007 pandemic exercise in Maricopa County, Arizona, the 5th largest urban population in the United States, revealed major vulnerabilities in planning, response, resource utilization, and the decision-making process, which would be common to any large urban setting where multiple independent organizations exist and have not yet coordinated or shared their plans. Communication challenges are both prevalent and magnified in large urban settings. There must be tough, broad-based decision making by healthcare leadership with guidance and processes at every level to assure compliance to the primary goals of pandemic flu plans necessary to control the transmission rate of the disease. A unifying decision-making element such as a Health-related Emergency Operations Center is critical for the coordination, which serves all urban health systems. Education and training in pre-event protocols for triage management is crucial at every level where resources will be scant. This is especially true in admissions to intensive care units and priorities for ventilator use.

Author Biographies

Wendy H. Lyons, RN, MSL

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

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

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

Deborah L. Roepke, MPA

Consultant, Scottsdale Healthcare, Scottsdale, Arizona

James E. Bertz, MD, DDS, FACS

Exercise Committee Member, Scottsdale Healthcare, Scottsdale, Arizona


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How to Cite

Lyons, RN, MSL, W. H., F. M. Burkle Jr, MD, MPH, DTM, FAAP, FACEP, D. L. Roepke, MPA, and J. E. Bertz, MD, DDS, FACS. “An Influenza Pandemic Exercise in a Major Urban Setting, Part I: Hospital Health Systems Lessons Learned and Implications for Future Planning”. American Journal of Disaster Medicine, vol. 14, no. 4, Oct. 2019, pp. 299-07, doi:10.5055/ajdm.2019.0343.

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