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A comparison of command center activations versus disaster drills at three institutions from 2013 to 2015

Laura G. Ebbeling, MD, Eric Goralnick, MD, MS, Matthew J. Bivens, MD, Meg Femino, HEM, Claire G. Berube, BA, HEM, Bryan Sears, BS, HEM, Leon D. Sanchez, MD, MPH


Objective: Disaster exercises often simulate rare, worst-case scenario events that range from mass casualty incidents to severe weather events. In actuality, situations such as information system downtimes and physical plant failures may affect hospital continuity of operations far more significantly. The objective of this study is to evaluate disaster drills at two academic and one community hospital to compare the frequency of planned drills versus real-world events that led to emergency management command center activation.

Design: Emergency management exercise and command center activation data from January 1, 2013 to October 1, 2015 were collected from a database. The activations and drills were categorized according to the nature of the event. Frequency of each type of event was compared to determine if the drills were representative of actual activations.

Results: From 2013 to 2015, there were a total of 136 command center activations and 126 drills at the three hospital sites. The most common reasons for command center activations included severe weather (25 percent, n = 34), maintenance failure (19.9 percent, n = 27), and planned mass gathering events (16.9 percent, n = 23). The most frequent drills were process tests (32.5 percent, n = 41), hazardous material-related events (22.2 percent, n = 28), and in-house fires (15.10 percent, n = 19).

Conclusion: Further study of the reasons behind why hospitals activate emergency management plans may inform better preparedness drills. There is no clear methodology used among all hospitals to create drills and their descriptions are often vague. There is an opportunity to better design drills to address specific purposes and events.


command center, disaster, drill, disaster preparedness, exercises, emergency management

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