Ready, aye ready? Support mechanisms for healthcare workers in emergency planning: A critical gap analysis of three hospital emergency plans


  • Carol A. Amaratunga, PhD
  • Tracey L. O’Sullivan, PhD
  • Karen P. Phillips, PhD
  • Louise Lemyre, PhD
  • Eileen O’Connor, PhD
  • Darcie Dow, MSc
  • Wayne Corneil, ScD



healthcare workers, occupational health and safety, infectious diseases, bioterrorism, organizational support, disaster management, hospital, pandemic


Background: In response to the 2003 global outbreak of severe acute respiratory syndrome (SARS), and the threat of pandemic influenza, Canadian hospitals have been actively developing and revising their emergency plans. Healthcare workers are a particularly vulnerable group at risk of occupational exposure during infectious disease outbreaks, as seen during SARS and as documented/reported in the recent National Survey of the Work and Health of Nurses (Statistics Canada, 2006). Approximately one third of Canadian nurses identified job strain and poor health, related to their work environment. Three years after SARS, this article presents a critical analysis of the gaps of three hospital pandemic influenza plans in the context of established organizational supports for healthcare workers.
Methods: Hospital pandemic influenza plans were obtained from institutional representatives in three Ontario cities. Qualitative gap analysis of these plans was conducted using a checklist of 11 support categories, developed from a review of existing literature and findings from a previous study of focus groups with emergency and critical nurses.
Results: Support mechanisms were identified in the plans; however, gaps were evident in preparation for personal protective equipment, education, and informational support, and support during quarantine. Hospital emergency planning could be more robust by including additional organizational supports such as emotional/psychological support services, delineating management responsibilities, human resources, vaccine/ anti-viral planning, recognition/compensation, media strategies, and professional development.
Conclusions: Since the 2003 SARS outbreak, hospitals have invested in pandemic planning, as evidenced by the comprehensive plans examined here. Organizational support mechanisms for healthcare workers were included in these hospital plans; however, the gaps identified here may have serious implications for employee health and safety, and overall response during a large scale infectious disease outbreak. The authors provide a number of recommendations for consideration in infectious disease pandemic plan development to better support the healthcare workers in their roles as first responders.

Author Biographies

Carol A. Amaratunga, PhD

Faculty of Medicine, Department of Epidemiology and Community Medicine and Women's Health Research Unit, Institute of Population Health, University of Ottawa, Ottawa, Ontario.

Tracey L. O’Sullivan, PhD

Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario.

Karen P. Phillips, PhD

Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario.

Louise Lemyre, PhD

Faculty of Social Sciences and Institute of Population Health, University of Ottawa, Ottawa, Ontario.

Eileen O’Connor, PhD

Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario.

Darcie Dow, MSc

Women's Health Research Unit, Institute of Population Health, University of Ottawa, Ottawa, Ontario.

Wayne Corneil, ScD

Institute of Population Health, University of Ottawa, Ottawa, Ontario.


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How to Cite

Amaratunga, PhD, C. A., T. L. O’Sullivan, PhD, K. P. Phillips, PhD, L. Lemyre, PhD, E. O’Connor, PhD, D. Dow, MSc, and W. Corneil, ScD. “Ready, Aye Ready? Support Mechanisms for Healthcare Workers in Emergency Planning: A Critical Gap Analysis of Three Hospital Emergency Plans”. Journal of Emergency Management, vol. 5, no. 4, July 2007, pp. 23-38, doi:10.5055/jem.2007.0012.