Hazard vulnerability analysis (HVA) is used to risk-stratify potential threats, measure the probability of those threats, and guide disaster preparedness. The primary objective of this project was to analyse the level of disaster preparedness in public hospitals in the Emirate of Abu Dhabi, utilising the HVA tool in collaboration with the Disaster Medicine Section at Harvard Medical School. The secondary objective was to review each facility's disaster plan and make recommendations based on the HVA findings. Based on the review, this article makes eight observations, including on the need for more accurate data; better hazard assessment capabilities; enhanced decontamination capacities; and the development of hospital-specific emergency management programmes, a hospital incident command system, and a centralised, dedicated regional disaster coordination centre. With this project, HVAs were conducted successfully for the first time in health care facilities in Abu Dhabi. This study thus serves as another successful example of multidisciplinary emergency preparedness processes.

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.

Introduction: Crises in the operating room (OR) are uncommon events that require an expeditious response from all providers to minimize morbidity and mortality to both patients and staff. Evacuation during a surgical procedure presents a unique challenge. There is a paucity of data on the ideal response, ideal times, and training needs for hospital staff.Methods: The authors herein describe a full-scale simulation exercise of the emergent mid-procedure evacuation of seven ORs.Results: Median time to evacuate from the OR and reach the Post-Anesthesia Care Unit safety point was 3:50 minutes (range, 1:22 minutes to 6:00 minutes). Multiple lessons were learned from direct observation, post-drill debrief, and post-drill survey of participants.Conclusions: Emergent mid-procedure evacuation of ORs can be expeditious if needed. Critical themes in leadership, communication, and coordination of care were discovered. Surgeons, anesthesiologists, and OR staff should consider performing an OR evacuation drill to improve their local efficacy and efficiency in emergent OR evacuation.

existing capacity to respond. Operational capability scores ranged from 33% (death care industry) to 77% (offices of emergency management). Resource sharing capability analysis indicated that only 42% of possible reciprocal relationships between resource-sharing partners were present. The overall cross-sector composite score was 51%; that is, half of the key capabilities for preparedness were in place. Conclusion: Results indicate that the US mass fatality infrastructure is sub-optimally prepared for MFI that exceeds 25 or fewer additional deaths in a 48-hr period. National leadership is needed to ensure sector-specific and infrastructure-wide preparedness, with a special focus on training, drills, and planning activities for large-scale or complex MFI.

Background: Assessment of hazard vulnerability is a critical stage in the disaster preparation cycle. This process determines the relative priority of each disaster subtype to the organization, and provides guidance to the organization for allocating time and resources. Since 2001, the Joint Commission International requires all hospitals in the United States to perform a hazard vulnerability analysis annually, and use their findings to guide planning efforts. To date, there is no officially recommended method for the hazard vulnerability assessment of health care institutions, and little literature on best practices. As such, methods utilized are heterogeneous and institution specific. Methods: Qualitative and quantitative methodologies are used for this study. Surveys are administered by email and on paper to emergency managers at hospitals in Boston, Massachusetts USA, who are queried regarding their method for hazard vulnerability assessment, the instrument used, who completes the analysis, what guidance/training is given, and if subanalysis is completed when the hazard profile changes from previous years. Responses are analyzed using quantitative and qualitative methods. Results: This study is in progress, with results expected by March 2017. Conclusion: The study is currently ongoing. We anticipate that hazard vulnerability analysis methods and instruments will reflect a lack of standardization of practice in the field. Relative strength and weaknesses of different instruments will be highlighted, and common practices at health care institutions will be reviewed. Our hope is that such discussion will encourage greater standardization, and the development of best practices for this critical stage in the disaster preparation cycle.