Report: U.S. hospitals ill-equipped for large-scale disasters

Rescue workers traverse floodwaters
Johns Hopkins researchers suggest improved federal coordination as a way to close gaps in disaster preparedness among U.S. hospitals. Image: Hurricane Harvey. (U.S. Dept. of Defense)

U.S. healthcare systems perform well in smaller, localized disasters but respond poorly to larger-scale disasters and catastrophes, according to a new report. Better coordination could be the key to closing the gap.

The new report (PDF), published by the Johns Hopkins Center for Health Security, details a gap analysis of current healthcare facilities in the face of four categories of likely disaster. Researchers found that healthcare organizations generally responded well to localized events that happen frequently. However, they struggle more with responses to larger-scale disasters, such as bombings or weather events. The report found hospitals least prepared for “catastrophic health events,” such as pandemics or bioterror attacks.

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Eric Toner, M.D., the principal investigator on the report, doesn’t see a need to radically reinvent disaster preparedness so much as a need for incremental improvement. “The change should be evolutionary, not revolutionary,” he said in an announcement about the findings.

The report offers four recommendations for improving coordination among healthcare organizations as they prepare for and deal with disasters:

  • Coordinate hospitals’ disaster responses at the federal level. The authors recommend creating a group within the U.S. Department of Health and Human Services that focuses solely on preparation for national catastrophic health events, allowing for greater coordination among existing disaster-preparedness initiatives.
  • Foster disaster resilience among individual healthcare facilities. As a policy measure, the report recommends a federal program to identify and encourage facilities to prepare for healthcare disasters. Recent research suggests areas that may seem unconnected to disaster preparedness, particularly day-to-day stress levels causing burnout among healthcare staff members, can leave hospitals vulnerable in a large-scale emergency.

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  • Create and support regional coalitions to bring together disparate players in disaster preparation. Large-scale weather events like Hurricane Harvey have highlighted areas of potential improvement among organizations providing shelter, security and effective communication. The report recommends connecting responsive organizations before a disaster strikes and engaging them in preparedness work.
  • Share disaster-preparedness knowledge and best practices. Researchers recommend identifying geographically dispersed healthcare institutions as “Disaster Resource Hospitals” dedicated to serving as a resource for public health officials and other institutions as they engage in disaster preparation.