Hospital Disaster Preparedness in Los Angeles County Export

@article{citeulike:4311465, abstract = {Background There are no standardized measures of hospital disaster preparedness or hospital "surge capacity." Objectives To characterize disaster preparedness among a cohort of hospitals in Los Angeles County, focusing on practice variation, plan characteristics, and surge capacity. Methods This was a descriptive, cross-sectional survey study, followed by on-site verification. Forty-five 9-1-1 receiving hospitals in Los Angeles County, CA, participated. Evaluations of hospital disaster plan structure, vendor agreements, modes of communication, medical and surgical supplies, involvement of law enforcement, mutual aid agreements with other facilities, drills and training, surge capacity (assessed by monthly emergency department diversion status, available beds, ventilators, and isolation rooms), decontamination capability, and pharmaceutical stockpiles were assessed by survey. Results Forty-three of 45 hospital plans (96\%) were based on the Hospital Emergency Incident Command System, and the majority had protocols for hospital lockdown (100\%), canceling elective surgeries (93\%), early discharge (98\%), day care for children of staff (88\%), designating victim overflow areas (96\%), and predisaster "preferred" vendor agreements (96\%). All had emergency medical services2013compatible radios and more than three days' worth of supplies. Fewer hospitals involved law enforcement (56\%) or had mutual aid agreements with other hospitals (20\%) or long-term care facilities (7\%). Although the vast majority (96\%) conducted multiagency drills, only 16\% actually involved other agencies in their disaster training. Only 13 of 45 hospitals (29\%) had a surge capacity of greater than 20 beds. Less than half (42\%) had ten or more isolation rooms, and 27 hospitals (60\%) were on diversion greater than 20\% of the time. Thirteen hospitals (29\%) had immediate access to six or more ventilators. Less than half had warm-water decontamination (42\%), while approximately one half (51\%) had a chemical antidote stockpile and 42\% had an antibiotic stockpile. Conclusions Among hospitals in Los Angeles County, disaster preparedness and surge capacity appear to be limited by a failure to fully integrate interagency training and planning and a severely limited surge capacity, although there is a generally high level of availability of equipment and supplies.}, address = {Department of Emergency Medicine, Torrance, CA; South Bay Disaster Resource Center, Torrance, CA; Harbor-UCLA Medical Center, Torrance, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Los Angeles Biomedical Research Institute, Los Angeles, CA}, author = {Kaji, Amy H. and Lewis, Roger J.}, citeulike-article-id = {4311465}, citeulike-linkout-0 = {http://dx.doi.org/10.1197/j.aem.2006.05.007}, citeulike-linkout-1 = {http://www3.interscience.wiley.com/cgi-bin/abstract/119820452/ABSTRACT}, doi = {10.1197/j.aem.2006.05.007}, journal = {Academic Emergency Medicine}, keywords = {crisis-response, disaster-planning, disaster-response, earthquakes, is366c, medical, trauma-response}, number = {11}, pages = {1198--1203}, posted-at = {2009-04-15 02:47:58}, priority = {0}, title = {Hospital Disaster Preparedness in Los Angeles County}, url = {http://dx.doi.org/10.1197/j.aem.2006.05.007}, volume = {13}, year = {2006} }

TY - JOUR ID - citeulike:4311465 L3 - citeulike-article-id:4311465 N2 - Background There are no standardized measures of hospital disaster preparedness or hospital "surge capacity." Objectives To characterize disaster preparedness among a cohort of hospitals in Los Angeles County, focusing on practice variation, plan characteristics, and surge capacity. Methods This was a descriptive, cross-sectional survey study, followed by on-site verification. Forty-five 9-1-1 receiving hospitals in Los Angeles County, CA, participated. Evaluations of hospital disaster plan structure, vendor agreements, modes of communication, medical and surgical supplies, involvement of law enforcement, mutual aid agreements with other facilities, drills and training, surge capacity (assessed by monthly emergency department diversion status, available beds, ventilators, and isolation rooms), decontamination capability, and pharmaceutical stockpiles were assessed by survey. Results Forty-three of 45 hospital plans (96%) were based on the Hospital Emergency Incident Command System, and the majority had protocols for hospital lockdown (100%), canceling elective surgeries (93%), early discharge (98%), day care for children of staff (88%), designating victim overflow areas (96%), and predisaster "preferred" vendor agreements (96%). All had emergency medical services2013compatible radios and more than three days' worth of supplies. Fewer hospitals involved law enforcement (56%) or had mutual aid agreements with other hospitals (20%) or long-term care facilities (7%). Although the vast majority (96%) conducted multiagency drills, only 16% actually involved other agencies in their disaster training. Only 13 of 45 hospitals (29%) had a surge capacity of greater than 20 beds. Less than half (42%) had ten or more isolation rooms, and 27 hospitals (60%) were on diversion greater than 20% of the time. Thirteen hospitals (29%) had immediate access to six or more ventilators. Less than half had warm-water decontamination (42%), while approximately one half (51%) had a chemical antidote stockpile and 42% had an antibiotic stockpile. Conclusions Among hospitals in Los Angeles County, disaster preparedness and surge capacity appear to be limited by a failure to fully integrate interagency training and planning and a severely limited surge capacity, although there is a generally high level of availability of equipment and supplies. IS - 11 JF - Academic Emergency Medicine AD - Department of Emergency Medicine, Torrance, CA; South Bay Disaster Resource Center, Torrance, CA; Harbor-UCLA Medical Center, Torrance, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; Los Angeles Biomedical Research Institute, Los Angeles, CA EP - 1203 TI - Hospital Disaster Preparedness in Los Angeles County VL - 13 SP - 1198 KW - crisis-response KW - disaster-planning KW - disaster-response KW - earthquakes KW - is366c KW - medical KW - trauma-response AU - Kaji, Amy AU - Lewis, Roger PY - 2006/// UR - http://dx.doi.org/10.1197/j.aem.2006.05.007 ER -