W4 D2 Kramer Response


Process Analysis:

Issue Identification:  Because of the increasing instances of active shooters, terrorists and more frequent and intense natural disasters, hospitals must prepare for these situations ahead of time to be more effective and to mitigate casualties when the situations arise.  

Mitigation Strategy:  Many major hospitals around the country are participating in disaster drills where the staff simulates a disaster.  This allows for training exercises in areas like triage, transport, communication, evacuation, and other emergency response protocols.  The existing evidence suggests that hospital disaster drills are effective in allowing hospital employees to become familiar with disaster procedures, identify problems in different components of response (e.g., incident command, communications, triage, patient flow, materials and resources, and security) and provide the opportunity to apply lessons learned to disaster response. The strength of evidence on other training methods is insufficient to draw valid recommendations (Hsu et. al., 2004). It is also important to involve the local police and fire departments so that all agencies can work as a team when major problems arise.  Communication between these entities is very important to quicken response times and efficiency in delivering services to the public.

Cost Analysis:  Although these training drills can cost the hospitals and other agencies time and money, being prepared for major disasters will, in the long run, actually save money and, most importantly, people’s lives.  For example, cities that are affected by flooding, if they prepare by fortifying levees and flow diversion, will suffer less damage and loss of life.


Hsu, E., Jenckes, M., Catlett, C., Robinson, K., Feuerstein, C., Cosgrove, S., . . . Bass, E. (2004). Effectiveness of Hospital Staff Mass-Casualty Incident Training Methods: A Systematic Literature Review. Prehospital and Disaster Medicine, 19(3), 191-199. doi:10.1017/S1049023X00001771

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