O3229: A Novel Approach to Enhancing Hospital Disaster Preparedness: The Disaster Roll Call

Purpose/Objectives: Mass casualty incidents (MCIs) can lead to large influxes of patients that quickly overwhelm hospitals. The Centers for Medicare and Medicaid Services require hospitals perform two exercises annually to prepare for these rare events. Standard exercises take significant time and resources to plan and execute, including removing staff from duties for hours at a time. Although these exercises meet regulatory requirements, they may fail to generate long-term retention of protocols among staff. To address this gap in preparedness, the novel concept of the “disaster roll call” was developed. The disaster roll call is a no-notice, in-situ, time-limited drill aimed at improving hospital response during the first fifteen minutes of an MCI. The objective was to evaluate the effectiveness of disaster roll calls on emergency department (ED) and hospital response during simulated MCIs.

Design/Methods: This project had two phases: phase one was ED specific, and phase two included additional hospital departments. Each roll call was a no-notice event, with hospital staff having no prior knowledge of the drill. Each drill began with a facilitator notifying the ED of a fictional MCI, prompting disaster protocol activation. Eleven critical tasks were identified for successful initiation of disaster protocols. A checklist was utilized by observers to document task completion. Phase two included additional departments, including surgery, anesthesia, pediatrics, neurosurgery, PICU, orthopedics, inpatient nursing, and others. Observers completed a survey rating communication, leadership, and organization from 0 (ineffective) to 2 (highly effective).

Results: During phase one, seven ED-specific drills were completed. On average, each drill took 10.0 minutes to complete (range 8-15 minutes). Three drills had a 100% task completion rate, and four drills had a 91% task completion rate. In phase two, three hospital wide drills were performed over six months. The average time to complete a hospital wide drill was 11.67 minutes (range 10-13 minutes). The first drill had an 83% task completion rate, and the subsequent two drills had a 100% task completion rate. The overall response rate of all key departments across all hospital-wide drills was 83%.

Improvement in time to completion of several critical tasks was demonstrated between phases. Overall, efficiency improved by approximately 2.5 minutes, about a 25% reduction in time to readiness for a disaster. Post-drill surveys showed improvements across all categories: clear leadership improved by 10%, communication by 52%, and overall organization by 75%.

Conclusion/Discussion: The disaster roll call is a novel tool which can effectively and efficiently supplement a hospital’s preparedness plans. Improvements were demonstrated in all aspects of the disaster plan, including task completion, leadership, verbal communication, and overall organization. This data supports disaster roll calls are a time efficient and effective training tool that can be used to optimize hospital disaster preparedness.