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Tool for Evaluating Core Elements of Hospital Disaster Drills

Public Health Emergency Preparedness

This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: Let us know the nature of the problem, the Web address of what you want, and your contact information.

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Hospitals must be prepared to respond to public health emergencies that that may create a sudden demand on services. Disaster drills allow hospitals to test response capabilities to these emergencies in real time. This tool can be used by hospitals to identify the most important strengths and weaknesses in disaster drills. The results can be applied to training and drill planning.

This resource abridges a 2004 report. For a comprehensive drill evaluation, the 2004 report should be used. To efficiently identify the most important strengths and weaknesses in hospital disaster drills, the abridged disaster drill evaluation modules should be used.


This tool has been reviewed by the Department of Homeland Security. DHS's statement follows.

The Department of Homeland Security, Office for Health Affairs is pleased to report that we support the use of the AHRQ publication "Tool for Evaluating Core Elements of Hospital Disaster Drills." This document has undergone review through our internal processes and has been found to be in concurrence with DHS efforts. FEMA reviewers stated, "It is a well developed/written tool to assist evaluators that encompasses unique components of hospital evaluation, such as those required for Joint Commission certification, and complies with the National Incident Management System (NIMS) since it includes an evaluation of an Incident Command System...The tool provides a certain level of detail of actual results, and along with appropriate EEGs and well documented exercise timeline, each module provides a good tool to evaluate hospital exercises. Equally important, the modules serve as a valuable tool to develop specific and measurable exercise objectives."

Jon R. Krohmer, M.D.
Assistant Secretary (Acting) for Health Affairs
and Chief Medical Officer
Office of Health Affairs
Department of Homeland Security

This report was prepared for AHRQ by the Johns Hopkins University Evidence-based Practice Center, Baltimore, MD under Contract No. 290-02-0018. Select to download print version (PDF File, 457 KB; PDF Help).

Investigators: Sara E. Cosgrove, MD, MS; Mollie W. Jenckes, MHSc, BSN; Lisa M. Wilson, ScM; Eric B. Bass, MD, MPH; and Edbert B. Hsu, MD, MPH


Copyright Information and Disclaimer
Chapter 1. Background
  Guiding Principles in Developing Evaluation Modules
Chapter 2. Methods for Development of the Abbreviated Evaluation Tool
  Identification of Expert Reviewers
  Selection of Items for Inclusion
  Summary Items
Chapter 3: Use of the Abridged Modules
  Description of Modules and Addenda
  Overall Value of Abridged Modules
Table 1: Recommended Use of Evaluation Modules and Addenda
Modules and Addenda
  Pre-Drill Module
  Incident Command Center Zone Module
  Decontamination Zone Module
  Triage Zone Module
  Treatment Zone Module
  Biological Incident Addendum
  Radiological Incident Addendum
  Group Debriefing Module


We thank Sally Phillips, RN, PhD, Director, Public Health Emergency Preparedness Research Program, Agency for Healthcare Research and Quality, and Sumner L. Bossler, LCDR, Senior Program Analyst, Office of the Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services, for their guidance and direction in the development of this document. We also would like to acknowledge our external experts, listed below, for their participation in review and comment during this document development.

Michael Allswede, DO
Department of Emergency Medicine
University of Pittsburgh, Pennsylvania

Duane C. Caneva, CDR, MC, USNR
Navy Medicine Office of Homeland Security
Bureau of Medicine and Surgery

Steve Cantrill, MD, FACEP
Department of Emergency Medicine
Denver Health Medical Center, Colorado

Parker Ferguson, Senior Scientist
Consultant to the Department of Homeland Security, Center for Domestic Preparedness and the Department of Defense, Homeland Defense Installation Preparation Program

Paul Guptill, MBA, MA
Director of Regulatory Analysis
Missouri Hospital Association

Kelly J. Henning, MD
Special Advisor
New York City Department of Health and Mental Hygiene

Marguerite Littleton-Kearney, DNSc, FAAN
School of Nursing
Johns Hopkins University

Lewis Rubinson, MD, PhD
Bend Memorial Clinic, Oregon

Richard Schwartz, MD, FACEP
Department of Emergency Medicine
Medical College of Georgia

Joan Stanley, PhD, RN, CRNP, FAAN
Director of Education Policy
American Association of Colleges of Nursing, Washington, DC

Thomas E. Terndrup, MD, FACEP
Chair of Emergency Medicine
University of Alabama at Birmingham, School of Medicine, Alabama

Copyright Information and Disclaimer

This document is in the public domain and may be used and reprinted without permission except those copyrighted materials noted for which further reproduction is prohibited without the specific permission of the copyright holders.

The authors of this report are responsible for its content. Statements in the report should not be construed as endorsement by the Agency for Healthcare Research and Quality (AHRQ) or the U.S. Department of Health and Human Services.

AHRQ Publication No. 08-0019
Current as of June 2008


The information on this page is archived and provided for reference purposes only.


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