New AHRQ guides offer hospitals advice on emergency evacuation, assessment, and recovery

Research Activities, August 2010, No. 360

Two new guides are now available to help hospital planners and administrators make important decisions about how to protect patients and health care workers and assess the physical components of a hospital when a natural or manmade disaster, terrorist attack, or other catastrophic event threatens the soundness of a facility. Published by the Agency for Healthcare Research and Quality (AHRQ), the guides examine how hospital personnel have coped under emergency situations in the past to better understand what factors should be considered when making evacuation, shelter-in-place, and reoccupation decisions.

Hospital Evacuation Decision Guide and Hospital Assessment and Recovery Guide are intended to supplement hospital emergency plans, augment guidance on determining how long a decision to evacuate may be safely deferred, and provide guidance on how to organize an initial assessment of a hospital to determine when it is safe to return after an evacuation.

The evacuation guide distinguishes between "pre-event evacuations"—which are undertaken in advance of an impending disaster, such as a storm, when the hospital structure and surrounding environment are not yet significantly compromised — and "post-event evacuations," which are carried out after a disaster has damaged a hospital or the surrounding community. It draws upon past events including the 1994 Northridge, California earthquake; the 1979 Three Mile Island nuclear reactor incident in Pennsylvania; and Hurricanes Katrina and Rita in 2005. The guide offers advice regarding sequence of patient evacuation and factors to consider when a threat looms.

The assessment and recovery guide helps hospitals determine when to get back into a hospital after an evacuation. Comprised primarily of a 45-page checklist, the guide covers 11 separate areas of hospital infrastructure components, such as security and fire safety, information technology and communication, and biomedical engineering that should be evaluated before determining that it is safe to reoccupy a facility.

The Hospital Evacuation Decision Guide is available at and the Hospital Assessment and Recovery Guide is available at Free copies of the guides are available by calling 800-358-9295 or E-mailing

More than 60 other Public Health Emergency Preparedness tools and resources are available on the AHRQ Web site at:

Current as of August 2010
Internet Citation: New AHRQ guides offer hospitals advice on emergency evacuation, assessment, and recovery: Research Activities, August 2010, No. 360. August 2010. Agency for Healthcare Research and Quality, Rockville, MD.