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Hospital Evacuation Decision Guide

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.

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Table 5. Evacuation Time Self-Assessment Worksheet

Evacuation-Relevant Resources Implication
  • If a mandatory city-wide evacuation order is issued, what percentage of your staff is likely to leave with their families (and not report for work)?
  • Have additional trained staff been identified/located to assist, if necessary, with the evacuation?

High % = more vulnerable

N = more vulnerable

Evacuation Resources and Patient Mix
Patient Census and Mix
  1. How many patients are in the ICU (including adult, pediatric, and neonatal intensive care units) and other units (e.g., burn units) with special evacuation needs (e.g., patient must be accompanied by two health care professionals)?
  2. Typical census of adult and pediatric patients?
  3. Typical census of patients with special evacuation needs (e.g., psychiatric patients, bariatric patients, patients from correctional facilities)?
The more ICU and specialty care patients, the more limited the options for where they can be transported.
Patient Transportation Needs
  1. What percentage of patients could self-evacuate (e.g., be taken home or evacuated by family/friends)?
  2. What percentage of patients are ambulatory (e.g.,could be evacuated in a bus)?
  3. What percentage can sit up but not walk (e.g., could be evacuated in wheelchair vans)?
  4. What percentage require medical attention at the BLS level during transport?
  5. What percentage require life support equipment (e.g., could only be evacuated in an ALS ambulance or medevac helicopter)?

Percentages in items a-e should sum to 100%.



The higher the percentage, the more vulnerable if ALS ambulances are scarce.

Evacuation Transportation
  • Does the hospital have an exclusive contract with transportation providers to supply vehicles, or is it dependent on public/private vehicles that must also provide services to other hospitals?
  • Has the hospital established relationships with State and regional emergency management agencies and developed coordinated plans for sharing transportation resources?
  • How many different access roads reach the hospital, where there are ramp-equipped exits for moving patients?
  • How long would it take to get all of the patients out of the hospital and on the road to another location (assuming the hospital is full, roads are not damaged/blocked, and appropriate vehicles and staff are available)?
  • Does the hospital plan specify an off-site "assembly point" where patients could be moved without vehicles, and from which transportation/loading into vehicles would be faster?
  • How long would this two-stage evacuation take?
  • How quickly could all the patients be moved out of the building (e.g. in case of a fire)?

No exclusive contract = more vulnerable

N = more vulnerable

1-2 = more vulnerable

Hours = time until evacuation

No off-site "assembly point" specified = more vulnerable

Hours = time until evacuation

Minutes = time until evacuation

Closest Appropriate Care Site
  • How close is the nearest care site that could provide appropriate care for:
    • NICU patients
    • PICU patients
    • CICU patients
    • Other adult ICU patients
    • Psych patients
    • Other ventilator-dependent patients
    • Other patients with special/advanced medical needs
  • Are there nearby "sister" facilities under the same corporate or organization umbrella?
  • What percentage of patients could that nearest care site or sister facility safely accept in an emergency (how many would they have room for)?
  • If capacity at the nearest care site is insufficient, how close is the next-nearest care site?

< 1 mile
1-5 miles
6-10 miles
11-20 miles
21-50 miles
51-100 miles
100+ miles

N = more vulnerable

The lower the %, the more vulnerable

< 1 mile
1-5 miles
6-20 miles
21-50 miles
51-100 miles
100+ miles

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