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Hospital Assessment and Recovery Guide

Public Health Emergency Preparedness

This resource was part of AHRQ's Public Health Emergency Preparedness (PHEP) 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 It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work.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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Other Considerations for Hospital Assessment

This guide can be used after evacuations caused by many types of emergency events, ranging from a fire to the loss of municipal water to earthquakes. The specifics of the emergency event will have implications for the type of damage sustained by the hospital and the assessment strategy upon return. Therefore, the Administration (ADMIN) team should consider the following issues when developing the hospital assessment strategy, and each team should consider these issues as they conduct their assessments.

  1. What emergency event took place (e.g., fire, hurricane, flood), and what was the ultimate reason for evacuation (e.g., loss of municipal water or heat, smoke, flooding)?
    • The type of event that took place, and subsequent damage, will affect the scale, strategy, and approach of the hospital assessment that follows. For example, if the hospital was evacuated because a fire filled the building with smoke and soot, the hospital grounds will not need to be assessed. It is important to keep in mind that some damage may not be always be obvious (for example, a fungal agent that has spread within the ventilation system) or expected (for example, water damage can be caused by broken pipes due to extreme cold during the hospital vacancy as well as by a flood, earthquake, or the sprinkler system in the event of a fire).
  2. Was the hospital able to implement the evacuation plan, or was departure so rapid that an orderly evacuation was not possible?
    • If the evacuation took place quickly and the full evacuation plan was not followed, there may be additional issues that will need to be considered and dealt with upon return. For example, the oxygen system may not have been turned off; biological samples may have been left in autoclaves or other equipment and may need to be decontaminated, paper documents containing confidential patient medical information may have been left scattered in patient care areas, and so on.
  3. Did the hospital lose power or water during the emergency event or subsequent vacancy?
    • If power and/or water were lost, additional damage may have occurred, and additional testing will be needed to assure that systems throughout the hospital are functioning correctly and can be safely used (e.g., sprinklers, elevators). Damage from power surges can be caused when power returns suddenly; faucets left in the 'open' position may cause flooding when water returns suddenly. Also, if power was lost, frozen/refrigerated biological samples throughout the hospital may have been compromised.
  4. Were environmental controls/HVAC lost, and was it very hot or very cold during the evacuation/vacancy?
    • Even if power remained on, loss of environmental control systems can mean the hospital sustained extreme heat or cold. Extreme heat or cold, or a rapid change in temperature, can cause condensation damage and the potential for short circuits to sensitive equipment throughout the hospital.
  5. Was the hospital occupied by rescue workers or others (e.g., remaining staff, squatters, rescue personnel) while it was shut down?
    • If so, there may be additional damage to the hospital from this occupation (for example, toilets may need to be emptied of human waste, and areas of the hospital may have been vandalized).
  6. How long was the hospital closed/evacuated (days, weeks, or months)?
    • A lengthy vacancy can mean greater damage, and additional regulatory inspections may be necessary.

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