Hospital and Healthcare Facility Disaster Operations
Hospital command and operations
Hospitals activate HICS and an incident command center. Know the roles: Incident Commander, Public Information Officer, Safety Officer, Liaison Officer, and section chiefs. The Hospital Command Center (HCC) coordinates logistics, patient tracking, and communication with the EOC and EMS.
Surge and capacity
Understand bed surge, staffing surge, and supply surge, and the concept of crisis standards of care. Hospitals must plan for evacuation (horizontal and vertical), shelter-in-place, and decompression (transferring patients out). Evacuation decision triggers include loss of utilities, structural damage, or contamination. A frequent trap: confusing evacuation with decompression-the latter moves patients to other facilities to free capacity, not because the building is unsafe.
Utilities and infrastructure
Know the critical utilities: power (generators, fuel), water, medical gases, HVAC, communications, and information systems. Generators typically have limited fuel and may not power all circuits. Cyberattack is a growing threat that can disable EHR and imaging.
Security and safety
Understand lockdown, access control, and the role of hospital security during a violent incident. Patient tracking and family reunification are operational priorities.
Rule of thumb: Evacuation is a last resort; shelter-in-place is often safer for a contaminated or violent external event, while evacuation is required for internal structural or utility failure.
Worked example: A hospital loses water pressure. HICS activates Logistics to obtain water and portable sanitation; if the loss is prolonged and unsafe, the IC may order partial evacuation or decompression to other facilities.