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Educate physicians, nurses, and administrative staff about their roles and responsibilities in potential disaster events. Work with state and local partners to improve our collective policies and plans for emergency response to health threats. Paul Biddinger shares insight lessons from Emergency Preparedness as part of a collection of videos used by managers around the world in the broader business community to improve their leadership skills. CDM and hospital emergency management program members meet regularly with the leadership of many hospital departments and divisions including trauma surgery, nursing, the hospital safety office, and others. Fellows are based at one institution, but receive training experiences and education at all of the participating institutions. In addition, residents are encouraged to complete an eight-hour Occupational Safety and Health Administration (OSHA) Operations-level Hazardous Materials training developed and sponsored by the CDM to allow them to safely wear appropriate Personal Protective Equipment (PPE) in a hazardous materials event.
Medical students from Harvard Medical School, and also those visiting from other medical schools, are included in the HAEMR disaster curriculum lectures. Members of the Center for Disaster Medicine have been invited to speak at local, national, and international events on topics of emergency preparedness and response. The MGH Hazmat Team has won a special citation from the Mayor’s Office of the City of Boston, and is one of the most active hospital-based programs in the state.
On September 28, 2010, David Chin and Sheryl Davies made this presentation at the 2010 Annual Conference.
Notes: This is a simplified graphic that illustrates the general process of developing and validating measures, both for this set and past sets.
To the right of these steps is a cog captioned, "Ongoing Feedback, Refinement, and Reassessment"; an arrow indicates that the cog is turning.
Hospital has a plan for alternative means of communication or backup communication systems. Hospital has a plan for coordinating all levels of communication, including both intra- and inter-organizational communication, as well as required technology.
Hospital has a plan specifically for protecting staff and other responders using countermeasures, supplies, and personal protective equipment (PPE). Hospital has a plan for safety and security of people, including staff, patients, and supplies, which may involve partnering with local law enforcement agencies. Hospital has a plan for evacuation, including transport of patients and information to alternate care sites. Hospital inventory of equipment and supplies includes items such as vents, PPE, negative pressure isolation, ICU beds, decontamination showers, antidote kits, and pediatric equipment. Hospital has a plan for facility access control and staff is able to gain access to the facility when called back to duty. In ramping up for surge, hospital has the ability to increase physical space and resource capacity through tactics such as rapid discharge, home care, and alternate care sites. Hospital's emergency operations plan (EOP) is modified based on exercises or actual emergencies.
Hospital has a plan for modification of normal clinical activities (including specialized care) or standards of care as related to disaster response.
Did not favor topics derived from guidelines from any single source, or from multiple sources.
Number of participating hospitals statewide that have access to pharmaceutical caches sufficient to cover hospital personnel (medical and ancillary), hospital based emergency first responders and family members associated with their facilities for a 72-hour period.


The organization plans for replenishing medical supplies that will be required throughout response and recovery, including access to and distribution of caches (stockpiled by the hospital or its affiliates, local, state, or federal sources) to which the hospital has access. Number of drills conducted during the FY 2005 budget period that included hospital personnel, equipment or facilities.
For each site of the hospital that offers emergency services is a community-designated disaster receiving station, at least one of the hospital's two emergency response exercises includes an escalating event in which the local community is unable to support the hospital.
Possess sufficient numbers of PPE to protect both the current and additional health care personnel deployed in support of an event. The organization keeps a documented inventory of the assets and resources it has on site that would be needed during an emergency (at a minimum, personal protective equipment, water, fuel, staffing, medical, surgical etc.
Only 7 represented in the linkages between databases to the major topic areas in Priority 1 and 2 (n = 16). Proxy measures not yet linked to outcomes, and limited ability to establish link given frequency of actual events.
Limited knowledge about best "preparation" to improve outcomes, limited ability to establish.
Resources dedicated to EP and EP measurement may draw resources away from day to day clinical care. Example: Time to evacuate a hospital, based on small demonstration evacuation and modeling to extrapolate time to evacuate the entire hospital. Define how to move from hospital based data collection to aggregate measures at state-level. Proposed Measure 1: The time to relay a field asset request or critical field information to a non-hospital-based emergency operations center (EOC) during an exercise. Hospital has a plan for safety and security of people, including staff and patients, and supplies, which may involve partnering with local law enforcement agencies. Proposed Measure 1: The time to establish a functioning security screen checkpoint during an exercise, according to the hospitals EOP. Proposed Measure 2: Does the hospital have an MOU or MOA with a security agency for security support? Step 6: Collect pilot data, including test-retest reliability, inter-rater reliability, and measure performance. Internet Citation: Challenges and Approaches to Measuring Hospital Emergency Preparedness (Text Version). The hospital is located in an urbanized environment and the emergency department is highly utilized by the community.
Paul Biddinger, the CDM is closely integrated with the hospital emergency preparedness program and is supported by participation from clinicians on the MGH Department of Emergency Medicine faculty as well as MGH ED nursing and MGH ED administration. CDP designs and conducts regular training events and exercises within MGH to develop, disseminate and test emergency plans. Gregory Ciottone of the Beth Israel Deaconess Medical Center, participating in the structure and design decisions of the overall program and opportunities for fellows.
The two year program includes didactic lectures, seminars, readings, goal-related research in a specific area of DM and EM, and fieldwork resulting in a thesis. Residents are also given multiple opportunities each year to participate in exercises to further advance their training in disaster response. In addition, medical students at MGH are invited to participate in the MGH disaster exercise program.


To date, CDM members have led more than 50 local and regional training events and have been invited to speak more than 70 times on emergency preparedness and response. Biddinger has completed work on various CDC-funded projects to conduct both research and trainings on topics of emergency preparedness. Biddinger has served as an advisor on planning for standards of care in disaster situations, and currently serves as a consultant on health emergency preparedness. The feedback loop shows the iterative nature of the process by which information from literature reviews, users' evaluation and experience is used to select the most promising measures and then refine definitions. This Section (comprised of faculty from most of the Harvard teaching hospitals’ Departments of Emergency Medicine) has collectively developed a fellowship in Disaster Medicine (DM).
Upon completion of this fellowship, fellows are skilled in all aspects of the disaster cycle and have the ability to assume a leadership role on the local, regional, federal, or international level in the area of Disaster Medicine and Emergency Management. The CDM designs and conducts between three and six full-scale exercises each year dealing with mass casualty, chemical hazards, and radiological hazards. The DM fellowship program is designed to provide qualified emergency physicians the opportunity to develop an expertise in the related fields of Disaster Medicine (DM) and Emergency Management (EM).
After graduation, fellows can assume a leadership position and be active in research and academics, eventually becoming an internationally noted expert.
He has also completed work on four separate AHRQ-funded research projects on disaster preparedness, and one Department of Health and Human Services (HHS)-funded research event in 2009.
In addition, hospital officials wanted the existing ambulance emergency entrance, which was open to the outside, to be part of the garage and to provide shelter and space for the ambulances and patients entering the ED. The MGH CDM has hosted fellows from the disaster section in its lectures and preparedness exercises, and fellows have met with Dr. Let us know the nature of the problem, the Web address of what you want, and your contact information. All of the faculty members in the MGH Department of Emergency Medicine are required to participate in a CDM-sponsored activity at least once every three years.
Biddinger is also the principal investigator on numerous statewide preparedness projects in Massachusetts funded by the Assistant Secretary of Preparedness and Response (ASPR) via the Massachusetts Department of Public Health. Since 2005, the CDM has published 17 peer-reviewed articles, 12 non-peer reviewed articles, chapters and reports, and presented 24 abstracts at national conferences. Mass General takes great pride in our responsibility to prepare to serve our diverse communities in times of need. In addition, before the site was a garage, it had various other usages that dated back to the 1840s. There were over 200 undocumented caissons underground that were found as the team developed and dug foundations.In March of 2015, the ambulance drop-off area opened early. The team understood from past experience that the closer triage rooms were to the ambulance drop-off area, the better the outcomes of the patient would be.“We considered this the difference between life and death in some cases,” Stepelevich added.



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