Focus Area: Evacuation

Flood. Fire. Bomb threat. Power outage. Backup generators fail to come on. There are multiple scenarios that cause a hospital floor, unit, or building to evacuate patients to another area. Does your facility’s evacuation plan guide your staff in the process? Are you able to quickly prioritize patients and destinations for optimal safety outcomes?

The purpose of hospital evacuation is simply to move patients and providers out of harm’s way and continue to provide appropriate care for patients. Evacuation is tied to the most important emergency response objective of saving lives.

Evacuations may be necessary for many reasons and may come with time to prepare or mere minutes to implement a plan. It is therefore imperative that your facility has the resources, personnel, strategies, and routes prepared ahead of a disaster and considered through all phases of the disaster cycle. It is also important that all appropriate stakeholders have been invited to the table for planning meetings and drilled on those plans. Hospitals, EMS agencies, Healthcare Coalitions, and others should be involved in the planning discussions in an open, honest and realistic manner for an evacuation plan to be executed efficiently.

Meeting Schedule

Meetings are held the first Tuesday of each month 2:30-3:45 pm CT.

Session DateLinksSession Details
2025
March 4DetailsRecording and Slides
April 1DetailsRecording and Slides
May 6 (Full Collaborative)DetailsRecording and Slides
June 3Register
July 1Register
August 5 (Full Collaborative)Register
September 2
October 7
November 4 (Full Collaborative)Register
December 9 (Office Hours)
2026
January 6
February 3 (Full Collaborative)Register
March 3
April 7
May 5 (Full Collaborative)Register
June 2

Planning

The quality of pre-planning, staff training, and engagement in exercise activities involving hospital personnel and jurisdictional partners such as Fire, EMS, Healthcare Coalition partners, and others will influence evacuation decision-making.

All four DRC intervention bundle guides are based on information and recommended strategies within the Checklist of Essential Pediatric Domains and Considerations for Every Hospital’s Disaster Policies (also known as “The Disaster Checklist”). Evacuation, domain 4, includes recommended activities at foundational, intermediate, and advance levels and can be viewed on pages 18-19. As you use The Disaster Checklist to develop and/or enhance your evacuation plan, below are key considerations.

Key considerations:

  • Understand your facility’s unique services and capacity (NICU, PICU, L&D, etc.)
  • An up-to-date Hazard and Vulnerability Assessment should be used to inform or update the evacuation plan
  • Identify a prioritization plan for patient movement during an evacuation
  • Ensure legal and ethical considerations are a part of the prioritization plan for critical patients
  • Include a process to identify patients eligible for early discharge
  • What local, community, and regional partner resources and guidelines are available to augment capabilities
    • Special patient population considerations: burn, pediatric critical care (advanced respiratory and blood pressure support)
    • Is there a system within your state and/or interstate to identify immediately available pediatric capable beds, including SNFs, LTAC, hospice (hospital throughput)?
  • Staff processes need to address varying degrees of evacuation, including emergent and staged evacuation. Consider good, better, best scenarios
  • An assembly point for meeting after evacuation, as well as contingency plans, should be included
  • Create a list of resources needed that are specific to evacuation
    • Create a list of supplies (essential, important, and less important) to have during evacuation
  • Ensure a process for internally communicating the decision to evacuate is included in the plan
  • Permission to evacuate if deemed necessary should be included in the permission to treat form

Tabletop Exercises and Drills

The DRC teams will be offered guidance and support to review/update their disaster plans during a 3-hour virtual tabletop exercise (VTTX) in 2025.  An After-action report completed by exercise participants will help identify gaps and steps for improvement that the facility can consider and follow up on. The gaps and process measures can be tested in two follow-up drills to be conducted in 2026. See the VTTX Checklist and the DRC Tabletop Exercises and Drills webpage.

Quality Improvement and Intervention Strategies

Global AIM

Support children’s hospitals to develop robust evacuation plans in the event of diverse large scale disaster events that recognize the unique scope of healthcare services at their individual facility.

AIM Statement

By June 2026, 50% of children’s hospitals in the DRC choosing to focus on Evacuation will have evaluated one or more strategies to improve performance on at least one of the following process measures:

Quality Measures

Select one or more measures from the list below to focus on in the two drills.

  • Time to identify resources needed for the evacuation, including equipment and additional staff
    • Intervention Strategies:
      • Establish a clear notification process for the occurrence of an evacuation event and activation of incident command, including who will communicate, how the communication occurs, and who must receive the information, and all applicable community partners.
      • Identify which threats are the highest risk in your community (e.g. fire, severe weather, active shooter).
      • Create and regularly update a list of additional staff and abilities to call upon during an evacuation.
      • Create a list of possible equipment needed during an evacuation, with the ability to update if/when needed. Ensure the equipment is maintained.
      • Develop a clear list of transportation and transport resources internal and external to the hospital (vehicles, necessary staff, equipment, and supplies that must be in the vehicles).
  • Time to systematic prioritization of patients to be evacuated
    • Intervention Strategies:
      • Identify and implement a standardized prioritization methodology and add to protocols, ensuring legal and ethical considerations are a part of the plan for critical patients.
      • Ensure appropriate staff are trained and understand the prioritization methodology and how to implement this. Consider knowledge, skills, and ability surveys or demonstrations. Consider both advance and just in time training.
  • Time to evacuation of entire unit (optional)
    • Intervention Strategies:
      • Establish a clear notification process for the occurrence of an evacuation event and activation of incident command, including who will communicate, how the communication occurs, and who must receive the information, and all applicable community partners.
      • Work with and ensure Hospital C-suites, local government authorities, fire department authorities and others are involved in preparation discussions and have plans in place so that decisions can be made in times of crisis. Understand what roles non-hospital employees (EMS, firefighters, healthcare coalitions, national guard, school personnel, etc.) will be allowed to take on during emergency evacuations.
      • Establish a clear evacuation plan for the unit, to include where the patients will need to be placed during evacuation and an assembly for transport to a definitive care site (in or outside of the state). Review and update exit plans and maps, including where they are placed and condition of printed materials.

If you have identified other objectives or measures because of an exercise after-action report or state/organizational requirements (CMS, Joint Commission, ACS Trauma Level 1, etc.), you can use those.

Resources

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