Activating physicians within a hospital emergency plan: A concept whose time has come?

Abstract

Background: Clinicians are an essential component of the medical response to an emergency in which there are actual or suspected injuries. However, little is known about the institutional notification methods for clinicians during emergencies, particularly for off-site staff. Further, there is little knowledge regarding clinicians’ level of awareness of the emergency plans at hospitals with which they are affiliated, or of their knowledge regarding the notification protocols involved in plan activation during an emergency. If physicians are unaware of how to respond to an actual or threatened emergency, the effectiveness of any hospital emergency plan is severely limited. Objective: This study sought to examine hospital emergency plans, institutional clinician notification, and recall procedures, as well as clinicians’ level of knowledge regarding the emergency notification and recall protocol(s) at the hospital(s) with which they are affiliated. Methods: Written surveys were sent to hospital emergency coordinators, chiefs of service, and individ-ual clinicians employed by a large, multihospital healthcare system in a major urban area. Results: We found that 64 percent of respondents’ hospitals had a recall protocol; of those, 53 percent required that the hospital contact clinicians, with 17 percent of those hospitals using a central operator to make the calls. Of the chiefs of services who participat-ed, 56 percent claimed to be very familiar with their facility’s emergency plan, and 53 percent knew that it had been activated at least once in the past year. Conclusions: Hospital emergency responders are not sufficiently knowledgeable of their institutions’ emergency plans. In order to ensure sufficient surge capacity and timely response, a tiered activation sys-tem, intimately familiar to potential responders, should be developed, taught, and drilled by hospitals to formalize physician call-up.