Hospital bioterrorism preparedness linkages with the community: Improvements over time

Background: Strong linkages between hospitals and community response entities such as fire safety, law enforcement, emergency management agencies. emergency medical services, public health, and local government administration are an essential element of overall hospital preparedness. These pre-established relationships enable an integrated community response during an emergency Methods: This pilot study assessed changes in linkages between hospitals and key community entities related to preparedness for a bioterrorism (BT) event before and after the events of fall 2001. A 51-item questionnaire was mailed to two consecutive hospital samples scheduled for accreditation surveys (April-May 2001 and May-June 2002; n = 68 and n = 97 responses, respectively). On-site visits by surveyors verified the presence of a plan addressing bioterrorism issues. Results: Substantial improvement in collaborative planning for surge capacity and lab/pharmacy issues occurred. Hospital plans that addressed BT increased significantly (47.1% to 90.7%), as did awareness of community BT-related plans (48.5% to 74.2%). Hospitals that conducted a BT-related drill increased from 19.1% to 48.5%. Conclusions: Adequate resources are needed, but opportunities remain to further improve collaborative planning, such as agreements with other hospitals on a single media spokesperson or development of a protocol for pharmaceutical distribution. Additional guidance is needed on expected levels of performance regarding linkages.