Emergency Exercises

Q: If a health care organization has no part in the community wide disaster plan, does the organization still have to have one exercise per year with an influx of patients from the outside? Can the "influx of patients" be from patients or visitors who are injured by an event occurring inside the organization?

A: Any accredited organization that provides emergency services or is designated as a disaster receiving station needs at least one exercise per year that includes an influx from outside the organization of volunteer or simulated patients. If you have an exercise scenario whereby only patients and visitors within the hospital are injured during some sort of disaster, then that would be considered an internal disaster exercise. Enough "victims" should be used for the mass-casualty exercise to adequately test the system, with the number of victims necessary to test the organization's resources and reactions under stress. A real incident may be used if it activates the plan; modifies the normal use of services, equipment, staff, and normal patient management procedures; and fits the timing requirements outline in the standards.