Hospital disaster preparedness in the Netherlands

Introduction: Despite having a good health care system, recent studies show that the Netherlands scores low on hospital disaster preparedness. A possible reason could be that there is a Dutch framework based on self-evaluation and intercollegiate evaluation but no formal set of requirements for hospital disaster preparedness plans.Study Objective: Evaluation of disaster preparedness of hospitals in the Netherlands by using the WHO Hospital Emergency Response Checklist to systematically assess the quality, strengths, and weaknesses of Dutch hospital disaster preparedness plans. Methods: Hospital crisis coordinators sent their most recent disaster hospital plan and crisis plan. Two researchers independently studied and scored the content of the received plans according to the WHO Checklist. Overall scores per hospital and key components were calculated based on the number of points assigned to each priority action.Results: Twenty hospitals (29% of all Dutch hospitals) participated in the study and scored between 33 and 97 out of 184 points. Twelve hospitals scored 'insufficient', eight scored 'unacceptable' according to WHO cutoff points. No hospital scored 'effective'. The key components command and control, triage, and communication scored highest. Logistics and supply management, human resources, and continuity of essential services scored low. An unexpected finding was a large variety in configuration of the studied plans.Conclusion: None of the participating hospitals reached an effective preparedness score. Issues that received attention in response to previous disasters scored well on the WHO Checklist. Components that were not addressed in the Dutch evaluation framework for crisis management scored low.