Disaster preparedness in 2025: Recommendations for healthcare chief executive officers
September is National Preparedness Month, which aims to raise awareness about the importance of preparing for emergencies. The American College of Healthcare Executives advises healthcare executives to actively participate in disaster preparedness for natural and man-made disasters. This advice has never been more relevant as healthcare organizations plan for the 2026 fiscal year. The decreased financial resources from local, state and federal agencies require increased vigilance by healthcare leaders. Due to hospital roles as seminal entities during natural or man-made disasters, our community responsibilities remain fundamental, particularly within growing fiscal limitations. Our preparedness now for the potential of man-made or natural disasters will benefit both our local communities and our workforces as we strive to keep highly reliable and effective operations under all situations.
Five Recommendations for Healthcare CEOs
1. Standardize hospital policy manuals and hospital alert systems across shared health systems. Consider standardization of disaster policies with flexibility to accommodate special considerations by geographies. The National Incident Management System (NIMS) provides consistency within the hospital leadership command through a hospital incident command structure (HICS) during a disaster. However, there is no national standard for hospital alert systems and only 50 percent of U.S. hospitals have standardized codes. Codes Blue, Pink and Silver are no longer standard. Plain language hospital alerts are the industry best practice because they improve clarity, enhance safety and support transparency.
2. Incorporate regional hazards into the hospital Hazard Vulnerability Assessment (HVA) to better inform the NIMS planning cycle. National and regional hazards are often missed in the hospital HVA. Hospitals appropriately direct resources toward the higher-ranking hazards within the HVA. Incorporating state-recognized hazards into hospital planning addresses vulnerabilities in staff training, pharmaceutical availability, specialty materials and personal protective equipment required for the HVA hazards.
3. Ensure all hospital planning includes patients with special needs. Twenty-seven percent of the U.S. population falls into one or more special needs or disability category. Categories of special needs include Alzheimer’s, autism, blindness or limited sight, deaf or diminished hearing, dialysis dependency, homelessness, limited mobility, medically dependent on equipment using refrigeration, oxygen or electricity, mentally disabled, non-English speaking, pregnancy and children. Populations with special needs may have increased vulnerability during a disaster and hospitals need to plan for the varied needs of these populations. Hospitals must also remember to plan for the special needs of first responders, such as the police, fire and emergency medical technicians responding to a disaster.
4. Senior executives and board members should take a visible role during disaster drills. Staff focus mirrors leadership priorities. The time for executives to understand the incident response plan is before the actual event. The chief executive officer (CEO) should designate a senior leader to be accountable for emergency management within the system and hospitals. This senior leader oversees and supports the program before, during and after events. Transparent reporting through the quality structure and discussion at board meetings ensures vulnerabilities and challenges are understood and sufficient resources are allocated to address any problems.
5. Plan to be self-sufficient beyond the 96 hours required by the Joint Commission. While a hospital is not required to continue normal operations during the first 96 hours of a disaster, it must have a plan ensuring resources are managed and services prioritized, specific to the hospital’s size and critical functions. This recommendation is not a supply mandate but rather an attempt to foster awareness. The reality of local, state and federal resource reductions requires CEOs to consider their hospitals’ capabilities and limitations differently, plan for the progressive curtailment of services and identify trigger points for decisions within emergency operations.
Planning now, and following the outlined steps, will help to ensure smooth operations when a hospital is confronted with a crisis.
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