title: Y2K medical disaster preparedness in New York City: confidence of emergency department directors in their ability to respond.
abstract: OBJECTIVE
  To study the preparedness New York City for large scale medical disasters using the Year 2000 (Y2K) New Years Eve weekend as a model.
  
  
  METHODS
  Surveys were sent to the directors of 51 of the 9-1-1-receiving hospitals in New York City before and after the Y2K weekend. Inquiries were made regarding hospital activities, contingencies, protocols, and confidence levels in the ability to manage critical incidents, including weapons of mass destruction (WMD) events. Additional information was collected from New York City governmental agencies regarding their coordination and preparedness.
  
  
  RESULTS
  The pre-Y2K survey identified that 97.8% had contingencies for loss of essential services, 87.0% instituted their disaster plan in advance, 90.0% utilized an Incident Command System, and 73.9% had a live, mock Y2K drill. Potential terrorism influenced Y2K preparedness in 84.8%. The post-Y2K survey indicated that the threat of terrorism influenced future preparedness in 73.3%; 73.3% had specific protocols for chemical; 62.2% for biological events; 51.1% were not or only slightly confident in their ability to manage any potential WMD incidents; and 62.2% felt very or moderately confident in their ability to manage victims of a chemical event, but only 35.6% felt similarly about victims of a biological incident. Moreover, 80% felt there should be government standards for hospital preparedness for events involving WMD, and 84% felt there should be government standards for personal protective and DECON equipment. In addition, 82.2% would require a moderate to significant amount of funding to effect the standards. Citywide disaster management was coordinated through the Mayor's Office of Emergency Management.
  
  
  CONCLUSIONS
  Although hospitals were on a heightened state of alert, emergency department directors were not confident in their ability to evaluate and manage victims of WMD incidents, especially biological exposures. The New York City experience is an example for the rest of the nation to underscore the need for further training and education of preparedness plans for WMD events. Federally supported education and training is available and is essential to improve the response to WMD threats.
authors.affiliation: Department of Emergency Medicine, New York Methodist Hospital, New York City 11215, USA. sts9005@nyp.org
authors.forename: S H
authors.initials: SH
authors.lastname: Silber
authors.forename: N
authors.initials: N
authors.lastname: Oster
authors.forename: B
authors.initials: B
authors.lastname: Simmons
authors.forename: C
authors.initials: C
authors.lastname: Garrett
mesh_terms: D001291:Attitude of Health Personnel; D001694:Biological Warfare; D002910:Chronology as Topic; D003199:Computer Systems; D004189:Disaster Planning / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D004868:Equipment Failure; D005544:Forecasting; D006302:Health Services Research; D006740:Hospital Administrators / Q000523:psychology*; D006786:Hospitals, Urban / Q000458:organization & administration*; D006801:Humans; D020380:Needs Assessment / Q000458:organization & administration*; D009519:New York City; D008486:Physician Executives / Q000523:psychology*; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D023481:Terrorism; D013995:Time