title: Promoting regional disaster preparedness among rural hospitals.
abstract: OBJECTIVE
  Rural communities face substantial risks of natural disasters but rural hospitals face multiple obstacles to preparedness. The objective was to create and implement a simple and effective training and planning exercise to assist individual rural hospitals to improve disaster preparedness, as well as to enhance regional collaboration among these hospitals.
  
  
  METHODS
  The exercise was offered to rural hospitals enrolled with the Rural and Community Health Institute of the Texas A&M University System Health Science Center, and 17 participated. A 3-hour tabletop exercise emphasizing regional issues in a pandemic avian influenza scenario followed by a 1-hour debriefing was implemented in 3 geographic clusters of hospitals. Trained emergency preparedness evaluators documented observations of the exercise on a standard form. Participants were debriefed after the exercise and provided written feedback.
  
  
  RESULTS
  Observations included having insufficient staff for incident command, facility constraints, the need to further develop regional cooperation, and operational and ethical challenges in a pandemic.
  
  
  CONCLUSIONS
  The tabletop exercise gave evidence of being a simple and acceptable tool for rural medical planners. It lends itself well to improving medical preparedness, analysis of weak spots, development of regional teamwork, and rapid response.
authors.affiliation: Rural and Community Health Institute, Department of Humanities in Medicine, Texas A&M University, Bryan, Texas 77802, USA. EDWARDS@tamhsc.edu
authors.forename: Janine C
authors.initials: JC
authors.lastname: Edwards
authors.forename: JungEun
authors.initials: J
authors.lastname: Kang
authors.forename: Rasa
authors.initials: R
authors.lastname: Silenas
mesh_terms: D004189:Disaster Planning / Q000379:methods*; D006780:Hospitals, Rural; D015397:Program Evaluation; D011795:Surveys and Questionnaires