title: Evidence-based support for the all-hazards approach to emergency preparedness.
abstract: BACKGROUND
  During the last decade there has been a need to respond and recover from various types of emergencies including mass casualty events (MCEs), mass toxicological/chemical events (MTEs), and biological events (pandemics and bio-terror agents). Effective emergency preparedness is more likely to be achieved if an all-hazards response plan is adopted.
  
  
  OBJECTIVE
  To investigate if there is a relationship among hospitals' preparedness for various emergency scenarios, and whether components of one emergency scenario correlate with preparedness for other emergency scenarios.
  
  
  METHODS
  Emergency preparedness levels of all acute-care hospitals for MCEs, MTEs, and biological events were evaluated, utilizing a structured evaluation tool based on measurable parameters. Evaluations were made by professional experts in two phases: evaluation of standard operating procedures (SOPs) followed by a site visit. Relationships among total preparedness and different components' scores for various types of emergencies were analyzed.
  
  
  RESULTS
  Significant relationships were found among preparedness for different emergencies. Standard Operating Procedures (SOPs) for biological events correlated with preparedness for all investigated emergency scenarios. Strong correlations were found between training and drills with preparedness for all investigated emergency scenarios.
  
  
  CONCLUSIONS
  Fundamental critical building blocks such as SOPs, training, and drill programs improve preparedness for different emergencies including MCEs, MTEs, and biological events, more than other building blocks, such as equipment or knowledge of personnel. SOPs are especially important in unfamiliar emergency scenarios. The findings support the adoption of an all-hazards approach to emergency preparedness.
authors.affiliation: Emergency and Disaster Management Division, Ministry of Health, Tel Aviv, Israel. adini@netvision.net.il.
authors.forename: Bruria
authors.initials: B
authors.lastname: Adini
authors.forename: Avishay
authors.initials: A
authors.lastname: Goldberg
authors.forename: Robert
authors.initials: R
authors.lastname: Cohen
authors.forename: Daniel
authors.initials: D
authors.lastname: Laor
authors.forename: Yaron
authors.initials: Y
authors.lastname: Bar-Dayan