title: Complete self-sufficiency planning:  designing and building disaster-ready hospitals.
abstract: OBJECTIVE
  The need for healthcare systems and academic medical centers to be optimally prepared in the event of a disaster is well documented. Events such as Hurricane Katrina demonstrate a major gap in disaster preparedness for at-risk medical institutions. To address this gap, we outline the components of complete self-sufficiency planning in designing and building hospitals that will function at full operational capacity in the event of a disaster. We review the processes used and outcomes achieved in building a new critical access, freestanding children's hospital in Florida.
  
  
  METHODS
  Given that hurricanes are the most frequently occurring natural disaster in Florida, the executive leadership of our hospital determined that we should be prepared for worst-case scenarios in the design and construction of a new hospital. A comprehensive vulnerability assessment was performed. A building planning process that engaged all of the stakeholders was used during the planning and design phases. Subsequent executive-level review and discussions determined that a disaster would require the services of a fully functional hospital. Lessons learned from our own institution's previous experiences and those of medical centers involved in the Hurricane Katrina disaster were informative and incorporated into an innovative set of hospital design elements used for construction of a new hospital with full operational capacity in a disaster.
  
  
  RESULTS
  A freestanding children's hospital was constructed using a new framework for disaster planning and preparedness that we have termed complete self-sufficiency planning.
  
  
  CONCLUSIONS
  We propose the use of complete self-sufficiency planning as a best practice for disaster preparedness in the design and construction of new hospital facilities.
authors.affiliation: Office of Medical Education Outpatient Care Center, All Children's Hospital, Johns Hopkins Medicine, 601 Fifth St. S, St Petersburg, FL 33701, USA. Chad.Brands@allkids.org
authors.forename: Chad K
authors.initials: CK
authors.lastname: Brands
authors.forename: Raquel G
authors.initials: RG
authors.lastname: Hernandez
authors.forename: Arnold
authors.initials: A
authors.lastname: Stenberg
authors.forename: Gary
authors.initials: G
authors.lastname: Carnes
authors.forename: Jonathan
authors.initials: J
authors.lastname: Ellen
authors.forename: Michael
authors.initials: M
authors.lastname: Epstein
authors.forename: Timothy
authors.initials: T
authors.lastname: Strouse
mesh_terms: D055867:Cyclonic Storms; D004189:Disaster Planning; D011211:Electric Power Supplies; D004632:Emergency Medical Services / Q000458:organization & administration; D005431:Florida; D006749:Hospital Design and Construction / Q000379:methods*; D006776:Hospitals, Pediatric; D006801:Humans; D014481:United States