Hospital Disaster Preparedness in Italy: a preliminary study utilizing the World Health Organization Hospital Emergency Response Evaluation Toolkit.
Natural and human-initiated disasters are occurring with greater devastating consequences and increased frequency. During these events, hospitals have the burden to care for acutely ill and injured patients. The aim of this study was to evaluate the level of disaster preparedness of Italian hospitals.



Site visits were conducted from January, 2014 to December, 2014. The hospital emergency response checklist, developed by the WHO, was used as an evaluation toolkit. It consists of 92 items classified as 9 key components, such as command and control, triage, and critical services. The status of each component was determined by consensus of 3 independent evaluators.



The study selected 15 hospitals from different areas in Italy. Out of the 15 hospitals, 12 were considered to be at insufficients level of preparedness, only 3 were considered to have an effective level of preparedness. The average preparedness of all components were lower than the optimal level suggested by the WHO checklist.



The study revealed that a large majority of Italian hospitals evaluated are not well prepared to manage potential disasters. Also, all important elements of hospital preparedness, such as the command system, surge capacity, and safety, were insufficiently implemented. Nationwide standards, guidelines and procedures are required to improve hospital disaster preparedness in Italy.
Department of Translational Medicine, Università degli Studi del Piemonte Orientale, CRIMEDIM, Research Center in Emergency and Disaster Medicine and Education in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice, Novara, Italy.
Pier L
PL
Ingrassia
Department of Health Science, Section of Anesthesiology and Intensive Care, University of Florence, Florence, Italy - eat 83@hotmail.com.
Marco
M
Mangini
Department of Translational Medicine, Università degli Studi del Piemonte Orientale, CRIMEDIM, Research Center in Emergency and Disaster Medicine and Education in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice, Novara, Italy.|Sant'Anna Hospital, Emergency Department, Cantù Hospital, Cantù, Como, Italy.
Massimo
M
Azzaretto
Anesthesiology and Intensive Care Unit, Department Rizzoli, Rizzoli Orthopedic Institute, Palermo, Italy.
Ilenia
I
Ciaramitaro
Department of Anesthesiology and Intensive Care, University of Turin, Turin, Italy.
Laura
L
Costa
Harvard Humanitarian Initiative, Harvard University, Cambridge, MA, USA.
Frederick M
FM
Burkle
Department of Translational Medicine, Università degli Studi del Piemonte Orientale, CRIMEDIM, Research Center in Emergency and Disaster Medicine and Education in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice, Novara, Italy.
Francesco
F
Della Corte
Department of Translational Medicine, Università degli Studi del Piemonte Orientale, CRIMEDIM, Research Center in Emergency and Disaster Medicine and Education in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice, Novara, Italy.
Ahmadreza
A
Djalali
D002959:Civil Defense / Q000458:organization & administration; D004189:Disaster Planning / Q000458:organization & administration*; D004190:Disasters; D004636:Emergency Service, Hospital; D006739:Hospital Administration; D006801:Humans; D007558:Italy; D014218:Triage