title: Assessment of disaster preparedness among emergency departments in Italian hospitals: a cautious warning for disaster risk reduction and management capacity.
abstract: OBJECTIVE
  Since the 1990s, Italian hospitals are required to comply with emergency disaster plans known as Emergency Plan for Massive Influx of Casualties. While various studies reveal that hospitals overall suffer from an insufficient preparedness level, the aim of this study was to better determine the preparedness level of Emergency Departments of Italian hospitals by assessing the knowledge-base of emergency physicians regarding basic disaster planning and procedures.
  
  
  METHODS
  A prospective observational study utilized a convenience sample of Italian Emergency Departments identified from the Italian Ministry of Health website. Anonymous telephone interviews were conducted of medical consultants in charge at the time in the respective Emergency Departments, and were structured in 3 parts: (1) general data and demographics, (2) the current disaster plan and (3) protocols and actions of the disaster plan.
  
  
  RESULTS
  Eighty-five Emergency Departments met inclusion criteria, and 69 (81 %) agreed to undergo the interview. Only 45 % of participants declared to know what an Emergency Plan for Massive Influx of Casualties is, 41 % believed to know who has the authority to activate the plan, 38 % knew who is in charge of intra-hospital operations. In Part 3 physicians revealed a worrisome inconsistency in critical content knowledge of their answers.
  
  
  CONCLUSIONS
  Results demonstrate a poor knowledge-base of basic hospital disaster planning concepts by Italian Emergency Department physicians-on-duty. These findings should alert authorities to enhance staff disaster preparedness education, training and follow-up to ensure that these plans are known to all who have responsibility for disaster risk reduction and management capacity.
authors.affiliation: CRIMEDIM - Research Center in Emergency and Disaster Medicine, Università del Piemonte Orientale, Via Lanino 1, 28100, Novara, Piemonte, Italy. paganini.mtt@gmail.com.|Emergency Medicine Residency Program - Department of Medicine, Azienda Ospedaliera Università di Padova, Padova, Veneto, Italy. paganini.mtt@gmail.com.
authors.forename: Matteo
authors.identifier: http://orcid.org/0000-0002-7556-6928
authors.initials: M
authors.lastname: Paganini
authors.affiliation: CRIMEDIM - Research Center in Emergency and Disaster Medicine, Università del Piemonte Orientale, Via Lanino 1, 28100, Novara, Piemonte, Italy.|Emergency Medicine Residency Program - Department of Medicine, Università di Modena e Reggio Emilia, Modena, Emilia Romagna, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Borrelli
authors.affiliation: School of Medicine, Università del Piemonte Orientale, Novara, Piemonte, Italy.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cattani
authors.affiliation: CRIMEDIM - Research Center in Emergency and Disaster Medicine, Università del Piemonte Orientale, Via Lanino 1, 28100, Novara, Piemonte, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Ragazzoni
authors.affiliation: CRIMEDIM - Research Center in Emergency and Disaster Medicine, Università del Piemonte Orientale, Via Lanino 1, 28100, Novara, Piemonte, Italy.
authors.forename: Ahmadreza
authors.initials: A
authors.lastname: Djalali
authors.affiliation: CRIMEDIM - Research Center in Emergency and Disaster Medicine, Università del Piemonte Orientale, Via Lanino 1, 28100, Novara, Piemonte, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Carenzo
authors.affiliation: CRIMEDIM - Research Center in Emergency and Disaster Medicine, Università del Piemonte Orientale, Via Lanino 1, 28100, Novara, Piemonte, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Della Corte
authors.affiliation: Harvard Humanitarian Initiative, Harvard University, Cambridge, MA, USA.
authors.forename: Frederick M Jr
authors.initials: FM
authors.lastname: Burkle
authors.affiliation: CRIMEDIM - Research Center in Emergency and Disaster Medicine, Università del Piemonte Orientale, Via Lanino 1, 28100, Novara, Piemonte, Italy.
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Ingrassia
mesh_terms: D004189:Disaster Planning / Q000592:standards*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007558:Italy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D036301:Qualitative Research; D012308:Risk Management
keywords: Disaster; Emergency department; Hospital disaster preparedness; Hospital plan