title: A comparison of command center activations versus disaster drills at three institutions from 2013 to 2015.
abstract: Disaster exercises often simulate rare, worst-case scenario events that range from mass casualty incidents to severe weather events. In actuality, situations such as information system downtimes and physical plant failures may affect hospital continuity of operations far more significantly. The objective of this study is to evaluate disaster drills at two academic and one community hospital to compare the frequency of planned drills versus real-world events that led to emergency management command center activation.
  
  
  
  Emergency management exercise and command center activation data from January 1, 2013 to October 1, 2015 were collected from a database. The activations and drills were categorized according to the nature of the event. Frequency of each type of event was compared to determine if the drills were representative of actual activations.
  
  
  
  From 2013 to 2015, there were a total of 136 command center activations and 126 drills at the three hospital sites. The most common reasons for command center activations included severe weather (25 percent, n = 34), maintenance failure (19.9 percent, n = 27), and planned mass gathering events (16.9 percent, n = 23). The most frequent drills were process tests (32.5 percent, n = 41), hazardous material-related events (22.2 percent, n = 28), and in-house fires (15.10 percent, n = 19).
  
  
  
  Further study of the reasons behind why hospitals activate emergency management plans may inform better preparedness drills. There is no clear methodology used among all hospitals to create drills and their descriptions are often vague. There is an opportunity to better design drills to address specific purposes and events.
authors.affiliation: Clinical Instructor of Emergency Medicine, Department of Emergency Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Laura G
authors.initials: LG
authors.lastname: Ebbeling
authors.affiliation: Medical Director of Emergency Preparedness, Brigham and Women's Healthcare, Boston, Massachusetts; Assistant Professor of Emergency Medicine, Harvard Medical School, Boston, Massachusetts; Instructor of Health Policy and Management, Harvard T.H. Chan School of Public Health, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Eric
authors.initials: E
authors.lastname: Goralnick
authors.affiliation: St. Luke's Hospital Affiliated EMS Medical Director, Co-Chair, Southcoast Emergency and Disaster Preparedness Committee, St. Luke's Hospital, New Bedford, Massachusetts.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Bivens
authors.affiliation: Director, Emergency Management, Silverman Institute for Health Care Quality and Safety, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Meg
authors.initials: M
authors.lastname: Femino
authors.affiliation: Project Manager, Emergency Management, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Claire G
authors.initials: CG
authors.lastname: Berube
authors.affiliation: Project Manager, Emergency Management, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Bryan
authors.initials: B
authors.lastname: Sears
authors.affiliation: Associate Professor of Emergency Medicine, Harvard Medical School, Vice Chair for Operations, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Leon D
authors.initials: LD
authors.lastname: Sanchez
mesh_terms: D004189:Disaster Planning; D004190:Disasters; D005390:Fires; D015386:Hazardous Substances; D006764:Hospitals, Community; D006784:Hospitals, Teaching; D006801:Humans; D054527:Mass Casualty Incidents; D000066908:Simulation Training; D014887:Weather
chemical_list: D015386:Hazardous Substances