Integration of resources and efforts on all levels in response to an emergency or disaster provides critical layers of support and intervention. Without doubt the community and the organizations within the community are the first level of support, your first responders. State and national efforts provide a different level of support to include the National Stockpile which provides critical medications and supplies in the event of an emergency or disaster. September 11, 2001 was an eye opening event where all the players federal, state, local, and community recognized how unprepared we are for an unexpected disaster. Having lived in Tampa, Florida for three years, I can say the local area hospitals and community were absolutely prepared for nature’s wrath in the form of hurricanes on a regular basis. The problem is you can exercise it every year, twice a year, as the Joint Commission requires, but when faced with it, it just seems different. At Dyess AFB, we exercised several times a year, and involved the local community hospitals in every event to include an annual mass casualty exercise. Both hospitals in Abilene have well organized and developed emergency preparedness and disaster plans, in part, because of the proximity to the Air Force base and the probability of an unexpected event. About 10 years ago, a B-1 bomber crashed on the outskirts of the base and interestingly base personnel could not respond because the site was city land, not federal.
The fragmentation of the US healthcare delivery system lends itself to issues with coordinating disaster response because the burden of response for the most part seems to fall on the tertiary care facilities. Collective community response and preparedness drives local medical involvement but does not necessarily draw in all levels of care. As a hospital administrator, I would work to ensure a solid, practical and regularly exercised plan was established. Coordinating with first responders and local authorities to organize a community wide response strategy would be essential in targeting needs and efforts required to respond. Ensuring all personnel, on all levels, are trained and prepared for a variety of disasters on a consistent basis and can step in at any time, on any level, is essential in any response plan. Additionally, all departments within the facility must have ready access to a stockpile supplies, approved in advance as part of the plan. Access to the Strategic National