Deciding whether and when to evacuate a hospital during an emergency situation can be a daunting decision, as can the decision about when it is safe to return after the event. New resources from the Agency for Healthcare Research and Quality are available to help hospital administrators and facility planners make these critical decisions.

The Hospital Evacuation Decision Guide (found at www.ahrq.gov/prep/hospevacguide) walks users through the process of deciding when to evacuate, shelter in place, or defer and reassess as the situation evolves. It distinguishes between “pre-event evacuations”—which are undertaken in advance of an impending disaster (such as a storm), when the hospital structure and surrounding environment are not yet compromised—and “post-event evacuations,” which are carried out after a disaster has damaged a hospital or the surrounding community.

The guidance draws on expert panel experiences, as well as lessons learned from past events including the Northridge, Calif., earthquake of 1994; the Three Mile Island nuclear reactor incident of 1979; and Hurricanes Katrina and Rita in 2005.

Included is a self-assessment worksheet to help hospitals consider the critical infrastructure issues that affect a decision to evacuate.

The companion piece, Hospital Assessment and Recovery Guide (www.ahrq.gov/prep/hosprecovery), helps hospital leaders and facility managers assess a facility’s infrastructure after an emergency event to determine when it is safe to reoccupy the area. Made up primarily of a 45-page checklist, the guide covers 11 areas of hospital infrastructure components that should be evaluated before determining that it is safe to reoccupy a facility.

These two resources specifically address issues related to evacuation and reoccupation and are intended to supplement existing hospital emergency plans, which often do not include such decision-making guidance.

Both guides are available on the AHRQ Web site at www.ahrq.gov/prep.