HAP Blog

How Would You Evacuate Your Hospital during an Emergency?

Why planning for worst-case scenarios leads to the best outcomes

September 02, 2021

Part of our job as emergency management professionals is to prepare for situations we hope never come to pass.  

We’re always thinking about the worst-case scenarios, whether it’s the generator system that won’t come back online or the wildfire that’s creeping closer to our facility. Prepping for difficult situations protects our staff and patients, and it’s all about being ready. One question in particular has always been known to give emergency managers goosebumps. 

If you had to evacuate your hospital during a crisis, what would you do? 

This week, emergency management staff from Pennsylvania and across the country joined our colleagues on the Gulf Coast to support the emergency response to Hurricane Ida. The storm provided another reminder of the stakes that come with managing emergencies. 

While some facilities reported less storm damage, others faced much more difficult circumstances, such as generator and roof failures that required internal and external evacuations. The hospital evacuation strategies were further complicated by COVID-19, layering one complex emergency on top of another. 

As emergency managers and health care leaders know, sheltering in place is almost always our preferred option, but if your facility is not safe and the lives of patients and staff are at risk, evacuation should be considered and initiated. 

The decision to evacuate has so many challenging components, not just for your hospital, but for other nearby acute care hospitals, post-acute facilities, emergency management services, transport agencies, and other local/county emergency managers.  

Here are three important areas to identify as you make plans to evacuate your facility. 


If your hospital loses power, you need a plan to get the lights back on, particularly while treating patients in intensive care with COVID-19. Documenting the critical information about your generators is an important starting point, but you should have a plan when your generators fail.

Having a back-up generator plan is all about the details, such as: 

  • Temporary Generators:  Have a pre-established location identified for the placement of a temporary generator. The distance between the current generator and the placement of a temporary generator should be identified and documented  
  • Hardware:  Know what type and size of cables and connections you need 
  • Timing:  If available, temporary generators can take hours or days to arrive. Account for that time in your plan 
  • Fuel:  Know your generator’s fuel requirements to maintain operations 

Severe Weather 

We don’t always get notice of severe weather. When you have the benefit of time, develop a coordinated plan for patients and staff. 

As a tornado, hurricane, or blizzard comes on the radar, your facility should consider: 

  • Patient logistics:  If a portion of your facility became unsafe, where would you move patients and how would you get an accurate count for everyone in the building?   
  • Supplies:  Have the essentials handy, such as flashlights, headlamps, two-way radios, duct tape, masks, and goggles 
  • Securing the site:  During an earthquake, everything becomes a projectile. Practice storing or securing potential projectiles like IV poles, carts, oxygen tanks, and clip boards 
  • Next steps:  If you experience a natural gas leak, and the generators kick on, your situation might get worse. Know your doorways and evacuation routes 

Evacuation sites 

Hospital patients have extraordinary needs, and they need a lot of space. 

When evaluating evacuation sites, consider all the essentials that must come with your patients for their survival—such as oxygen tanks and ventilators. There are a host of other patient accessories, including wheelchairs, walkers, and lamps, just to name a few.  

The size of the evacuation sites shouldn’t be underestimated—not just to treat patients but for your staff. You should identify multiple relocation sites prior to any emergency. Due to the size and magnitude of the situation, you may need to relocate a significant distance from your facility. 

You’ll also want to consider your vendors. Are they able to fill your requests during a crisis, or will they be impacted by the same challenges you are? It’s helpful to have multiple options to call when an emergency hits. 

Communications and partnerships are an important part of the process. It’s not helpful if an acute care facility is unknowingly identified as an evacuation site for multiple post-acute care facilities in the region. A coordinated strategy helps during unpredictable times. 

While we hope to never need our evacuation plans, you can feel better knowing you’ve done the legwork ahead of time. Like so much of what we do, the work before the crisis pays dividends during the storm. 

If you or your organization would like to learn more about hospital evacuation plans, HAPevolve resources are available to help. Contact HAP’s Emergency Management Team or HAPevolve for more information.  


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