In October 2007, five fires raged in San Diego County that caused the evacuation of more than 500,000 people, millions of dollars in damage, and significant disruption to the county's health care system. Two of the county's 20 acute care hospitals, along with multiple long term care facilities, were evacuated and closed for up to nine days. Sixteen other hospitals were directly involved in transferring patients.

With support from the California HealthCare Foundation, Kurt Salmon Associates conducted research to understand how inpatient evacuations were managed in the face of the firestorm.

Overall, the report finds that San Diego's hospitals successfully responded to the challenge, as nearly all immediately implemented disaster plans. Communication and coordination among hospitals were improved by a sophisticated Medical Operations Center (MOC), which had been established as a department within the county's EMS agency after major fires threatened San Diego County in 2003.

Among the lessons learned:

• Technology and technology-enhanced cooperation contributed greatly to success. Improved access to patient records and staff phone numbers, along with the coordinating oversight of the MOC were crucial. However, communications technologies might have proven less reliable in a different sort of disaster.
• Planning and experience are helpful, but nothing can replace leadership and staff who are quick thinking and flexible. Hospital disaster planning more often anticipates an incoming surge of patients rather than an evacuation.
• Scale is important. Had the fires directly threatened larger or more numerous institutions, the outcome may have been substantially different. Access to emergency transport vehicles capable of accommodating inpatients is essential.
• The effects can lag behind resolution of the immediate crisis. As life returns to normal, many people seek outpatient care deferred during the crisis, and this can have implications on staffing and supplies.

The report's executive summary is available on the Kurt Salmon Associates site through the External Link.