• J Christopher Farmer and Paul K Carlton.
• Program in Translational Immunovirology and Biodefense, Mayo Clinic, Rochester, MN, and Center for Homeland Security, Texas A&M University Health Science Center, College Station, TX, USA.
• Crit. Care Med. 2006 Mar 1;34(3 Suppl):S56-9.

ObjectiveRecent natural disasters have highlighted shortfall areas in current hospital disaster preparedness. These include the following: 1) insufficient coordination between hospitals and civil/governmental response agencies; 2) insufficient on-site critical care capability; 3) a lack of "portability" of acute care processes (i.e., patient transport and/or bringing care to the patient); 4) education shortfalls; and 5) the inability of hospitals to align disaster medical requirements with other competing priorities.ConclusionsDefinition of the roles and responsibilities of a hospital during a disaster requires additional planning precision beyond the prehospital response phase. Planners must also better define plans for circumstances when or if a hospital is rendered unusable. Disaster medical training of hospital personnel has been inadequate. This article details the specifics of these issues and outlines various potential approaches to begin addressing and formulating remedies to these shortfalls.

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