HEALTHCARE EMERGENCY PREPAREDNESS CHECKLIST: RESPONSE & RECOVERY

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--- RISK ASSESSMENT & PLANNING ---
[ ] Describe potential natural disasters relevant to the facility's location.
[ ] Identify potential human-caused emergencies (e.g., fire, active shooter, hazardous materials incident).
[ ] Estimated patient capacity during a disaster scenario.
[ ] Which facility areas are at highest risk (e.g., electrical room, pharmacy, lab)? (Electrical Room, Pharmacy, Lab, Radiology, Patient Records Storage, Other (Specify))
[ ] Date of last comprehensive risk assessment.
[ ] Summary of identified vulnerabilities and associated risks.

--- COMMUNICATION PROTOCOLS ---
[ ] Primary Communication Method (Phone, Email, Pager, SMS/Text)
[ ] Emergency Contact List
[ ] Designated Communication Lead
[ ] Number of Active Communication Channels
[ ] Last Communication Protocol Review Date
[ ] Communication Methods for External Agencies (Radio, Fax, Secure Messaging, Direct Line)

--- STAFF TRAINING & ROLES ---
[ ] Emergency Response Training Completion (Completed, In Progress, Not Started)
[ ] First Aid/CPR Certification Status (Current, Expired, Not Certified)
[ ] Last Training Date (MM/DD/YYYY)
[ ] Designated Role in Emergency Response (Incident Commander, First Responder, Communication Liaison, Evacuation Coordinator, No Designated Role)
[ ] Specific Training Notes (e.g., modules completed, refresher dates)
[ ] Next Certification Renewal Date
[ ] Proof of Certification (e.g., copy of certificate)

--- RESOURCE MANAGEMENT ---
[ ] Backup Generator Fuel Level (Gallons)
[ ] Medical Supplies - PPE Stock (N95 Masks)
[ ] Medical Supplies - IV Fluids Stock (Units)
[ ] Emergency Power Source Status (Operational, Needs Maintenance, Offline)
[ ] Copy of Emergency Resource Inventory Document
[ ] Date of Last Resource Inventory Check
[ ] Critical Resources Secured? (Medications, Oxygen, Equipment, Patient Records)

--- EVACUATION & SHELTER-IN-PLACE PROCEDURES ---
[ ] Evacuation Route Designated? (Yes, No, N/A)
[ ] Shelter-in-Place Location Identified? (Yes, No, N/A)
[ ] Estimated Evacuation Time (minutes)
[ ] Date of Last Evacuation Drill
[ ] Scheduled Time for Next Drill
[ ] Areas Requiring Assistance During Evacuation? (Patients with Mobility Issues, Patients with Cognitive Impairments, Infants/Children, Other (Specify))
[ ] Notes/Specific Considerations for Evacuation

--- PATIENT SAFETY & CARE ---
[ ] Patient's Immediate Medical Needs Addressed? (Yes, No, Partial)
[ ] Detailed Notes on Patient Condition and Care Provided
[ ] Vital Signs Monitoring Frequency (minutes)
[ ] Date of Last Vital Signs Assessment
[ ] Time of Last Medication Administration
[ ] Necessary Support Services Provided? (Respiratory Support, IV Fluids, Pain Management, Psychological Support, Other)
[ ] Nurse Signature

--- DATA BACKUP & IT RECOVERY ---
[ ] Last Full Backup Timestamp (Epoch Seconds)
[ ] Next Scheduled Full Backup Date
[ ] Backup Storage Location (Primary) (On-site Server, Cloud Storage (Specify Provider), Off-site Data Center)
[ ] Systems Included in Backup (EHR/EMR System, Financial Systems, Patient Portal, Billing System, Imaging Systems)
[ ] Backup Retention Period (Days)
[ ] Recovery Point Objective (RPO) - Detailed Explanation
[ ] Recovery Time Objective (RTO) - Detailed Explanation
[ ] Last Disaster Recovery Drill Date

--- FACILITY SECURITY & ACCESS CONTROL ---
[ ] Number of Security Personnel on Duty
[ ] Access Control System Status (Active/Deactivated/Maintenance) (Active, Deactivated, Maintenance)
[ ] Last Security System Inspection Date
[ ] Security Breach Points Identified (e.g., Front Entrance, Loading Dock, Windows) (Front Entrance, Loading Dock, Windows, Back Door, Perimeter Fencing)
[ ] Location of Security Camera Recordings
[ ] Details of Recent Security Incidents (if any)
[ ] Visitor Log Status (Active/Inactive) (Active, Inactive)

--- POST-EMERGENCY EVALUATION & IMPROVEMENT ---
[ ] Date of Incident Review
[ ] Summary of Emergency Event
[ ] Assessment of Plan Effectiveness - What worked well?
[ ] Assessment of Plan Effectiveness - Areas for Improvement
[ ] Staff Performance Feedback â€“ select all that apply (Demonstrated Proficiency, Required Additional Guidance, Followed Procedures Effectively, Showed Initiative, Required Further Training)
[ ] Estimated Downtime (hours)
[ ] Overall Rating of Emergency Response (Excellent, Good, Fair, Poor)
[ ] Recommendations for Future Preparedness

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