A 10-year analysis of hospitals’ preparedness for pandemics and other mass casualty events in the years prior to COVID-19 is warning that the nation’s health care system may not be adequately prepared for the next one. For the study, a team of researchers from the University of Maryland School of Medicine and University of Maryland Medical Center used a surge index tool called Hospital Medical Surge Preparedness Index (HMSPI) to score data from more than 6,200 hospitals nationwide. 

The hospitals had partaken in the American Hospital Association annual surveys. The team also used census data to determine population estimates in various cities and geographic service area and combined it with the survey information to calculate the HMSPI score. 

Metrics evaluated in the HMSPI included staff, supplies, space such as the total number of beds that staff can handle, and systems, including a framework for enabling electronic sharing of information. 

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While the team found varying degrees of improvement in some areas over the years, they also said that the scores indicated "ideal readiness had not yet been achieved in any state before the COVID-19 pandemic." 

Between 2005 and 2014, Montana experienced the largest increase in HMSPI scores, with the smallest increase noted in Nevada. The improvements across the country appeared to plateau in the final year of data. 

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The team concluded that "after more than $5 billion of federal investments in disaster preparedness since the 9/11 attacks, the nation’s hospitals and health care systems continue to struggle with disaster readiness."

The full results were published last month in the Journal of Healthcare Management, according to a news release.

"This is just the starting point," David Marcozzi, M.D., professor of emergency medicine at UMSOM and chief clinical officer/senior vice president at UMMC and study lead author, said. "We need to better understand the ability of our nation’s hospitals to save lives in times of crisis." 

Marcozzi said follow-up research could involve data from the COVID-19 pandemic to see how hospital preparedness impacted patient outcome. 

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"This pioneering work is a needed advancement that could allow for a transparent assessment of a hospital’s ability to save lives in a large-scale emergency," Marcozzi said. "The COVID-19 pandemic demonstrated that there is still plenty of room for improvement in the ability of our nation’s health care system to triage and manage multiple patients in a crisis and that translates into lives lost, unnecessarily. Our research is dedicated to those who lost their lives in his tragedy and other mass casualty events. We can do better."