FIGURE 7-1 U.S. News and World Report, cover story on September 10, 2001.

SOURCE: Reprinted from Shute and Marcus, 2001, with permission.

decision, and how does a large, complex organization shift from routine to disaster mode? How does a hospital protect itself and its staff from chemical or biological agents when patients are contaminated?

This chapter examines these and other questions, and considers the current level of hospital disaster preparedness. It also explores the special problems associated with rural hospitals, and presents the committee’s recommendations for enhancing hospital preparedness.


The term “disaster” denotes a low-probability but high-impact event that causes a large number of individuals to become ill or injured. The In-

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