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Healthcare Emergency Preparedness Checklist: Response & Recovery

Ensure rapid, effective responses with our Healthcare Emergency Preparedness Checklist. Streamline your disaster response plan, maintain compliance, and protect patients and staff-ready for download and customization.

This Template was installed 3 times.

Risk Assessment & Planning

1 of 9

Initial assessment of potential emergencies and development of preparedness plans.

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)?

Date of last comprehensive risk assessment.

Summary of identified vulnerabilities and associated risks.

Communication Protocols

2 of 9

Establishing clear communication channels and procedures for internal and external stakeholders.

Primary Communication Method

Emergency Contact List

Designated Communication Lead

Number of Active Communication Channels

Last Communication Protocol Review Date

Communication Methods for External Agencies

Staff Training & Roles

3 of 9

Ensuring staff are trained on emergency procedures and understand their assigned roles.

Emergency Response Training Completion

First Aid/CPR Certification Status

Last Training Date (MM/DD/YYYY)

Designated Role in Emergency Response

Specific Training Notes (e.g., modules completed, refresher dates)

Next Certification Renewal Date

Proof of Certification (e.g., copy of certificate)

Resource Management

4 of 9

Inventorying and securing essential resources like medical supplies, equipment, and backup power.

Backup Generator Fuel Level (Gallons)

Medical Supplies - PPE Stock (N95 Masks)

Medical Supplies - IV Fluids Stock (Units)

Emergency Power Source Status

Copy of Emergency Resource Inventory Document

Date of Last Resource Inventory Check

Critical Resources Secured?

Evacuation & Shelter-in-Place Procedures

5 of 9

Planning and practicing evacuation and shelter-in-place strategies.

Evacuation Route Designated?

Shelter-in-Place Location Identified?

Estimated Evacuation Time (minutes)

Date of Last Evacuation Drill

Scheduled Time for Next Drill

Areas Requiring Assistance During Evacuation?

Notes/Specific Considerations for Evacuation

Patient Safety & Care

6 of 9

Protocols for patient safety and continuity of care during and after an emergency.

Patient's Immediate Medical Needs Addressed?

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?

Nurse Signature

Data Backup & IT Recovery

7 of 9

Protecting and restoring critical data and IT systems.

Last Full Backup Timestamp (Epoch Seconds)

Next Scheduled Full Backup Date

Backup Storage Location (Primary)

Systems Included in Backup

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

8 of 9

Maintaining security and managing access to the facility during an emergency.

Number of Security Personnel on Duty

Access Control System Status (Active/Deactivated/Maintenance)

Last Security System Inspection Date

Security Breach Points Identified (e.g., Front Entrance, Loading Dock, Windows)

Location of Security Camera Recordings

Details of Recent Security Incidents (if any)

Visitor Log Status (Active/Inactive)

Post-Emergency Evaluation & Improvement

9 of 9

Reviewing the emergency response, identifying areas for improvement, and updating the preparedness plan.

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 – select all that apply

Estimated Downtime (hours)

Overall Rating of Emergency Response

Recommendations for Future Preparedness

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