Emergency preparedness as a continuous improvement cycle: perspectives from a postacute rehabilitation facility

To describe the iterative process of emergency planning and preparedness: risk assessment, planning, rehearsal, implementation, and refinement.

A narrative reflection of two complete facility evacuations in advance of major hurricanes in 2005 (hurricane Rita) and 2008 (hurricane Ike) conducted by a postacute rehabilitation facility located on the Texas gulf coast.

Facility staff involved in the evacuation and ongoing care post evacuation, and adults with moderate to severe acquired brain injury receiving residential postacute rehabilitation and long-term care services.

Experiences from two evacuations revealed that planning and preparation beyond what is required by licensing and accrediting agencies is necessary; attending to the needs of staff during and after and the emergency is a critical component of planning and preparedness; and the necessity of incorporating "lessons learned" into refinement of emergency preparedness plans.

Facilities providing residential services to persons with neurological injury are potentially vulnerable to a number of natural and manmade disasters. Careful planning, preparation, and practice are necessary to ensure safe evacuation of persons served and facility personnel in response to an emergency. Experiences (i.e., "lessons learned") from each evacuation, subsequent changes to emergency preparedness plans, and recommendations for emergency preparedness beyond a natural disaster, such as a hurricane, are presented.