Not Ready: The Need for a Training Standard in Healthcare Emergency Preparedness.

Natural and human-induced disasters are increasing, which affects public health and safety in many ways including disruption of healthcare. Emergency preparedness mitigates the impacts of these disasters and training improves preparedness. However, no standard for training emergency managers exists. This study aimed to explore the state of US healthcare preparedness and the impact of training on preparedness and proposes a training standard for healthcare emergency managers. Mixed methods research was conducted to understand different aspects of training, inform the design of a training standard, and explore potential barriers. The first phase included a quantitative survey with 67 participants who responded to questions about training topics, quantity, and delivery format. In the second qualitative phase, 5 focus groups with 29 participants were conducted to deepen the understanding of survey results and collect information about training topics, barriers to adopting a standard, and recommendations for overcoming barriers. Ten training topics, for a quantity of 11 hours or more per topic, were identified in the quantitative phase and reinforced in the qualitative phase. In-person training was preferred for all but 3 topics, where online synchronous delivery was preferred. Other aspects of training were further explored, and the concept of a basic versus advanced training standard emerged as a major theme. Barriers to training included financial support and time to attend training as well as gaps in leadership knowledge and support. While training is key to improved healthcare emergency preparedness, variation in training exists. This study recommends a standard in healthcare emergency manager training.