Lessons Learned from a Multi-Hospital Pediatric Disaster Full-Scale Surge Exercise

Introduction: Children are frequently victims of disasters. However, gaps remain in pediatric disaster preparedness. The New York City Pediatric Disaster Coalition (NYCPDC) is funded by the NYC Department of Health and Mental Hygiene (DOHMH) to prepare NYC for mass casualty events that involve large numbers of children. On May 23, 2024, the NYC PDC conducted a pediatric disaster full-scale exercise testing surge, communications, and secondary transport. Participants included three NYC pediatric hospitals and the NYC Pediatric Intensivist Response Team (PIRT). Methods: The full-scale exercise was prospectively designed with specific goals: to test and improve communications with staff and city agencies; to test and improve hospitals’ pediatric surge capacity plans and response; to identify space, staffing, and equipment needs for pediatric disaster; and for hospitals to identify and triage patients requiring secondary transport to another facility. In collaboration with the DOHMH, PDC designed a Master Scenario Events List (MSEL) along with other tools to measure strengths and weaknesses to be identified at each institution at a system level. PDC created an exercise evaluation guide to assess: Communications, Emergency Operation Plans, Surge, Patient Tracking, Patient Transfer, Supplies, and Staffing, utilizing a performance rating scale from 1-4 and qualitative reporting. Results: This information was used to report lessons learned and challenges to the participants and DOHMH in an after-action report. An after-action report was written based on information from evaluation guides, site-specific and group hot-washes, and an after-action meeting. Conclusion: This presentation will highlight the strengths, challenges, and lessons learned from the exercise. Conducting a multi-hospital pediatric disaster full-scale surge exercise produced lessons learned to address exercise gaps that can improve surge capabilities during future exercises and real-time events.