Read the complete 2007 San Diego Fires Executive Summary.

In October 2007, five major fires raged within San Diego County causing evacuation of more than 500,000 people, millions of dollars in damage, and significant disruption to the county’s health care system. Two of the county’s 20 acute care hospitals, along with multiple long-term care facilities, evacuated and were closed for up to nine days; 16 other hospitals were directly involved in transferring patients.

With support from the California HealthCare Foundation, KSA conducted research to understand how inpatient evacuations were managed in the face of the firestorm.

Among the lessons learned:

• Technology and technology-enhanced cooperation contributed greatly to success. Improved access to patient records, staff phone numbers, and the coordinating oversight of the MOC were critical, but communications technologies may have proven less reliable in a different type of disaster.

• Planning and experience are helpful, but nothing can replace quick-thinking, flexible leadership and staff. Hospital disaster planning more often contemplates handling an incoming surge of patients vs. an evacuation.

• Scale is important. Had the fires threatened larger or more institutions, the outcome may have been substantially different. Access to emergency transport vehicles capable of accommodating inpatients is essential.

• Impacts can lag behind resolution of the immediate crisis. As life returns to normal, many seek care they avoided during a crisis, which can impact staffing and supplies.