Involvement of local municipalities in promoting emergency preparedness has been recognized as a key factor to build a resilient community. As part of the efforts to build and maintain knowledge and capabilities, the Israeli Ministry of Health initiated a series of conferences aimed at capacity building of city councils to provide services to the population following disasters.

6 conferences have been planned for the years 2010-2011 in which 250 senior administrative employees from all municipalities, responsible for the health status in their communities are expected to participate. Each conference covers a variety of emergency scenarios, including biological events, regional hostilities and management of massive Acute Stress Reactions among the civilian population. Pre-post tests based on Multiple Choice Questions are conducted before and following each conference to identify impact of the training program.

Findings from the pre-post tests conducted up to date showed a significant increase in all elements included in the training program. The average knowledge scores of the pre-post tests were 33% and 79% respectively. The highest increases in level of knowledge were found in regard to deployment of community centers for light casualties in chemical warfare scenarios (48% and 100% respectively) and concerning population that requires evacuation during emergencies (68% to 100% respectively). Overall levels of knowledge regarding community treatment centers in biological events were relatively low both before and after the training (16% and 44% respectively).

Training local municipalities' personnel is crucial in order to promote emergency preparedness. Raising knowledge regarding response to newly emerging threats (such as deployment of exposure centers in biological events) was found to be more complex in comparison to well-recognized hazards (such as deployment of community treatment centers in chemical warfare). There is a need to conduct follow-up studies to determine the retention of knowledge over time.

Pandemic influenza poses a great challenge to healthcare systems. Vaccinating medical teams and the population against pandemic influenza is the global recommended strategy to contain spread of the disease. As part of the efforts made to overcome the H1N1 pandemic, the Israeli Ministry of Health (MOH) initiated a general vaccination program for medical teams and the total country population. Due to low compliance rates of the medical staff, the MOH conducted regional conferences aimed at providing knowledge and encouraging staff to be vaccinated.

To evaluate the effect of the regional conferences on the compliance rates amongst medical providers to be vaccinated against H1N1.

Medical providers from the primary health care services were invited to conferences that were conducted in 3 regions. Attitudes of the teams regarding compliance to be vaccinated were assessed pre and post the conferences. Additionally, the actual rates of vaccinations were recorded over the period of vaccination program. Actual compliance rates before and after the conferences were compared to detect differences as well as the relationship between teams' attitudes and actual vaccinations.

Vaccination rates of medical providers remained low during the full vaccination period. Among the non-vaccinated, 24% to 29% reported before the conference that they agree to be vaccinated versus 57% to 62% following the conference. Analysis of the actual vaccination data among the medical providers did not demonstrate a change in compliance following the conferences and an overall decrease was noted after the first two weeks of the vaccinated project.

A statistically significant relationship was not found between reported attitudes of medical providers regarding readiness to be vaccinated and their actual vaccination. The MOH intervention did not achieve the expected result and did not raise compliance to be vaccinated.

Israeli Hospitals are required to maintain a high level of emergency preparedness.

To investigate the effect of on-going use of an evaluation tool on acute-care hospitals' emergency preparedness for mass casualty events (MCE).

Evaluation of emergency preparedness for MCE was carried out in all acute-care hospitals, based on an evaluation tool consisting of 306 objective and measurable parameters. Two cycles of evaluations were conducted in 2005 to 2009 and the scores were calculated to detect differences.

A significant increase was found in the mean total scores of emergency preparedness between the two cycles of evaluations (from 77.1 to 88.5). An increase was found in scores for standard operating procedures, training and equipment, but the change was significant only in the training category. The relative increase was highest in hospitals that did not experience real MCE.

This study offers a structured and practical approach for ongoing improvement of emergency preparedness, based on validated measurable benchmarks. An ongoing assessment of the level of emergency preparedness motivates hospitals' management and staff to improve their capabilities and thus results in a more effective response mechanism for emergency scenarios.

Utilization of predetermined and measurable benchmarks allows the institutions being assessed to improve their level of performance in the evaluated areas. The expectation is that these benchmarks will allow for a better response to actual MCEs. The study further demonstrated that even hospitals without “real-life” experience can gear up using preset benchmarks and reach a high standard of mass casualty event preparedness.