According to the Belgian Hospital Disaster Planning Act, all hospitals are required to have written disaster plans and to routinely conduct annual disaster drills. In 2010, three neighboring hospitals organized independently from each other an evacuation exercise of a critical care department (CCD): two university hospitals of a Dialysis Center and a One-day Surgery Clinic respectively and the military hospital of a Burn Unit.

To compare these CCD's evacuation plans and drills and the overall hospital emergency incident response and command system.

Conducting an evacuation exercise in a CCD, moving vulnerable highly dependent people towards an alternative shelter site is challenging, causing an important burden to ongoing medical specialist care, working staff and critical infrastructure. In all three CCD, it was decided to conduct a simulated evacuation exercise following an internal fire, thereby deploying fashioned simulated patients and visitors but bringing into action the regular attending medical, nursing and logistic staff. In each hospital a multidisciplinary design team was launched, consisting of the hospitals disaster preparedness coordinator, the EMS-staff, external emergency incident management and operational engineering experts. The appointed objectives for evaluation were the knowledge of the regular evacuation drills, especially the clearance of an intensive care or an operating room; access to evacuation routes; visibility of safety guidelines; need of specific evacuation equipment for the movement of patients; mission and tasks of the hospital's first response team and the medical incident manager; communication and information flow and the establishment of the hospital's coordination committee.

1. Simulated hospital evacuation exercises increased the hospital emergency preparedness, awareness and response to disasters within the hospital, in particular in a CCD, otherwise difficult to assess. 2. All three CCD experienced the same challenges and identified similar flaws. 3. A hospital disaster exercise manual might be of valuable help.