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Setting Foundations for Developing Disaster Response Metrics

  • Mahshid Abir (a1) (a2), Sue Anne Bell (a3), Neha Puppala (a4), Osama Awad (a5) and Melinda Moore (a2)...


There are few reported efforts to define universal disaster response performance measures. Careful examination of responses to past disasters can inform the development of such measures. As a first step toward this goal, we conducted a literature review to identify key factors in responses to 3 recent events with significant loss of human life and economic impact: the 2003 Bam, Iran, earthquake; the 2004 Indian Ocean tsunami; and the 2010 Haiti earthquake. Using the PubMed (National Library of Medicine, Bethesda, MD) database, we identified 710 articles and retained 124 after applying inclusion and exclusion criteria. Seventy-two articles pertained to the Haiti earthquake, 38 to the Indian Ocean tsunami, and 14 to the Bam earthquake. On the basis of this review, we developed an organizational framework for disaster response performance measurement with 5 key disaster response categories: (1) personnel, (2) supplies and equipment, (3) transportation, (4) timeliness and efficiency, and (5) interagency cooperation. Under each of these, and again informed by the literature, we identified subcategories and specific items that could be developed into standardized performance measures. The validity and comprehensiveness of these measures can be tested by applying them to other recent and future disaster responses, after which standardized performance measures can be developed through a consensus process. (Disaster Med Public Health Preparedness. 2017;11:505–509)


Corresponding author

Correspondence and reprint requests to Mahshid Abir, MD, MSc, Department of Emergency Medicine, University of Michigan, 2800 Plymouth Rd., NCRC Bldg. 14, Rm. G226, Ann Arbor, MI (e-mail:


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1. Reuters. Nepal quake death toll becomes highest on record; dozens still missing. Reuters. Published May 17, 2015. Accessed January 5, 2017.
2. United Nations Office for Coordination of Humanitarian Affairs. Performance and Accountability Framework. UNOCHA website. Published 2015. Accessed January 5, 2017.
3. Federal Emergency Management Agency. National Response Framework. FEMA website. Accessed January 5, 2017.
4. Norton, I, von Schreeb, J, Aitken, P, et al. Classification and Minimum Standards for Foreign Medical Teams. Geneva, Switzerland: World Health Organization; 2013.
5. Adini, B, Verbeek, L, Trapp, S, et al. Continued vigilance - development of an online evaluation tool for assessing preparedness of medical facilities for biological events. Front Public Health. 2014;2:35.
6. Rådestad, M, Jirwe, M, Castrén, M, et al. Essential key indicators for disaster medical response suggested to be included in a national uniform protocol for documentation of major incidents: a Delphi study. Scand J Trauma Resusc Emerg Med. 2013;21(1):68.
7. Agboola, F, Bernard, D, Savoia, E, et al. Development of an online toolkit for measuring performance in health emergency response exercises. Prehosp Disaster Med. 2015;30(5):503-508.
8. Belfroid, E, Hautvast, JLA, Hilbink, M, et al. Selection of key recommendations for quality indicators describing good quality outbreak response. BMC Infect Dis. 2015;15(1):166.
9. Daftary, RK, Cruz, AT, Reaves, EJ, et al. Making disaster care count: consensus formulation of measures of effectiveness for natural disaster acute phase medical response. Prehosp Disaster Med. 2014;29(5):461-467.
10. Kun, KE, Rose, DA, Morris, T, et al. Conceptualizing and measuring community preparedness within public health preparedness and response: complexities and lessons learned. J Public Health Manag Pract. 2014;20(4):E1-E5.
11. McCunn, M, Ashburn, MA, Floyd, TF, et al. An organized, comprehensive, and security-enabled strategic response to the Haiti earthquake: a description of pre-deployment readiness preparation and preliminary experience from an academic anesthesiology department with no preexisting international dis. Anesth Analg . 2010;111(6):1438-1444.
12. Abolghasemi, H, Radfar, MH, Khatami, M, et al. International medical response to a natural disaster: lessons learned from the Bam earthquake experience. Prehosp Disaster Med. 2006;21(3):141-147. Accessed May 1, 2015.
13. Bridgewater, FHG, Aspinall, ET, Booth, JPM, et al. Team Echo: observations and lessons learned in the recovery phase of the 2004 Asian tsunami. Prehosp Disaster Med. 2006;21(1):s20-s25. Accessed May 1, 2015.
14. Zoraster, RM. Barriers to disaster coordination: health sector coordination in Banda Aceh following the South Asia Tsunami. Prehosp Disaster Med. 2006;21(1):s13-s18. Accessed May 4, 2015.
15. Aitken, P, Leggat, P, Robertson, A, et al. Health and safety aspects of deployment of Australian disaster medical assistance team members: results of a national survey. Travel Med Infect Dis. 2009;7(5):284-290.
16. Telford, J, Cosgrave, J. The international humanitarian system and the 2004 Indian Ocean earthquake and tsunamis. Disasters. 2007;31(1):1-28.
17. Millard, WB. Starting from scratch: Haiti’s earthquake and disaster planning. Ann Emerg Med. 2010;55(5):A17-A22. Accessed May 1, 2015.
18. Jaffer, AK, Campo, RE, Gaski, G, et al. An academic center’s delivery of care after the Haitian earthquake. Ann Intern Med. 2010;153(4):262-265.
19. Hopmeier, MJ, Pape, JW, Paulison, D, et al. Reflections on the initial multinational response to the earthquake in Haiti. Popul Health Manag. 2010;13(3):105-113.
20. Peleg, K, Kreiss, Y, Ash, N, et al. Optimizing medical response to large-scale disasters: the ad hoc collaborative health care system. Ann Surg . 2011;253(2):421-423.
21. Lane, DA. Medical support to Sri Lanka in the wake of tsunamis: planning considerations and lessons learned. Mil Med . 2006;171(10 suppl 1):19-23. Accessed May 1, 2015.
22. Smith, J, Fink, S, Hansch, S, et al. Session 1.4: health services delivery: a critical review of experience. Prehosp Disaster Med. 2005;20(6):389-392. Accessed May 2, 2015.
23. Roy, N. The Asian tsunami: Pan-American Health Organization disaster guidelines in action in India. Prehosp Disaster Med. 2006;21(5):310-315. Accessed May 1, 2015.
24. Bayard, D. Haiti earthquake relief, phase two--long-term needs and local resources. N Engl J Med. 2010;362(20):1858-1861.
25. Auerbach, PS, Norris, RL, Menon, AS, et al. Civil-military collaboration in the initial medical response to the earthquake in Haiti. N Engl J Med. 2010;362(10):e32.
26. Rosborough, S. A tale of two responses: Haiti earthquake highlights the need for training in international disaster response. Disaster Med Public Health Prep. 2010;4(1):21-23. Accessed April 29, 2015.
27. Yamada, S, Gunatilake, RP, Roytman, TM, et al. The Sri Lanka tsunami experience. Disaster Manag Response. 2006;4(2):38-48.
28. Birnbaum, ML. STOP!!!!! Prehosp Disaster Med. 2010;25(2):97-98. Accessed May 2, 2015.
29. Van Hoving, DJ, Wallis, LA, Docrat, F, et al. Haiti disaster tourism--a medical shame. Prehosp Disaster Med. 2010;25(3):201-202. Accessed March 27, 2015.
30. Bateman, C. Haiti tragedy shakes up SA’s emergency response planning. S Afr Med J. 2010;100(9):552-553. Accessed May 1, 2015.
31. De Silva, T, Chikersal, J, Snoad, N, et al. Panel 2.18: logistics, information technology (IT), and telecommunications in crisis management. Prehosp Disaster Med. 20(6):464-467. Accessed February 23, 2016.
32. Kapila, M, McGarry, N, Emerson, E, et al. Health aspects of the tsunami disaster in Asia. Prehosp Disaster Med. 2005;20(6):368-377. Accessed May 1, 2015.
33. Joyce, N. Civilian-military coordination in the emergency response in Indonesia. Mil Med . 2006;171(10)(suppl 1):66-70. Accessed May 1, 2015.
34. Lee, VJ, Low, E, Ng, YY, Teo, C. Disaster relief and initial response to the earthquake and tsunami in Meulaboh, Indonesia. Ann Acad Med Singapore. 2005;34(9):586-590. Accessed May 1, 2015.
35. Rapid health response, assessment, and surveillance after a tsunami--Thailand, 2004-2005. MMWR Morb Mortal Wkly Rep. 2005;54(3):61-64. Accessed May 4, 2015.
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Disaster Medicine and Public Health Preparedness
  • ISSN: 1935-7893
  • EISSN: 1938-744X
  • URL: /core/journals/disaster-medicine-and-public-health-preparedness
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