The evacuation of two rural hospitals following a tsunami warning: What happened next.

This paper describes the lessons gained and actions taken following the evacuation of two small rural hospitals following a tsunami warning. These evacuations were unique in that the normal protocol to transfer within the health system was not feasible due to their geographical isolation. The after action review process provided valuable insight to all stakeholders, who entered into discussions to ensure procedures, supplies, equipment and arrangements would be put in place to support the safe and effective evacuation of patients in the event of a future emergency. A key component of this process was the after action report, which captured key lessons learned and actionable items pertaining to five areas: evacuation locations, equipment and supplies, hospital unit/department evacuation plans, site evacuation plans, and exercising and validating plans. Following this format, each lesson is broken down into steps taken to achieve these goals, outlining best practices and lived experiences or highlighting gaps where further research is required and step-by-step guidance that can be adapted by emergency managers within the field of healthcare. Through this, pertinent strategies and considerations involved in the planning and execution in the evacuation of rural hospitals are also offered.