MDH Earthquake Drill
Report of Sector / Floor Coordinators
Instructions:
Aside from the IEC accomplished by your staff, patients, and visitors and also by you, please include the following information in your report.
Pre-drill experience:
How many staff do you have in your unit?
How many of your staff has participated in an earthquake drill during the past 5 years?
How many of your staff has participated in a hospital earthquake drill during the past 5 years?
Drill proper:
How many of your staff actively participated in the earthquake drill (at least up to response right after shaking)? [Evidence of participation: Accomplished IEC with name, signature, and unit name]
How many of the patients and visitors in your unit were you able to entice to actively participate in the earthquake drill (at least up to response right after shaking)? [Evidence of participation: Accomplished IEC with name, signature, and unit name]
How many patients / visitors / staff outside your unit did your staff teach / assist during the drill?
Patients -
Visitors –
Staff outside your unit –
What are your general observations on the drill (aside from those placed in the IEC)?
What is the overall satisfaction rating of your staff on the drill? (Very high, high, low, very low)
What are your suggestions for improvement?
Name / Signature of Sector / Floor Coordinator / Unit Name