Preparedness is a healthcare executive's responsibility.

K. JOANNE MCGLOWN, PH.D., CHE K. JOANNE MCGLOWN, PH.D., CHE, IS AN ASSISTANT PROFESSOR AT JACKSONVILLE STATE UNIVERSITY IN ALABAMA. THE FOLLOWING PASS AGE from a handbook instructing action in jihad was found in a Taliban safe house in early February 2002: In every country, we should hit their organizations, institutions, clubs and hospitals ... The targets must be identified, carefully chosen and include their largest gatherings so that any strike should cause thousands of deaths. (Hendawi 2002) As the planes crashed, the world responded in shock and horror, but also in action. A survey published by globalcontinuity.com (2002) found that U.S. firms invoked business continuity plans following the attacks on 9/11 and * 60 percent activated crisis communication plans, * 40 percent contacted suppliers and 49 percent contacted customers, and * 74 percent briefed staff about the plan invocation and 70 percent briefed their boards. Did your hospital react appropriately? Did you activate a crisis communication plan? Did you place your healthcare facility on alert? Did you take advantage of the time to educate your board on the status of the facility in potential disaster situations? Did you try to reach your home health care, hospice, or clinic patients as an extension of your service? Those who have faced the reality of our present and future environment and are taking steps toward preparedness are wise. Terrorism is an "equal opportunity" threat. No one is immune; no locale is free of the threat. Emergency managers have been telling us to "get ready" for years. Proactive disaster preparedness has been an integral part of daily existence in some medical facilities-usually those led by ex-military officers for whom contingency planning was thoroughly ingrained into daily operations, or by executives who were once emergency responders. Most healthcare leaders, however, listened to presentations on disaster preparedness when they had to, delegated the responsibility to another manager, and rarely took personal interest in or made a commitment to preparedness in their organization; many laughed at fellow colleagues who felt this was an important role for the healthcare CEO. The old cliches-"it's not a matter of if, but a matter of when" or "a failure to plan is a plan to fail"-are worn and tattered, but they are still viable. As our lead authors have so well illustrated, and as the healthcare administration profession now realizes, time is short. Preparedness is not an option, but a responsibility. Leaders lead, and the need has never been greater for hospital and healthcare CEOs to be leaders in disaster mitigation, preparedness, response, and recovery. We have a false sense of security that the government will take care of us, and we believe that the federal government will augment our medical response needs so that hospitals need not be prepared. Although Cdr. Pietro D. Marghella states that "the collective network of U.S. health service support assets ... is quite robust, and the majority of personnel supporting this network are adequately trained, equipped, and organized to provide medical support during operations in a conventional environment," let this not create complacence in our responsibilities at the local level. Federal and military assets may be slowly deployed, required elsewhere, or not activated until the greatest need has passed, if at all. Cdr. Marghella provides an excellent overview of the broad realities and concerns facing the healthcare industry in a world in which terrorism has become reality. He states that "no community bears more of the heavy lifting than the medical community" in minimizing the (postdisaster) effects on the human population. Marghella illustrates his statements by addressing the efforts of our military toward preparedness and response. His terminology may be a bit foreign, but so are the times in which we live. …